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Trip Start Sep 12, 2009 Previous
Entry Trip End Dec 09, 2009

  Nkhata Bay, Nkhata Bay, Malawi
Tuesday, December 1, 2009

Back again folks, the blogs catching up a bit now after being way behind for a while and we're nearing the end of our time here. We're on our way up north to fly home, stopped in a very chilled little place called Nkhata bay. Thought this would be a good time to update and fill in my take on Monkey Bay, it might repeat some of the stuff kirsty's already mentioned but hopefully not too much.
    Although some aspects of the hospital work there were good, i think we were both pretty glad to see the back of Mangochi. I was pretty desperate to get settled in one place for a while too cos we kept moving to different accommodation with our masses of gear and were still humping around a big bag of medical supplies we'd brought for Monkey Bay which had become the bain of my life. As Kirsty mentioned we stayed at a place called Venice Beach which I'd arranged in advance with the guy who ran the place. It's a Malawian owned backpackers on the best bit of beach around Monkey Bay and we'd secured the best room - two floors, bed upstairs, bathroom downstairs and two hammocks outside on the upstairs decking. All for the paltry sum of 500 kwacha a night - just under 2 quid. We could use the kitchen and nip behind the bar for drinks whenever we pleased. The beach there is beautiful (the guys that work there rake the sand clear of footprints and leaves every morning). The lakes dead calm most of the time and the perfect temperature for cooling off but not too cool to cause any shrinkage like a giant luke warm bath. It was a pretty amazing set-up and coming home from work to that was an absolute joy. Monkey Bay is the southern port for the ferry that goes up and down the lake (the Ilala - built in Glasgow!) and it's also the closest bus link to a very popular backpacker town called Cape Maclear. This meant that, while we were the only long term residents, there was a small but fairly regular flow of travellers staying a night or two at Venice Beach before moving on. There were people from all over the place and some pretty interesting characters. Like the heavily bearded Swiss journalist/ DJ who was going around Malawi interviewing people with weird jobs and writing about them. There were Canadians, Australians, Columbians, South Africans, Japanese you name it. Of special note though were three Dutch guys who stayed a little longer than most for various reasons. These guys registered themselves as an NGO before leaving Holland and called themselves 'The 3 Left Hands'. They took a beat up old camper van and decided to travel East from Holland through Europe then down to South Africa via Israel and Egypt. This was originally supposed to take three months and they got to Malawi after 14 months. They're all quite technically minded and they're plan was to help in various places along the way that needed it by doing things like setting up solar power, setting up websites and general maintenance and after speaking to us they decided to help out for a few days at the hospital. A really good bunch of guys, great banter and great fun.
     Venice Beach, like most things in Africa was not without a few drawbacks. For a start there's no road to it. It's about 2 kilometres off the main road through a small fishing village. To get around during our stay we'd hired a couple of bikes from some locals - mine a battered old  Indian made bone rattler made of solid steel and heavy as fuck and Kirsty's a pretty little mountain bike. On the face of it 2km to get to work on a bike is bugger all but when you factor in the searing heat and the fact that the first 500m is across deep sand that's un-cyclable and necessitates pushing the bike it becomes a total pain in the sweaty arse. The walk through the village always drew a lot of attention from the local kids. We were regularly followed by 10-20 massively excited kids absolutely fascinated by the site of, not only muzungus, but muzungus with bikes! Initially this was endearing and we'd play with the kids pretending to chase them and ignoring they're incessant chants of "give me money" that is every kid in Malawi and Tanzanias first greeting to a white person. After a while i've got to admit unfortunately that i lost tolerance and wanted to knock them all out - not cause them any real harm you understand, just knock them out a wee bit so they'd shut up as i walked through, is that really so bad?
    Another drawback was the 'kitchen' where we cooked every day. It was fairly basic, the cooker was an open fire as kirsty mentioned and this doesn't allow for much temperature control and took some getting used to. If you were near it more than 5 minutes your eyes were streaming and your lungs black from the smoke and lack of a chimney not to mention the profuse sweating from being trapped next to an inferno when it's already 35 degrees outside. We got the hang of it though and after a while were making stews, fish and rice, omelettes and baking our own bread.

    The work in Monkey Bay was quite different from Mangochi. It's a much smaller but much nicer hospital for starters. The 3 clinical officers cover about 50 000 potential patients in the area so are alittle stretched. Our go-to guy at the hospital was Mr Mazonde the most overworked man there. Although there were technically 3 clinical officers one of them was the boss and specialised in orthopaedics so only really saw orthopaedic patients and was busy with the running of the hospital most of the time. The other guy Dan was the scarlet pimpernel of Monkey Bay and was rarely seen or briefly seen in the morning only to vanish soon after. So this left the bulk of the workload up to Mr Mazonde.
    We helped out by taking care of paediatrics and when there was surgery i would help out in the small operating theatre with hernias and c-sections (much less brutal than Mangochi) and sometimes we'd help out on the adukt ward too. Mazonde had been getting pretty fed up with work (understandably cos he was getting dicked on daily) and so was pretty grateful for the extra pairs of hands, although he did have a habit of sometimes vanishing just before things were totally finished.
    In general Monkey Bay was a big improvement on Mangochi in that the staff seemed to care a bit more and for the most part did their jobs properly but it definitely wasn't without its problems. During our time there were some very satisfying and encouraging moments but an equal number of frustrating and dissapointing moments -sometimes on the same day. One day like this came during a country wide diesel shortage. All the electricity in monkey bay was off for the day due to repairs so the hospital was running on a back up generator. There was a woman in labour who had been squeezing for a very long time with no results. It was looking like the baby wasn't gonna fit out and the labour had arrested (seems to be quite common here). This basically needs a c-section fairly urgently and she'd already been sitting there like this for a dangerously long time. Normally this wouldn't be a problem - into theatre, chop it out, done. But the generator had a problem and was overheating every 20 minutes and shutting itself off. Because of this the anaesthetist wouldn't allow the procedure as if it shut off he wouldn't have any monitoring for the mother - this obviously makes thing a little more risky but it's still possible to do it he's just a lazy bastard. The other option was to send her to Mangochi for the c-section, again usually no problem but there was no fuel for the ambulance so - no go. The general consensus it seemed was to leave her and see if she managed to pop it out or , far more likely, her uterus burst and killed her and the baby. Bollocks to that, i was getting pissed off with the 'oh well' attitude that is so common and was trying to convince them to do the c-section to give them a chance because at this stage there was no way it was coming out on it's own and it was better than their plan of doing fuck all. They wouldn't listen so, i found the 3 dutch guys who were in the hospital helping with maintenence and asked if they could fix it so that all the power from the generator went to the operating theatre to hopefully get some more time out of it. After not long they worked their magic and set it up and even managed to get hold of a smaller portable generator that would give some power if the big one cut out. I went back to the anaesthetist and Mazonde and convinced them that the power would stay on and they eventually agreed. The three of us took her to theatre and got the baby out quick smart. No problems during the surgery and mother and baby fine afterwards - Joyous! I was pretty chuffed with the whole thing but it's a common theme that people around here seem to give up all too easily if things look a little difficult and they would've just left the woman there and she would've probably died with her baby. You've got to take the rough with the smooth.
    Another cracking day was the blood transfusion day but I'm sure Kirsty will go into that. All in all it was an amazing experience but I think come the end of it I was ready to leave. 
   

Kirsty

Can't believe it, thats us all done.... this time round anyway. I've taken so long to find decent internet to write my bit that its now the 8th of December, and we're home tomorrow - yey! I have to be honest I wasn't sad at all to leave Monkey Bay Hospital, the last few weeks saw us getting more and more angry with the way things were run and so many of the local people who we thought we had built up a bit of a friendship with disappointed us. First of all Alfred the guy  we made firends with and hung out with at Venice beach stole some money from us - only what equates to about a tenner but that wasn't the point. We met Alfred a few days later and told him how sad we were which seemed to really hit home, Innes never did get renamed which was even sadder. Then there was the three left hands incident. As Sye said, we became great friends with these guys in the few weeks they stayed at Venice Beach. When they arrived they spoke to Jeoff who runs the place and explained that they were a travelling NGO and they were stuck in Monkey Bay due to the fuel crisis. They had very little money as they had been travelling for so long and wanted to park there van inside Venice beach and wait for the diesel to return. They told Jeoff they couldn't afford to pay for accommodation but could they sleep outside on the beach, which was agreed. We had a great time until ten days later when the fuel was back and the guys tried to leave. Jeoff asked them for 15000 Kwatcha for their stay which they obviously refused to pay, the police were called, passports confiscated, Ishmail the manager of venice beach was arrested and jailed for hitting one of the three left hands and apparently venice beach was officially closed by the government due to health and safety problems(the manager didn't tell us about thisso really we were staying there illegally) When we left the three left hands were still stuck in Monkey Bay without their passports and a broken down camper van. Because they have refused to give in to the corrupt system here and not pay the 15000 Kwatcha they are awaiting their court hearing on the 10th of December, I really hope it works out for them - good luck Henk, Minne and Martin!

In the last few weeks in the Hospital we did have a couple of great days which does make the hard work seem a bit more worth while. The hospital does a number of outreach clinics in the timy villages of the area which we were able to help out with. In particular the clinic at Mvunguti was amazing fun. This is a tiny village about 20km away from Monkey bay, there is a small path through the moutains to reach it but most of the population travel by boat on the lake to get to monkey bay for supplies. The clinic mostly involved immunisations for under 5's, ante-natal check-ups and contraception. The contraceptiion clinic was great. We set up in one of the locals houses and a big queue of women formed. Most women there recieve the 3 monthly contracetive injection the reason being is that contraception is quite a new thing here and many of the husbands do not agree with it - the more babies the better as far as they are concerned. The women tell their husbands they are off to the under 5's clinic with their kids and then sneek into the house get a quick injection in the bum then cover their heads with a scarf and run off down the road before they get caught. Its only after a couple of years of no babies that the men realise somethings up and get a bit suspicious - ingenious!

Another highlight was restocking the hospitals blood bank. In most afrcian coutries there is no blood transfusion service so when someone needs a transfusion(this is very common due to malaria) they get the blood from the father. The problem is alot of the time the father is not around, has died or is not fit for donating. We spent a couple of days doing a blood donation campaign and managed to collect enough blood to last them a couple of months.

Anyway I will fill eveyone in on all the missing bits when we're back. Can't wait. See you all soon. xx

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Buying our tomatoes	Wee fish in the market	Jimmy the charcoal seller	Coke delivery
The long road to Mangochi	The giant's turd narrowly missed kirsty's head	Pumping	Roofer
Bicycle ambulance	Mvunguti	Rob and Sye, Mvunguti	On the way to the mobile clinic, Mvunguti
David giving blood	HIV testing	Blood donors	Soldiers donating blood
What a guy!	The moment of entry!	Three left hands	Stuck in the sand
Trying to escape	Tea time	Weekend away	Jungle boy
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