Lutheran Mobile Clinic

     After a month in Malawi, I am starting to feel comfortable with the work of the Administrator.  I have spent time learning the basics of Quick Books and the routine of the clinic.  I have also been taking driving lessons at Kari’s School of Driving.  It is interesting that driving was one of the things I was most concerned about when coming here, and now I find that I like it.  Maybe it has something to do with the vehicle, which is a diesel-powered manual transmission Toyota Land Cruiser ambulance.  My opinion may change once rainy season arrives, and I am forced to drive on the wet, village dirt roads.  The biggest challenge with driving is not getting used to shifting with the left hand or driving on the opposite side of the road.  Rather, it is avoiding all the obstacles- foot traffic, bicycles, chickens, dogs, goats, and the occasional herd of cows.

A minibus creature

    There is also a creature called the minibus, which can cause great annoyance.  One of the missionaries said that in order to avoid becoming frustrated with the drivers, we should consider the minibus another obstacle like the chickens, dogs…  The minibus cannot help it if he fails to blink when pulling out in front of you.  Nor can he help it if he slows down and his brake lights are not working.  It is not his fault.  It is just the nature of the creature.  This new outlook has been helpful so far.  To the ugly minibus creature, we have added the sloth-like Alinafe-Driving-School creature as well as the Broken-Down-Lorry creature that could not seem to make it to the side of the road and is now blocking traffic.  Animal Planet needs a television series dedicated to these non-indigenous African creatures, which have so asserted themselves into the landscape, that we can no longer imagine life without them.

Loading the ambulance for clinic

     Back to the clinic.  My first trip on my own with the staff was quite a doozy.  When I had been out there in January and February with Kari, it was usually quite uneventful.  Our clinic day begins around 7 AM when we get things together and start loading the ambulance.  Our gardener Mr. Chirwa, our driver Enock, and housekeeper Kennedy do the heavy lifting to get all the kutundu (stuff) up on the top of the vehicle.  The ambulance leaves around 7:45 or 8 AM  and makes a few stops on the way to pick up the staff, which consists of 5 nurses, one nutrition worker, a clinical officer (like a doctor), a registrar, and a worker from the district health office who is responsible for vaccinating. 

Health teaching at clinic

     There are hundreds of people waiting for us when we arrive. Depending on the season, there are about 150-300 sick patients, and the rest are mothers with children under five or women of child-bearing age.  After unpacking the ambulance, we are called together for devotion by the ringing of a “bell” (actually a tire rim).  After the devotion, one of the medical staff leads health teaching in which he or she lectures on prevention of certain diseases and other health-related topics.  Then the patients can be seen.  Since I have no medical background, I cannot help with seeing any of the patients, but I can keep busy by filling prescriptions.  There are two nurses that work in pharmacy, and they only have a small amount of each medication with the correct dosage in pill bags.  My “job” is to label the bags and fill them with the required amount of pills.

     On that day when I went to clinic, I had just started filling some of those bags, when I was told that I was needed at the borehole.  There was a man assessing the borehole because it was not pumping out water like it should be.  It was very interesting how he was able to “fish” out the broken parts from 60 meters down.  After we finished that, Enock told me that there were some referrals to be taken to the hospital. 

Village Road

     A patient is referred to the hospital when he or she needs more care than our clinic is able to provide.  Usually the referrals happen at the end of the day at clinic, after we have packed everything together and are heading home.  Sometimes, though, as on this day, the patients are so ill that they cannot wait the few hours until clinic is finished.  There were three patients that needed to be taken to the city hospital in Lilongwe immediately.  We were at Suzi, a village about an hour’s drive from Lilongwe.  Most of that journey is on dirt roads.  That day, it only took 45 minutes to get to the hospital, which is in the heart of the city.  Fortunately for me, Enock was driving.  We raced at 80 kmh down those roads and into Lilongwe.  One of the patients was a baby with pneumonia or some respiratory problem.  I could hear it wheezing almost the entire trip.  Whenever it was quiet, I was afraid it had died.  When we got onto the paved road leading into Lilongwe, Enock turned on the siren and we wove through traffic.  Most people pulled over when they heard the siren, for which I am very thankful.  The most hair-raising part of the trip was when we went the wrong way around a round about so that we only had to go a 1/4 of the way around instead of ¾. 

     Our first stop at the hospital was to drop off the baby.  It was so sad to see little babies hooked up to oxygen.  That is what this baby needed, too, and I was almost bowled over by a nurse rushing past me to get oxygen for it.  We left that area and went to a different part of the hospital to drop off the other patients.  It was hard to see so many suffering people who had to wait hours to be seen by doctors and even then, they do not always get the help that they need.  So much for universal healthcare.  By the time we got back to Suzi, all the other patients had been seen, and things were packed up.  The second trip back to Lilongwe was uneventful.  What a first day!