Feeling teary

Our last night in Malawi and I think we all have mixed emotions. It’s been an amazing adventure. We didn’t make much of an issue of it here (no sense in worrying those of you at home), but Iris was pretty sick for a while mark knew exactly what was in store if we had to check her into a hospital, and that was pretty scary. And yet, we know that we always have the option to hire a car to a big city, or fly to South Africa if an emergency arose. Every day, mamas here have to decide whether to pay to ride on the back of a truck to take their sick baby to the health center, or buy food for their family.
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many of you have asked me to weigh in on what this trip is like with small children. Would I go back and do it again? Yes. BUt there are a few things I would like to do differently.
1. A cell phone would have made things much easier. I would also consider a dongle, which would allow you to have an Internet connection wherever cell service exists (which seems to be just about everywhere). Internet connections were few and those that existed were expensive and very unreliable.
2.  I’d bring more drugs. Even with mark’s careful planning and what felt like an entire mobile pharmacy, we still felt like there were drugs we wish we had access to when Iris was sick. And yoU won’t find them here.
3. I would have felt much safer if we’d been able to spring for a car rental or taxi instead of minibuses and matolas everywhere we went. BUt the price difference is phenomenal. Example, the 18 km from the main highway to the beach town was U$35 by private car, U$8 by matola. We lugged carseats halfway across the world for one car rental. Most transport around here doesn’t give yoU your own seat, much a seatbelt.
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We will miss the amazing places and the friendly people here in the ‘warm heart of Africa.’ We’ll not forget the intensity of color, smells and sound, and the density of vegetation and people. As mark said, this place gets Under your skin. I have no doUbt we’ll be back. And next time, we’ll make sure we have more than six weeks to contribute to and learn from these wonderful people.    

Tea Estates

;As much as I love public transport, we went crazy and sprang for a car rental this week to visit mount mUlanje. It’s a tall granite mountain and at the base are acres of tea estates and all I can say is wow. It might go down as one of the most beautiful places I’ve ever seen. 
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;It’s quite remote. The villages are farther between than the rest of Southern Malawi and the roads were rough. Every direction you looked gave a different incredible vista. It was sort of like a lush, green, exceptionally beautiful New Mexico, and I’m rather partial to New Mexico scenery.
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;Part way up the mountain is a church-run retreat. It is set next to a river with boulders that create deep swimmable holes and it lies under huge cedar trees. The  food was good and the staff was friendly. The only disappointment was that we only got to stay one night. UI would definitely recommend several days in this amazing place.
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;PictUres to come soon...

wrapping UP

Until the late 1970s, the capital of Malawi was the perfectly beautiful town of Zomba. This picturesque town is set at the foothills of lush, verdant mountains and the hilly terrain is drop-dead gorgeous. Now this is a place that makes sense to make the capital. The weather is breezy, cool in the shade, warm in the sun, and the hills would whip your calves into shape in no time.

BeaUtifUl Zomba

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Our home for the night was a rather uninspired hotel in a beautiful setting. Warning…rant. Malawi really is crazy expensive. Our hotel was UUS$100 per night, a price I refused to pay and negotiated to half that. But still. The linens were tolerable on the twin and double bed, the shower barely had any pressure, a naked bulb hung from the ceiling, the advertised TV and wireless Internet didn’t work. Seriously, to whom are these places catering??;

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I complain aboUt minibUsses, bUt at least I'm not riding on this.

On the minibus one last time (insert little happy dance here) to Blantyre. Actually finding it to be a cool city with lots of beautiful panoramic views of the mountains, an active market and a plethora of eateries. Prices astound me. Our UsU$35/night is getting Us three twin beds with semi-clean linens, a partially functioning bathroom in a downtown location. Cockroach visits throughout the day are free. We thought we’d move on to a nicer place after one night, but we’ve visited every hotel within walking distance that we can find and they are all USU$100-200/night.  Those Under U$185 classify as slightly yucky.

Press yoURself close enoUgh to the wall to feel the drizzle from the shower head and yoU risk pUnctUring yoUr abdomen.

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I was warned that Malawi was expensive, but UI have been overwhelmed at the cost of living here. With gas at USU$8.00/gallon (if it’s available…there are frequently hours-long waits at the pumps) and some of the lowest per capita income in the world, I mourn for the Malawians. I’ve not met warmer, more gracious people, and UI don’t know how they make it. Food costs are nearly identical to those in the US, sometimes higher. At least my weaknesses for avocado and mango are cheap here.

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Signing off for a bit. Iris is yelling ‘Fanta! Fanta!’ which must mean the addiction is official. I also overheard Grant talking about how Iris' gyrating belly reminds him of the Lady Gaga video he saw three nights ago in a bar/restaUrant. Yikes--mUst go investigate this. 

Hippos, hippos, hippos

What’s large, wet and laughs like a big fat man? Why, a hippo, of course!

We got our fill of hippos on our second trip to Liwonde National Park. This time, we went all out for an overnight boat trip and we were not disappointed. Really, I could get used to someone cooking delicious meals for me on the comfortably equipped mangUnda. Other than the fact that our South African host and his crew smoked like chimneys, it was an Utter delight.

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The hippo concentration in the Shire River through Liwonde is the densest in the world (or so they claim) and it was pretty fantastic. On either side of the river they snorted and laughed and bellowed. Many of them were even on land and they would lumber back in the water quickly as the boat approached. They are surprisingly fast for their rotund awkward-looking frames. Iris excitedly exclaimed ‘heepoosh! heepoosh!’ ever 90 seconds or so.

Birders would be absolutely beside themselves in this place. Impala, monkeys, crocodiles and waterbucks abound.

The kiddos were thrilled at the idea of sleeping on a boat, and we all enjoyed a virtually mosquito-free night (being anchored in the middle of the river – no sleeping Under nets), listening to all the entertaining hippo sounds.

On the mangUnda

We saw three herds of elephants the second day, but none close enough to get a very good look. Ah well., an excuse for another trip. There are big cats (lions, leopards,) in the park as well, but it is so lush they are rarely seen.

Maternity ward

So my time on the maternity ward was cut severely short with Iris’ illness and the need to catch transport early.  In addition, I was disappointed that I did not deliver any babies but in fact none of the doctor’s deliver babies unless it is via c-section for complications, of which there are many.  Birthing is largely done without direct oversight and with a circulating nurse midwife who is very busy. Women in Malawi have a 1 in 36 chance of dying as a pregnancy complication over their childbearing years. Phenomenally high and important given the number of births per month at this hospital (between 700-800 —roughly 3x the volume at women and children’s hospital in Columbia). I have three children and never once did I fear for my wife’s life or did it even occur to me to have that concern. In fact, I feared more for my own by pointing out when her clothes weren’t fitting as well—a bonehead move that perhaps one reader will avoid in the future.

            The ward is arranged with a post-partum c-section Unit, a general medical bay for women who are pregnant and ill (with conditions both related and Unrelated to pregnancy), a small neonatal Unit with one incubator, a high-acuity room for women who have had severe complications such as a Uterine rupture, and a kangaroo care bay for children who were born prematurely and weighed less than 2000gm (for those who can’t picture this, they can fit in your two outstretched hands easily).

Didn't want to be insensitive and take pictures of laboring women. Here's some cute kids outside the hospital instead.

            The number of women in the post-surgical Unit was easily over 50 and they shared a bed with another mother and the two new infants. Many women did not have a bed and so we examined their abdomens on the floor and ensured they were not fevering post-surgery. The general medical ward was the same with no fewer than 40 pregnant women lying on a concrete floor, many traveling long distances, waiting for their problem to be ‘severe enough’ to warrant a bed. Beds were for those who were vomiting, dehydrated or had very high blood pressures or pregnancy-threatening conditions. Those not lucky enough to have a bed were seen all at once on Wednesdays to see who had gotten worse. The thought crossed my mind that it seemed women had quite an incentive to not be pregnant here and also I thought about the kind of revolt that would occur in the states if we told our women to lay on the floor or share a bed with another new mother and infant. Also, how different for a child to enter the world in a Unit that looked like a war zone-(plywood dividing the labor beds) compared to our single rooms with TV’s and foldout couches for dad.

            I don’t want to ramble on so I’ll just say that it made a huge impression on me and if I was to return, this is definitely the area of highest need. There is an entire clinic chain dedicated to reproductive health and I think working there would be eye-opening into the choices that both men and women are making (and not making) about family planning.  We are all still doing well and I am beginning to have stomach pains thinking about the flight home.

Babies and Breasts

At home, I consider myself a resource in the areas of breastfeeding and baby wearing, but I am getting schooled here, that’s for sure.

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Every Malawian mother breastfeeds her babies and it is a regular occurrence to see toddlers nursing. Even HIV positive mothers do so. The medical community demands that a woman undergoing antiretroviral therapy breastfeed her baby for a minimum of two years. I had a conversation with the interns at the hospital about the rates of breastfeeding in the U.S. and they were appalled.

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mark witnessed one tired mother in the hospital dozing next to her squalling newborn. The attending physician walked over, whapped the mother on the arm, pushed the baby Up to mom’s breast and admonished ‘Feed that baby! Look, you have huge breasts filled with milk. It is for your baby, not for you!’

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I have seen one stroller since we arrived in Malawi. I saw it everyday in a stall at the market when I was shopping for meals. It never sold in the month we were in mangochi.

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Amayis wear their babies in their chitengas, a fabulous piece of cloth that is worn as a wrap-around skirt, blanket, dress, baby carrier, and more. Sometimes older siblings wear babies. More than once, I have seen a ‘big’ sister or brother carrying a sibling that had to be more than half her or his size.  

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;As UI anticipated, this trip is turning out to be quite the cultural exchange. It has certainly taught me that we don’t put nearly enough responsibility on our children at home. As soon as we’re stateside again, I’m putting Grant in charge of all food preparation and Lydia is taking over baby care. Iris will be responsible for all the chickens I plan to acquire. She’s quite enamored with the ‘Uncucus.’’

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;I love this sign from the mangochi hospital outside the laboring ward. I’d love to see something similar in the States, though the all-powerful formula lobby would surely find a way to get it removed.

Gone north

We have said ‘adieu’ to mangochi. It was a fabulous experience, but all of us were ready to move from the heat and on to a new adventure. We managed to find a ride in the back of an ambulance to Cape maclear, a major improvement from traditional Malawian transport.
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;We are lazing at the beach, soaking up rays and enjoying the hammock. It beats sweating all night in our 92-degree airless room in mangochi (though that would be a close second, of course).  We love the beach village lifestyle. Families come to the water multiple times each day to wash dishes, swim and bathe. There are always a slew of naked Malawian children splashing about.
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;We took a short boat ride to a nearby island where we got to snorkel among the world renowned cichlids of Lake Malawi and enjoyed a delicious meal of fresh fish cooked over the fire.  It doesn’t get much better than that.
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;I apologize for the great silence on our part the past two weeks. Lydia had serious intestinal distress for a few days, and then it hit little Iris. It’s taken her a while to recover, but she is finally herself again. And, now that we are on the beach with a lovely breeze, she is finally heat rash-free for the first time since we arrived in mangochi.
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;Our computer is on its last legs, I’m afraid (note the weird Uncorrectable typos in my text), so we will do our best to stay in touch the next two weeks.

Getting schooled

Mark here again. This week, I worked on the male ward and, not unlike home, it seems that men here tend to come to the hospital when they are more than “just a little” sick. Often taking a detour through a traditional healer, they arrive to be admitted in pretty grave conditions. I examined a young man in his 30s who was HIV positive and stated that he started poorly about 6 days prior. When I assessed him, he was breathing 5x faster than normal and had a temp of 104F. He indeed had full blown pneumonia and was going into septic shock.  He had a white blood cell count of 1.8 (normal 8-11 or so) and had no way of fighting this due to his HIV. I saw him at 10:30am and we gave fluids and antibiotics, the only real tools we had. When I returned from a short lunch, a nurse stated “that guy you saw this morning is dead,……..but he’s the ONLY one.” It seemed to me that she was used to seeing many more and I realized again that I was not in Missouri anymore. This week I’ve seen HIV, TB, pulmonary embolism, malaria, gas gangrene of the leg, cryptococcal meningitis, psoas abscess, acute respiratory distress, bullous impetigo, alcohol withdrawal and drumroll…….2 crocodile bites. Many of these conditions, which are very treatable at home,  get a futile attempt with an ill-suited antibiotic and a shake of the head as if to say “that’s a real shame”. I’ve also performed several lumbar punctures, removed ascitic fluid off abdomens, repaired a hydrocele and inguinal hernia, and emergently removed fluid from a adolescent’s penis which was being constricted by retracted foreskin. No boring days.

            I’ve become more efficient with my assessment of patients, learned to think quickly about how to best use the limited resources I have, and gained more confidence in procedures. I also know that as a whole, we complain about our health a lot more at home. Also, crocodile bites look very painful and I don’t ever want one.

            We are having a quiet weekend in Mangochi to save some cash and to figure out a strategy to get our visa extensions without paying an exorbitant amount of money. Sweating it out in our hot accommodations will make holiday seem all that much better. On to maternity ward next week. I am excited but nervous as I expect to see lots of complicated births. Stay tuned and stay well.

If you see this sign, pay attention

White gorilla

What will she ever do next??

I feel like I’m at the zoo. The Azungu Zoo. And I’m the star attraction.

We have a lovely shaded, grassy area outside of our hostel building. During the hottest part of the day, we frequently drag out a blanket and rest under the trees (the beauty of the 2.5 hour lunch). However, it is very difficult to do much resting when dozens of schoolchildren are gathered on the other side of the hospital ground's fence, hooting, laughing and yelling.

I felt much empathy for the gorillas at the zoo today as I picked through my rice in the shade. The rice was pretty pebbly and buggy, so I was at the task for quite a while. The kids never lost interest in my fascinating project. Really? Because I know your mom picks through rice at home, too. What could possibly be so intriquing? Then I thought of how we ooo and aah over the poor primates at the zoo…”Mom! Look! He’s eating a banana!” “That is so crazy how he’s just sitting there staring at us.” “Totally adorable! That mom is feeding her baby!”

So, I took a picture of the school kids watching me, which they, naturally, found hilarious.

Safari park

Can you see them?? Elephants! Or as Iris says "Ents!"

Kitchen at Liwonde Safari Camp

Beautiful Liwonde

One of many warthogs

I set my own personal record for minibus travel on the road to Liwonde National Park: nine people, an enormous bucket and three packed bags in three seats. Then we took a bike taxi ride for the last miles, much of which was dirt ruts. Let’s just say the 140 lb Malawian who peddled Mark, Grant and bag earned his taxi money.

Liwonde National Park is home to elephants, monkeys galore, hippos, numerous deer varieties, crocodiles, warthogs and lots of baobob trees. We stayed at Liwonde Safari Camp, a spot which was recently carved out of the jungle along the edge of the park. For $20 a night, we got the dormitory to ourselves (yeah, off season), and lots of attention from the rather bored staff.

The owner took us on a trip through the rustic park, where we encountered all kinds of wonderful wildlife. We didn’t get as close to the elephants as we’d hoped (half a football field, maybe), but it was pretty awesome. We’re going to try to get in another trip at the end of the month in hopes of catching a boat tour this time.

It was beautiful, and the evenings were incredible with delicious meals served by candlelight. We could hear hippos rummaging outside throughout the night, and monkeys cackling at all hours. Late one evening, we went on a candlelit hippo hunt through camp. We never did find one, but we certainly scared ourselves silly in the effort.

The kids at daycare

The kiddos and I have been making the day care a regular part of our morning. We spend a few hours there, working on the English alphabet (especially vowels – aka “VOWELOS!”) and playing. Today I brought books, which were a big hit with kids and teachers. I haven’t seen a book in Malawi yet, outside of the medical school’s library.


The facility is a sandy yard outside of a local family’s home. There’s a shaded structure in the corner of the yard and some nice trees. The educational materials are a few large sheets of paper with letters and numbers written on them and a small chalkboard. The toy selection is comprised of four car tires, a basketball, three stuffed animals and one of those mooing canister contraptions.

When the little ones get tired, there’s one twin plastic mattress in the shade, or they lie down in the dirt and take a nap. The day care provides a cup of tea in the morning, and a hot lunch of nsima (corn porridge) and ndiwo (beans, meat or veggies) that is cooked outdoors on a tiny, hot stove (which, by the way, sits on the ground right in the middle of loads of small children).

It should be noted that the children at this day care all have shoes, clothes in pretty good condition and their families send snacks each day. Basically, these are kids from privileged families who have the means to invest in their children’s education by sending them to a private preschool to prepare them for primary school. These children are in the great minority in Malawi.

It's hot, hot, hot

Ah, another delightful weather day in Mangochi. I try to do my laundry (a pretty vigorous activity) as early as possible. I finished by 8:15 am this morning, a sopping, sweaty mess, which is particularly annoying since this perpetuates the endless laundry cycle. You would think having to hand wash all diapers would lower the birth rate around here (which, by the way, is 6.3 children per woman).

Blackouts are fairly common and though the hospital campus has a generator, it isn’t always reliable. We’ve had a couple of nights with no fan. Combine that with no cross-ventilation in our room and all of us sleeping in one twin- and one full-sized bed and you’ve just defined “steamy.”

This is not a true Mangochi lady. A Mangochi Amayi would have that baby properly dressed in a crocheted hat, polar fleece head to toe and a snuggly polyester velour blanket wrapped around it. For goodness sake, it's only 94 degrees in Mangochi today, a cotton afghan is not going to cut it. I'm calling DFS.

Two nights ago I got caught in the hospital during a blackout. It required very cautious walking to get out of there, I will tell you. I walked to the market in the dark to pick up a couple of Valentine’s Day Fanta treats. Vendors had candles lit in their tiny stalls, I could hear singing and the stars were bright. Not a breeze stirred, but it was pretty cool nonetheless.

The hospital experience

Main signage, hospital layout

Mark here. I decided to hack Sara’s blog to post some shred of evidence that I am actually working while here. My apologies for some medical jargon that may follow, but there may be some folks reading this that are interested in the details…..

The Mangochi district hospital receives local patients as well as referrals from 40 smaller hospitals in the area (25 government, 15 private). For a medical hub, the resources leave quite a bit to be desired. As of writing this post, the hospital is experiencing an antibiotic shortage (oral drugs limited to Ciprofloxacin and Bactrim). They are also out of reagents involved in blood transfusions so many sick children with malaria are stuck with pretty severe anemia. In addition, a major petrol shortage has limited the transport of supplies from other facilities. Pretty rough going but seems to be the norm. Did I mention that electricity works about half time, limiting anesthesia machines and O2 supplies?

The hospital has an outpatient department, an operating theatre, an x-ray department, and clinical wards that provide services for women, men, maternity, pediatrics, nutrition, and male/female tuberculosis patients. I spent my first week on the female ward. This involved general medicine for hospitalized women but also includes going to the operating room for any identified conditions that require such. In one week’s time, I encountered and treated patients with HIV, malaria, sepsis, cirrhosis, congestive heart failure, bowel obstruction, pneumonia, kidney infection, tuberculosis, advanced cervical cancer in the immunosuppressed, and domestic violence-related knife wounds. In addition, I assisted in performing tubal ligations for women who desired sterility and performed quite a few uterine evacuations for women who had miscarriages and retained products of conception. Most patients have advanced disease and may have traveled many hours to get to the hospital. It was a challenging and rewarding clinical week to say the least.

This week, I have been on the pediatric ward and have witnessed a high degree of mortality—more than I had prepared myself for (I personally declared four children dead this week).  Rough estimates show that about 10% of kids under 5 yrs do not leave the hospital alive. This morning I rounded on 3 ward bays, which contain 4 beds each. The math should work out to 12 children, but when I finished, I had seen 62 children, with 4-5 per bed and many on the floors with their mothers. Most of these kids have severe malaria with anemia, interspersed among pneumonias, meningitis, malnutrition, HIV and various other conditions (hydrocephalus, abscesses, kidney disease). Transfusions are limited and IV treatments for malaria and sepsis are not always available, which means doing the best you can and hoping for some luck. Witnessing child death has been a particularly hard experience and it is very different culturally. The process is pronouncement and leave mother for 5-10 minutes. She is left alone and not comforted by hospital staff. After a short time, the child is unhooked from any IVs and the mother wraps the child on her back and there is a procession out of the ward. It is practice to have them buried very quickly.

It has been an incredible two weeks. I have so much appreciation for the health system we have at home and all the things I take for granted while supplying care. I have the pleasure of working with some fantastic colleagues here and I am impressed by the resilience of the Malawian people. There have been many successes among the tragedies mentioned above; I am seeing people get well and leave the hospital; and many of them have a nice smile for the crazy Azungu (white person) who helped take care of them. I’m having a great time.

And on top of all this cool work, I likely will have a chance to see elephants in the wild this weekend. Woo-hoo. 

I hope you are all well.  We are doing great.

Cape Maclear

Must get out of hot Mangochi for the weekend, so we are headed back to beautiful Lake Malawi. This time, we’re visiting a place that’s been called one of the most beautiful places in all of Africa – Chembe, or Cape Maclear. Getting there wasn’t too terrible (though the last 18 k of road are spine-jarring dirt ruts) and apparently a whole slew of people agree because we had trouble finding a place to stay when we got there. At our sixth stop, we found a little bit of paradise at the Mgoza. I could live here forever in a little thatched roof hut with a huge bed and walk-in mosquito net.

Cape Maclear

Aside…Mosquito netting with small children really bites. It’s like living in an A-frame on all sides, and little people are constantly jabbing a limb out of the side or pushing it against the net creating mosquito heaven. Walk-in netting, on the other hand, is lovely.

Makes a twin bed feel very small, especially when you have to share with a child!

Ah, yes. That's the ticket

Lydi and friends

Anywho, we had a tremendous time playing in the water with local kiddos (for whom Lydia’s golden locks had some kind of a magnetism that they couldn’t keep their hands off), swinging in the hammock and generally luxuriating. I began to think this was Shangri La until I woke up in my breezy hut to the sound of waves crashing and the feel of thousands of tiny black ants crawling through my hair and across my upper torso. Ewww.

Ants aside, a wonderful excursion and we will definitely try to get back for a few days at the end of our trip.

Note to all: sorry for the nearly total lack of communication. We have two internet connection options. One is at the hospital – which rarely works – and the other is an expensive internet café (more like a working library, really) across town, which is difficult to get to and my children seem to delight in interrupting the work of all who are there so I feel like an obnoxious Azungo everytime I go. Although, I am here now by myself (a rare treat) and the guy is asking "Where are the children?"

Breakfast on the beach

Hot blooded baby is so happy at the cooler lake!

We’re all safe and happy and having a great time!

Window of Hope

Today I spent my first morning with Window of Hope, a local organization that reaches out to maternal orphans. If you are unfamiliar with the term “maternal orphans,” join the crowd. Here’s the scoop…

When a mother dies while giving birth it is a shameful thing. The husband leaves surviving children behind with his wife’s brother and returns to his home village to remarry. However, since Malawi is largely a matrilineal society, the brother-in-law probably lives in his wife’s village anyway so the raising of the multiple maternal orphans passes to Agogo (grandmother) who has no way of supporting the children. Maternal orphans are even more likely to be uneducated than the general population, and the girls are generally married as soon as they have their first menses.

Window of Hope has a day care, a language center for women, and assists Agogos in keeping their grandchildren in school by helping with tuition, book fees, soap for cleaning uniforms, etc. The Charlotte, the kiddos and I spent the morning at the day care, which has two teachers for the 40 little ones. While we were there, they drilled the kiddos on their alphabet, sang songs and flew like airplanes through the yard.

I’m excited to help out with the day care and on drafting some public relations material while we’re here. Right now, the entirety of Window of Hope’s budget comes from the paying day care attendees.  If anyone has grant ideas, I’d love to hear from you!

Outdoor bath

No running water today and the kiddos needed a bath. Instead of hauling water from the Boro hole to the room, we went for a bath in the laundry sinks. I confidently balanced one bucket of water on my head, took a step, and became drenched. I need a lot more practice.

In a month, I'll be able to do this. Uh, probably not.

Iris and Lydia each occupied a sink, and I enviously watched them splashing nude in the cool water under the trees. Grant, who had adamantly stated he didn’t want a bath, crept closer and closer to the fun, and before you know it, had also stripped down.

The Amayis at the pump smiled at the laughing kids, and Charlotte and I enjoyed the breeze. What a beautiful day.

Hauling water for the day – though for us, it’s only a few hundred feet – reminds me of how much of the world does this every day, and how it consumes hours each day for some woman and girls. How lucky we are, and I am grateful for the opportunity to remember that.

Monkeys and lizards and camels, oh my!

Lydia on Malawian transport

We celebrated our first Sunday in Malawi by taking a minibus to nearby celebrated Lake Malawi. Now, by minibus, I actually mean the back of a ramshackle pickup truck. But, it was that or no transport, so off we went. It started off well, with just 10 of us in the back, but it quickly filled up, to the point where Grant leaned over and commented, “In Malawi, there is no full.”

The Sun ‘n Sand resort was beautiful and weird. It had a water park, opulent outdoor restaurant and cabana-like space for hundreds of people, and huge rose gardens. All this next to a tiny village where people walk a distance of several football fields to get water. We encountered two dozen guests and probably four dozen workers. We also encountered a sign that said “Please do not provoke the camels.” Whhhaaa? But that question was soon answered.

Where am I?

Can you imagine? One day these camels woke up to find themselves in lush, sub-Saharan Africa walking alongside local monkeys.

Little friend

Gorgeous setting, though, and we whiled away much of the day on the beach before setting back to Mangochi, listening to the excited calls of “Azungus, Azungus!” (white people) from children as we walked past their huts.

Houses near Sun 'n Sand

Laundry day

It is time to face Laundry Day. We have laundry facilities, which I am grateful for. As fun as washing laundry at the Boro Hole (pump) might be, I am glad I don’t have to lug my wet, clean(ish) laundry across the hospital campus to the drying lines. Handily, there are lines just out the door from the washing sink. This is what we call laundry facilities.

Washing machine

So, armed with my detergent from the local grocery, I set out to work. But I realize that my idea of hand washing is to fill a sink with suds and water, swish, swish, swish and rinse, but there’s no stopper here. It occurs to me that I am imitating a washing machine, and perhaps it should be the other way around? I scrub the first shirt and then decide that much of our laundry isn’t as dirty as I thought and I refold it. Wah lah! Half of the laundry is already finished!

I observe the Amayis (mamas) at the pump later that day and discover that they plug the drain hole with old plastic bags – aha! That makes the next laundry attempt a bit more effective. But, I’m sure I have a ways to go. Memory, the guard who is stationed outside our building, followed our friend Charlotte into the laundry, stood over her shoulder while she worked and exclaimed “I think you are being lazy!” and pushed Charlotte aside to do it herself. Ironic, I think, since Memory spends the vast majority of each shift lounging in her chair or sprawled on the ground waiting to see what funny thing the Azungus (white people, that’s us) will do next.

Life is in the journey

If life is all about the journey, we are really living! The short of it is that we have arrived in Mangochi, safe and sound after four long days of travel. The long of it is in the paragraphs below…

One of the biggest reasons I wanted to blog on this trip was because I had trouble finding resources for traveling 1. With kids 2. Without money 3. To this area. So, I will start by emphasizing that the best way to describe the journey is to borrow a little vernacular from the tween crowd and say…O  M  G.

We left Columbia Sunday afternoon at 3:30 pm. An overnight in STL and then off to the airport at 5:30 am where we caught our flight to DC. May I recommend the proximate Air and Space Smithsonian (offsite from the Smithsonian campus) for long layovers at Dulles? It’s essentially two ginormous hangers full of flying contraptions, which were pretty cool.

Now, one of the greatest advances in air travel (aside from the Concorde, which is moot now, anyway) is the inflight entertainment system. Except when it doesn’t work, like on this trip across the ocean. No movies, no games, and in an engineering genius move, it also meant that the cabin lights stayed on until 2am because they were controlled by the same system. Yikes. Eventually, we arrived in Johannesburg (happy birthday, Grant!), where we slept at a lovely Inn from 10:30 pm until 2 am, which was when the kids decided to wake up for the day. Double yikes.

On to Malawi on Wednesday morning, where we stayed at a hostel that caters to other long-haired freaky people.

The bus to Mangochi leaves at 6 am, so we were there, bright and early on Thursday morning. In developing nation fashion, we waited until we were loaded with at least 2 people for every seat before we left. Thank goodness, because after 4.5 hours sitting on a hot, fragrant bus listening to Mark singing “I’ve got two tickets to paradise….” we were all ready to move on.

Mangochi seems to be a fine place to reside the next 4-6 weeks. The hospital staff is working to make us comfortable and we are walking a fine line between being culturally reasonable while meeting some basic needs for the kids. Getting a fan is a first order of business today, cost be damned, as we don’t recall ever having been as hot as we were last night.

Early comments from the kids:
Grant: “ It’s a little bit embarrassing, but kind of cool, to always get attention because you’re different.”
Lydia: “I think we should move to Africa until Grant, Iris and me are grown-ups.”
Iris: “Milk.  Milk.”

Be back with an update soon.

The bus ride to Mangochi

Playing in the rain in Blantyre

This is how we roll

Most little boys would not rate a 17hr plane ride as their numero uno choice for a birthday party celebration. I'll pack some cookies and all, but let's face it...Grant's kinda getting a bad deal for his seventh birthday.

He's been a good sport about the whole thing, though, and so we did a little early celebrating with some buddies at the bowling alley. Now, nothing says fun for grownups like watching 7yr-olds bowl...for 1.5 hours...10 painfully slow frames. But, they loved it, and Grant was a happy boy. Can't believe he's almost seven. Sniffle.

Side note: Gerbes' balloons rule. Seriously, even the latex ones are still bouncing along our ceilings after a week.

From the mouths of babes

Just for kicks, I thought I'd get my kids' impressions of Malawi before we head off. I asked 4yo Lydia what she was most excited about for our upcoming trip. She exclaimed "I can't wait to see whales!," threw her arms in the air and demonstrated a lovely pirouette. Looks like my "learning through play" education model is taking a hit on this one, seeing how Malawi is a land-locked country (however, it appears the ballet money has been well spent). Guess we'll have to have a structured lesson on the definition of "land-locked."

19mo Iris was next. "What do think will be the best thing about being in Africa, Wee One?" I asked. She yelled "Rabbit!," then "One, two, three, GO!" and ran from the room. Hmmmm...

My most satisfying answer came from 6yo Grant who said he was really looking forward to seeing elephants and hippos in the wild, and getting to know kids from a different part of the world. He reminded me that he's been studying Africa and African animals at the enrichment program he attends once a week, and that it should be really helpful since he can answer all our questions while we're there. I'd call him out on that, but I did need his assistance earlier with a piece of electronic equipment, so I bit my tongue.

Getting excited! Twelve days 'till lift off.

Your seat cushion as a floatation device...

When you embark on an adventure to the developing world with your three young children, there are things you're just gonna have to get over. Say, the variant level of cleanliness, lack of privacy from your children and chicken with gristle. But carseat safety?

Admittedly, I am anal when it comes to carseats. My almost-7-year-old is still in a 5-pt harness. But when you are lugging three kids and bags through 3 airports, 2 bus stations, 24 hours of flights, 21 hours of layovers, 5 hours of bus rides and 3 taxi rides (that's one way), you begin to reexamine your dedication to the carseat.


My research led me to the BubbleBum. Yes, that's the name of an inflatable booster seat that hit the States' market in July. Seriously? Why don't I just dig into the pool bag, secure a plastic innertube around my kids and call it good? But, don't let my initial skepticism fool you. The Insurance Institute for Highway Safety gives the BubbleBum it's highest rating. And reviewers are going gaga over it.

The good people of BubbleBum have agreed to send me one for our trip, so you will definitely get my full review. In the meantime, feel free to find them at bubblebum.us and drool over how small this thing gets when it deflates.

The mango worm

All I set out to do was figure out what laundry detergent works best for hand washing in cold water, and I learn all about the Mango Worm (dunh, dunh, dunnnnnnhh)...

Apparently, there's this little creature called the mango worm. Flies (aka grown-up mango worms) like to lay eggs on your damp laundry that's hung out to dry. The eggs (future baby mango worms) get all nice and toasty when you slip into your undies (or shirts, or socks) and hatch. The little worms then sneak down into your epidermis and begin consuming tiny amounts of yummy human flesh. "What's this itchy red bump?" you ponder. Oh, no worries. It's just a little worm enjoying the pleasures of the flesh. If you cut off it's oxygen (think a good coating of petroleum jelly or piece of duck tape), it eventually pokes it's little worm head out of your skin. That's when you go after it with a tweezer.

I haven't decided if this is just plain gross, or a bit fun. Maybe I could convince the mango worms to focus on an area of my anatomy where I have a <ahem> little flesh to spare.