Malawi, Week 1

Most of you reading this are being constantly entertained by Ben's musings and curious Facebook posts -- some of this may be a duplicate recap! But I do want to share some of my own observations and ponderings, most of which are probably self-evident, especially to those of you who have had extended international experiences. Please indulge my reflections!

Malawi life:
It goes without saying that life here is extremely different than life at home. Our (and "our" meaning the Hutchinson/Ben/Beth clan) day-to-day has fewer of the conveniences we are so used to (drinking water from the tap, constant electricity and internet access, reliable ATMs and credit card machines, carpeted or hardwood floors, paved roads, and Starbucks), and it feels more strenuous to live here. But Malawian men, women, children actually work physically hard for their livelihood. They walk miles around or between villages, carrying massive loads of lumber or huge bags of who-knows-what on their heads; they spend hours picking a bowl of berries to sell for the equivalent of $1 or less; they chop wood and stone, they carry babies (or multiple babies) all day long. I've started to contrast the physical stress people experience here with the mental stress we experience in our world. Of course there is mental stress here, especially in experiences of loss, scarcity, trauma -- but there is notable absence of certain stressors. Time is plentiful -- no one is rushing to get through the grocery store line in time for something else or to catch a bus ("minibus" crowded with 12-18 people) or subway (nonexistent of course). Additionally, something I expect to experience more in the future, there is less institutional pressure to perform, improve, and stay accountable. Some of this is certainly problematic but also diminishes the level of mental/cognitive stress. A specific example is that the clinic in which we have begun working is "supposed to" have periodic staff meetings -- however, they just don't have them. In a discussion with a clinical officer Jane (she is about the equivalent of a PA in Ndirande), she acknowledged this ("We know we are supposed to"), but for some reason, the meetings don't happen. I am of the opinion that meetings should occur at this clinic :) -- but imagine the difference in stress level if you never had to attend a staff meeting and discuss the things that are going poorly!

On a general note, other specific observations that have caught me off guard or challenged my expectations:

There are paved simple roads with dirt on either side --not too much rubbage or waste. 
Smaller roads are dirt, with potholes. MANY people walk -- there are significantly more walkers than drivers on the road.

There are ways of making money I had never thought of before: carrying piles of coal to market on a bike, selling a puppy by holding it in the air for all to see by the side of the road.

Babies are carried by women who wrap them around their backs. They appear so content peering out at the world but I haven't had the chance to interact with one yet.

My first bedtime in Malawi, I was joined by two geckos on the walls --they are harmless, but I was very thankful for the protection of the mosquito net.

Our first full day was filled with some interesting trials -- the car keys were accidentally locked in the car at the supermarket. Thankfully Bill saw a friend in the store who gave him a ride back to the house; we gathered groceries, waited in line only to learn the credit card machine was not working (for the record it is still not working and they don't know when it will work again). The ATM around the corner was functional, so we were able to get enough cash (Kwacha) for the groceries. No one seemed to mind the 20 minute delay we caused.

There are so many funny uses of the English language --on buildings, cars, signs, and T-shirts. For instance:
                              Yahweh followed by a Nike swoosh on a minibus
                              "Maximum Leisure Center" on a creaky-looking gated area, no evidence of leisure anywhere around
                              "Toward power all day every day" -the power company slogan
                               Handwritten "Cake Boss 2014" on a bright orange Tshirt, and "Number one Grandpa" worn by a twenty-something.

I've become more aware of which aspects of my life might be unique to my culture as compared to Malawian (or any other) culture. There is a cultural aspect to pain -- I haven't seen this yet, but Elizabeth tells us that Malawian women don't make a sound during labor. When we examine patients with clear abdominal pathology (mass, PID), their faces don't register pain at all. Babies and children waiting in line to see the doctor aren't crying. The 4 Hutchinsons, Ben and I went on a nature walk at the top of Zomba plateau -- a large hill/mountain with a precarious road with beautiful trees, waterfalls, birds and monkeys (as well as a conference center) at the top. We were decked out in rain jackets, running shoes, carrying granola bars, trail mix, and a backpack -- this contrasted to our guide who was carrying nothing and found us some berries by the side of the road for a snack. And when we went to Circuits (see Ben's previous post) -- it kind of looked like the composition of Community Fitness in Seattle (3:1 female to male ratio, spandex, ponytails, no Malawians except the leader). Some of this is related to income, but I'm sure some of it is also purely cultural.  Currently, Liam, Micah, Ben and Bill are outside having a water fight while Blessings (the 25 year-old employed house staff) smiles in disbelief -- he reports he never did this as a kid (of course, the bright green water gun might have something to do with that).

We have only had two days in the clinic so far -- and a walk through Queen Elizabeth Central Hospital on a holiday (thus a slow day, because everyone thinks the hospital is closed on holidays) --but I have been amazed and invigorated by the amount of medical pathology. Working here affirms WHY we need Medicine -- because the human body will disintegrate and succumb to disease, infection, deformity to a much greater extent, much more quickly, without the tools of modern medicine.

My overall sense is one of thankfulness for the Hutchinsons and Elizabeth's commitment to participating in Global Health in a way that aims for sustainability and prioritizes the needs and desires of the community. We have much more to see and learn! Stay tuned :).

-Beth Thompson, SFH R3