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| Ron Shrewsbury |
On November 18th, I will embark on a one-month medical mission trip to Malawi, Africa. This trip is being made under the auspices of the Medical Benevolent Foundation, a partner of the
Presbyterian Church (and perhaps other denominations). While there I will be providing accounting services to the Nkhoma Hospital near Lilongwe,
Malawi. I will also be teaching
some simple basic accounting procedures to lower level management.
To get there I will fly from Charleston to Detroit, to Amsterdam, to Nairobi, Kenya, and finally to Lilongwe, Malawi, arriving on the 20th. From Lilongwe I will travel by car to Nkhoma. The
trip is being made by me as an individual, not as part of a group.
I plan to send regular reports to our Beckley Presbyterian Church website,
including pictures if possible. So...this is my page, "Ron in Africa,"
where I hope you will be able to find something of interest, at least occasionally.
I'm excited about this mission but also have lots of 'butterflies'. I solicit your prayers and good thoughts.
Information Links: PCUSA-Nkhoma Hospital Pictures at Nkhoma Hospital
Map of Africa ; Wikipedia > Malawi Lilongwe Nkhoma
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that address on his iphone.
So if you'd like to send him an email, I'm assuming he will get it.
December 5th
After
a breakfast of leftover date nut cake, I decided to have another cup of coffee. The water seemed
to be a little slow heating and I realized the power is off again. Dorica will heat some on the oil burning camp
stove. I bought okra in Lilongwe yesterday and Dorica will cook it with onions and tomatoes.
None of the young folks have eaten okra, some had never heard of it. When I asked Dan if he
liked okra, he thought I was asking if he liked Oprah. Ha! Well see how it goes over.
10:15 AM: Still no power. I lack thirty pages in Isaac's Storm, a
wonderful book that was recommended to me by Darrell Johnson, a resource that our public library
in Beckley is fortunate to have.
3:30 PM:
The power is finally on. Also, I have completed Isaac's Storm. The Australian med student, Dan, left for home this afternoon. He is
a very interesting and funny guy. He is also an agnostic. I decided to give him Isaacs Storm even though it belongs to the
library. I will replace it when I get home. I wrote Dan a short note and signed it "God bless." I think that's about as evangelistic
as a Presbyterian normally acts. I thought he wasn't leaving until tomorrow,
but I have just learned that he left a day early because of the fuel shortage. Fuel is now available
on the black market for 500 kwacha per liter, a little more than $3. Yesterday, it was 400. My trip to Lilongwe was made using black market fuel.
8:55 PM: Since most of the young group was out doing other things today, I had our housekeepers cook for me. The
menu was okra with tomatoes and onions, potatoes and rice. As there were only three of us here for dinner, I had enough
for all of us. James and Elizabeth had not eaten okra before but they both liked it a lot. James made a basic
yellow cake but added instant coffee to it and drizzled chocolate over it. The cake is very
good. Tomorrow, a group of us are going to visit one of the two orphanages Maralise
is involved with. I am looking forward to that. More about it tomorrow. Ron
December 4th
I took
the day off and went to Lilongwe with friends from South Africa and the Netherlands today. We dropped off Hemnie Smit at the airport for a flight to South Africa. Hennie is the manager of local waterworks and one of the nicer people I’ve
had the pleasure of meeting. Today he was flying home to S A for the Christmas holidays. Before we left Hennie's home, he
suggested we have a prayer after which he prayed a beautiful prayer. After leaving
the airport, Maralise and I did a little grocery shopping, a little Christmas shopping, and had lunch at Mimma Mia's. Afterward,
we picked up a hospital employee and his friend and headed back to Nkhoma. It was a full day and a nice diversion from my
regular work activities.
Another time I was in a group with Hennie, we were talking about hiring good employees. Hennie
told about a CEO who told his HR manager to forget about an applicant’s education, but to "find me a man who has sold
a set of used false teeth to a well dressed man in Hyde
Park on Sunday afternoon.” Ha! Hennie and I have talked about financial management at the hospital. He explained to me that the
hospital was controlled by the Dutch Reformed Church of South Africa up through the mid nineties.
At that time, control of the hospital was turned over to the Central Church of Africa, Presbyterian. Simultaneously, financial management of the hospital began to
deteriorate until now; there are pretty much no financial management procedures in place.
Have
I mentioned that there is a fuel shortage of crisis proportions in Malawi? I don't know the cause but it is real. At every filling
station we passed today there were a minimum of 100 vehicles sitting in line for it. The fuel shortage has spilled over into
other goods, and there are reports of food shortages.
Driving along the M1, the sights are pretty much the same as before--people walking with goods balanced on their heads,
bicycles with amazing amounts of cargo on them, a few ox carts, a few older trucks, and on and on. We came to a stretch
of road that Maralise called “coffin” road. I could see why. Lots of vendors were constructing and displaying
coffins. We came to a sign warning us of "loose chippings." A little further on, a man was sitting by a pile of rocks, hammer and chisel in hand, chipping away.
Dinner
with the young folks was pretty familiar--rice and pasta plus something called "chicken joy." I didn't ask but ate some
anyway. For dessert, we shared a date nut cake that I had purchased in Lilongwe. It was
my turn to wash dishes after which Lars put them away. For a late night snack, I ate peaches and a mango. Time to crawl under the mosquito net for a good night’s sleep before the rooster begins to crow. Ron
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| A woman with her baby |
December 3rd
I arrived
at the accounting office before it opened this morning. On my way I passed a
little goat again. The lady in the photo was sitting on the wall, waiting with her baby. A
little later this morning, the entire guest house plus surrounding areas are being sprayed for
mosquitoes. None too soon! After the spraying, all guests must remain outside for four hours. I hope it helps.
At the office, I did meet with Yowati. He listened to my concerns and had Evelyn
take me to see Bazilio, a cashier. Bazilio seems to understand my concerns. Just
as I think we are about to get somewhere, the network goes down! I am typing these notes as I wait. Have I mentioned that it is hot here? It is very hot here by Beckley standards. And if this is the rainy season, I wouldn't want
to be here during a dry season.
When I returned to the cashier's office, the network
was still down and is expected to be down for "awhile." I couldn’t get
back in the guest house because of the spraying, so I decided to go to the market for coffee and a haircut. None of the
vendors had coffee, and the barber was out. I came back to the hospital with rice, beans, bread, two pastries, and peaches--and
not much Kwacha in my pockets. Malawi impulse marketing is not very sophisticated but it is effective. 5:15 pm:
The guest house is pretty much back together now. In spite of everything
today, I was able to talk with Yowati and Bazilio, and we agreed to meet Monday at 3:00 pm. We
will see. Tomorrow I am going to Lilongwe with Hemny, the manager of Nkhoma waterworks, and Mary Elise, surgical
nurse supervisor. Lars has decided to join us. Should be a nice day and I can use a day away from Nkhoma
Mission Hospital. Tomorrow
is also Dan's last, and we are all going to the village to help him celebrate. Dan, a med student from Australia, is a little different. He cares about the patients and wants them to have the
best possible care. He was telling us today that he loves ants. He says a study
done in Australia proved that ants can do trigonometry. You had to be here.
Tonight,
we had another vegetarian dinner – rice, pasta, and a sauce for the pasta. I ate some
and it was pretty good, but I have no idea what was in it. Meghan, from Holland, has been making a couple of cakes most every night, all very good. I wondered where she was getting such good recipes.
Tonight, I found out that the recipes are coming from a cookbook published specifically for Malawi by the Peace Corps. Following dinner, three
girls from Columbus, Ohio joined us for coffee, tea and cake. Later, their guide joined us and it was a fun evening. Ron
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| My Bed |
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| Hospital Chapel |
December 2nd
This
bed is where I sleep. It’s been much better the past two nights. On
Wednesday mornings at the hospital, there is a worship service in their chapel. I'm
told it is a nice service and I will attend this morning. Otherwise for today,
I'm hoping Yowati will have some time to work with me. Tonight I have dinner
with Dr. and Mrs. TerHaar and a time to discuss financial reporting for Ebenezer School.
This
is the chapel where I attended services this morning, not a very clear photo I know. Maybe you can see the pews. They are not a type that makes it easy to take a nap! The
wall hanging behind the pulpit, in Chichewa, refers to and quotes Psalm 17:8.
The following is the refrain
of a hymn we sang at chapel services this morning:
“Dzina la Yesu NSF lokoma…Dzina la Yesu lipambana…Dzina lake lakukonda…Yesu, inde Yesu.” Sung in Malawian native language, Chichewa, the melody was very nice. In fact, the
entire service, done in both English and Chichewa, was nice. It was led by the hospital Chaplin who seems to be a very nice
fellow. His name is Laston and he led the singing which included some hand clapping
and rhythmic parading back and forth in front of the congregation of 30-35. Even though this particular song was sung
in Chichewa, I noticed that some Anglos were singing along. As a part of the
service, Marie, whose name is really Mary Elise I was told, and her Malawian friend made an appeal for support to be able
to provide each hospital patient with a Christmas gift. I will contribute 1,500 Kwacha, approximately ten dollars.
After chapel service,
I went to the accounting office, optimistic that I would finally have my day with Yowati. Alas, Yowati said he was "very sick"
and would have to go home. Among other things, Yowati planned to introduce me to the IT staff. So, I ventured up to the IT
office on my own. The door was locked. All that said though, I learned something
from the medical director yesterday that allows me to proceed with some real work. That is very encouraging.
Right now it's time
for me to shower and dress for dinner with the Medical Director and his wife. BTW,
I did not drink any of that brown water I referred to earlier. Our drinking water is boiled,
filtered, and stored in an old fashioned ice cream chest using every
kind of plastic container you can imagine. As I returned to the guest house a
short while ago, a little goat was meandering around the open air hallway. Goats are everywhere.
This evening: It's almost ten thirty
and I have just now returned to the guest house following dinner with Dr. and Mrs. TerHarr and their six children of which
two are adopted. We all sat at the table and the family sang a very nice grace. We then shared shepherd's pie and a nice dessert. What followed was truly amazing to me. First, son James read a passage of scripture.
That was followed by the singing of 2-3 hymns, and they then joined in singing several Christmas carols.
Surprisingly, it was the children who didn't want to stop. These kids have never watched TV.
After the children went to bed, Dr. TerHarr went back to the hospital while Mrs. TerHaar and I spent an hour reviewing
financial procedures and reporting at Ebenezer School.
Then, about nine o'clock, a couple from Holland, Eric and Naomi, dropped in and we all talked for another hour. Eric is in public health
and Naomi is a physician working in the hospital's maternity ward. Eric and Naomi may be the brightest two people I have met
here. They both seem very nice and I hope to get to know them better. It has
been a long day and a good day. I am wondering if Yowati will be in tomorrow and whether I will get any of his time. Ron
December 1st
For the
past few days I have thought many times of Sallie's final days She died one year ago November 30,
4:55 am, 11:55 Malawi time. I looked at my watch and remembered.
This has been a morning of just a tiny bit of progress
with my project. Yowati believes we will need to discuss some questions with the IT department and will go there with me tomorrow.
Today, he has to go to Lilongwe. That's how it goes day after day.
At breakfast this morning, the med student
from Australia mentioned that approximately 25 percent of Nkhoma Mission hospital patients
have AIDS. About twelve percent of the total population have it, he said. BTW the total population of Malawi is about fourteen million.
Medical Director Dr. Reynier
TerHarr's wife, Villica, has asked that I do some work to improve the financial report of a private school she is involved
with. I am pleased to do it, as I needed a doable project! That's what I will work on this afternoon.
This morning
I put my laundry out for Matrine to wash, iron, and fold. With the laundry, I included 500 Kwatcha, approximately $3.
That is the price regardless of quantity. I did not include my name with the
bundle. James says that somehow they know.
Dan, the med student, informed me that the water is off. A little later
he told me that when it comes back on the procedure is: "When it's yellow let it mellow. When it's brown flush it down.”
It was brown during all my first week here!
My workday was frustrating
again with little progress toward the objective. I do believe Yowati is beginning to grasp the objective, and he promises
to work with me tomorrow. We shall see.
I talked with the supervisor of surgical nurses, Marie, for awhile this evening.
She, too, is frustrated. Her ward has one toilet for seventeen patients and is, for lack of funds, out of toilet tissue and
cleaning supplies. Yet, on Saturday the hospital arranged and paid for transportation for 25 staff to attend a wedding of
a staff member. Marie asked how fuel would be paid for and was told all the ambulances would be filled with fuel, and
that fuel would then be siphoned off into the truck being used to transport staff to the wedding. All seems quite sad.
Following
three days of speculation, Elizabeth arrived today from London. At present, she is staying at the guest
house and joining us for dinner, now being prepared by the young guests. The menus are interesting, but
they are pretty good cooks. No power
outages today, not yet anyway. Water was off for a short time but all is well now. Ron
November 30th
I think
I told that the five young folks staying here went to the lake
over the weekend. They rode buses--four of them. On one of the buses a local passenger got on with a goat. James, the
Canadian, said he had to move his legs to the isle to make room for the goat. I might not have believed that if I had not
seen four goats loaded into the tiny compartment behind the back seat of a bus.
The work continues to be frustrating.
I am attempting to work with Yowati, the number two accounting assistant. It doesn't help much that I seldom understand
a word he says. English is the official language but they all speak Chechewa. When they do speak English, it comes out sounding
like the native language, rhythmic and fast.
Last night I decided to try sleeping under the mosquito net. I will use
it every night from now on. Dorica, assistant housekeeper, prepared my lunch today. There is plenty for dinner and lunch
again tomorrow. Menu is boiled potatoes, dried beans and warm slaw which is very good.
Ron
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| The Market |
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| At the Market |
November 29th – More Power Problems
These photo
scenes are from the market yesterday…not
very similar to Kroger’s on Harper Road! There were two live goats tied to the rack on back of a bike. While I watched, a third one was added. It was hard for me to watch.
Sunday
AM: The power finally
came on last night at 9:45 PM. Right now it’s 5:45 AM Sunday morning and the power is off again…thus, no coffee. Yuck! The fuel shortage is becoming more
serious and leading to other shortages. Now it's flour.
Later: The power came back on around 10:00 AM. The coffee at jack's was held in their backyard and was very nice.
Jack and Henrietta are leaving tomorrow and I will miss them. I have been alone in the guest house all weekend so it was nice to have the birthday party yesterday and
the coffee this morning. Time to warm up my lunch before the power goes off again.
Sunday Dinner: I just discovered that power
is off again so I'll probably have leftovers by candlelight again. Not a problem as I have leftovers pretty often when at
home. It is beginning to sprinkle rain which I believe is much needed. This is
supposed to be the rainy season but it has only rained twice
in the nine days I've been here. Ron
November 28th
This
morning I put on my brave face and ventured to the market on my own. But that was after sleeping till eight and treating myself
to two cups of coffee, a first since Dec. 17. The market
was as amazing as I had been told – many kinds of veggies, bananas, mangos, pastries, goats and chickens, art works,
ad infinitum. I took lots of photos and hope some will be good.
On my way back, I met Wayne and Judy who are hosting
the birthday party later this afternoon. They are from Toronto and seem very nice. Wayne
is teaching in a high school here and Judy is a health planner. They had purchased a newspaper and loaned it to me.
I will return it when I go to their party this afternoon. It will be my first paper since Nov 17. Time for lunch,
a shower, and off to the party.
This evening: It's nearly eight
and the power has been off about eight hours. I had dinner of cold leftovers, beans, cabbage and rice. Wasn't bad plus it
was a candlelight dinner. Ha! It's three minutes before eight and I'm hoping that will be the moment the power comes on.
Something
that is strange to me--I have not seen a single napkin or paper towel since arriving in Malawi nine days ago. I need to ask about that. Two minutes after and
still no power. I need some light for taking my medicine. Meantime, pretty much all I can do is sit here, alone, and watch
the candles burn. Maybe Abe Lincoln could read by candle but my eyes aren't that good. So, I
will wait. Ron
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| Playground Soccer Game |
November 27th – One Week Completed
Work wise,
my week has been pretty frustrating but today ended on a hopeful note. I am ready to tackle my primary task again Monday.
The task basically is to determine whether computer generated revenue amounts can be reconciled to bank
deposits. Reasons for my frustrations are too numerous to describe in an email.
On my way from the hospital
to the guest house tonight, I heard happy sounds, looked to see and there was a playground soccer
game. Not sure you can tell from the photo but the teams are divided, shirts and skins.
Tomorrow
I go to the market for butter, cabbage, rice and bananas. Matrene, the housekeeper, will cook for me tomorrow. I already have
beans, tomatoes, potatoes, onions and pasta. It will be interesting to see what Matrene comes up with.
All the young
folks went to a lake for the weekend, leaving me here as the lonely American. I have read “A Letter to America” and “With Love from Baghdad.” 'Letter’ is very good, ‘With Love’
not so much. I have begun “Isaac’s Storm” and it is very good. Have a good weekend. Ron
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| A Common Scene |
PS:
I caught these two ladies as I walked to Jack's and Henrietta’s last evening for dinner.
The dinner was delicious and the fellowship was delightful, very entertaining. Believe it or not, one subject discussed
was predestination. As most always, another topic discussed was the culture of Malawi and how it can be changed.
Dinner did not include pumpkin pie but did include pumpkin soup.
I will ask for that recipe as it was very tasty. Time for me to go to work in the hospital accounting office.
Ron
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| My hut before moving to hospital guest house |
November 26th - Thanksgiving Day
Not a holiday here of course. However, Canadian friends have invited me to dinner tonight along with a South African
and an American, the first one I will have seen since my arrival here. I'm looking forward to it.
Now that I have been
here for a week, I will share some personal activities and observations. I am almost past the "What was I thinking"
phase. When I emptied my pockets and removed my shoes for the fourth time in Nairobi, I was not sure. On the drive from the airport, with people
and goats milling along the road, two of the goats had been slaughtered and were hanging by the road, and I thought "what
have done?"
I moved into the hut (see photo) with shower and restroom facilities fifty yards away in a separate building,
and my thoughts were the same. Three days later, I moved into the hospital guest house, inside plumbing and a small
group of young people who made me feel at home; all very kind and helpful to this 75 year old rookie.
The work ranges
from hopelessly frustrating and discouraging to hopeful and optimistic. Today, I feel hopeful. My room is very
plain but ok. My bed is a thin mattress laid on a one inch piece of plywood fastened to a frame. Amenities are few but it's
ok.
Two of the young guys took me to market on Tuesday. It is indescribable. I plan to return there Saturday, which
is the "big day," and I’ll get some photos. Btw, the guys advised that I wear old shoes, and I soon felt grateful for
that advice. One item I should have brought is a backpack. Without it, I can't carry very many provisions at a time.
In addition to dinner this evening, I am invited to a birthday party on Saturday and a coffee following church
on Sunday.
One of the med students just came in the accounting office to deliver a donation from his church
in Australia -- 180,000 kwatcha, app $1,000 in US currency. The med student said it had been a morning of mess-ups. A young man had an accident and someone at
the hospital accidentally administered a double dose of a blood thinner. Someone else accidentally punctured a woman's uterus.
The med student said he "opened her up and fixed it.” As the Anglos say,
"Hey it's Africa."
The day is a melancholy one for me. It was Thanksgiving Day
a year ago when it became obvious that Sallie was slipping away. Ron
As you can
see, I am sending this message from another's computer, as I have thus far been unable to send email using my iphone.
Here in Nkhoma, Malawi, there don't seem to be kids around who can solve all these tech
problems us old folks seem to have. At this
point, I don't expect to be able to send photos, perhaps no more text either. We'll see. My reports may have to
wait until I return home.
Following a
long and tiring 40-hour trip, I arrived at Nkhoma hospital in Nkhoma, Malawi. The state of poverty becomes immediately obvious.
During the hour or so drive from the Lilongwe airport here, I did not see any of our American chain stores, restaurants, etc.
There are many
people walking, lounging, whatever, along the roadsides. At one point, land was being cleared. Clearing was not
being done with a backhoe but by manpower. Stumps were being removed by two-man teams using axes. Merchandise
was being transported by carts, bicycles, persons, and an occasional old truck.
There are also
many goats grazing along the roadway. My driver, Eddie, says the goats go home at night and they know where home is.
I did not ask about the people. At one point, two goats had been slaughtered and hung up on a crude stand, presumably
for sale.
I arrived at
the hospital about 12:30 local time, 7 hours ahead of EST. Everything here is depressing but hopeful. An accounting system is pretty much
non existent, reason being it seems…..hey it's Africa. What do you expect?
I walked through
a 20-bed ward yesterday, maybe 5-6 feet between beds. Most patients were children, all accompanied by a guardian, generally
a mother. That means the parent may be accompanied by other small children. The ward was quite crowded.
I walked into
a volunteer business manager's office, Jack from Canada. His sister, Nell, is also here helping with accounting procedures. My impression is that both are good, capable people. First thing I
saw upon entering was a small scorpion on the floor. As jack would soon tell me, the little scorpion may be the nicest
thing here.
Jack says there
is no accounting system in place and no financial controls in place. The hospital
administrator is away for three months and he, Jack, is leaving next Friday because of the hopelessness of the
situation.
The daily devotions
for the past week have been on the subject, Managing My Daily Fears. That seems quite appropriate at the moment.
We'll see what happens. My lodging accommodations
are ok. I’m in a little round guest house near the medical director's house. I have a shower, lounge, kitchen
and toilet--all in a separate building.
Nell is waiting
for her computer, so I will sign off. Hopefully, I will be able to send further messages and photos. But that
is anything but certain at this point.
Ron in Africa
Wow! It's almost departure time! On October
14 (Sallie's birthday), I informed Chip Lambert of the Medical Benevolent Foundation that I would be ready to leave
for Nkhoma Hospital, Malawi, Africa on November 18, 2009.
At the time, November 18 seemed to be pretty far into the future.
Now, impossible as it seems, November 18 is tomorrow.
Since October 14, I have been vaccinated for Hepatitis A, Hepatitis B, Tetanus, Typhoid
Fever and Yellow Fever. Airline tickets have been purchased and I have learned about weight limits for checked baggage, allowable
quantities of liquids packed in carry-on luggage, and how meds have to be packed (The cost of a four-week organizer was
wasted money.).
My clothes have been sprayed with Permethrin to repel
mosquitoes, Off containing 25% Deet (a new word to me) has been packed, Immodium has been purchased and packed along
with a supply of Tylenol. and my aerosol can of shaving cream has been replaced with a squeeze tube.
I have made what I hope will be my final "to do" list which,
seventeen hours prior to departure, has six items on it. Most of the six items were not on the list I prepared this
morning. Gifts for school children and the hospital
staff I will be working with have been purchased and packed. They include ball point pens, pencils along with a sharpener,
two soccer balls and a pump, and a hand-carved clock from Tamarack's assortment of West Virginia crafts.
My expected duties while at the hospital in Nkhoma seem to
be evolving and my perception is that the level of difficulty of my assignment is increasing with each noted change.
As my "to do" list has grown from six items to eight items
while I have been writing this report, it seems only reasonable that I stop writing. So I will.
More later, I hope. Ron
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