Mary in Malawi

First of all, thanks to everyone who has written emails and who made comments on my blogg! =) I love to get comments! Unfortunately is it not possible to respond to the comments.. But keep posting them, I love to read them! =) And also thanks to mum, christian and Sofia for sending my packages! =) sofia sent me a movie. I only say: Never see movies recommended by my sister...... If you're not up for one week without sleeping and years of therapy, I mean..... Me and Link where sitting petrified and nauseaus when watching "the human centipede"....It was a really mentally disturbing movie. Don't watch it. don't even google it. Let it's creator stay unknown to the world.. ;) awful awful awful awful.

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Today I donated blood. It hurt really bad, everyone who says anything else just tries to play cool. But i ain't to pride to bow. It hurts. Ick. And because I have a rare blood group they kind of drained me, hehe...They took 600 mls over 5 minutes. At home you give 300 mls over 30 minutes.. But well, it feels ok and I will definately do it again, and I had a high hb, 15 g/dl! So I can probobly give sooner than recommended. The blood I gave today will be given to a specific woman in medical ward. It is fun to know where it goes.. =) You never know that at home. And at home, they also mix red blood cells from many different people in the same bag. Here, you fill a bag of blood from one person, and you give it to the patient. No mixing, no dividing into blood cells. Just full blood. Straight from the cow... ;-)

Immigration are continuing bugging us. Thrid time there, they still won't accept our papers. They say new things everytime, new signatures we need, new letters etc etc.. This is actually the face of corruption. They know that if they keep being difficult like this, white people will finally bribe them to accept their papers. But we're refusing to fall for that, so we just keep on collecting every stupid thing they ask for. We have now got everyone important at the hospital to back us up, write them letters, and one of them will follow us there next time to help us. It is just so annoying... You come to country to help people, and all you get from the government is trubble and people trying to steel your money.

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Some of the staff members are not really willing to to do the triage. Before they didn't do anything about it, and now they suddenly have to look at a lot of patiens and take decisions. They are annoyed with us and want to go back to ”the old system”. I.e, no system at all. So right now it feels like trying to get water to run upwards.... Or trying to swim in thick syrup. But I guess these are obstacles everyone who tries to introduce something new to a place like this will meet.. But that doesn't make it less frustrating...I think a problem is also that we who are from the western part of the world are used to handle in a certain way in emergency situations. We are used -and trained- to take control, make sure everything is done and get the patient stablized. Here they are used to another way of working, and they don't really have thee same emergency thinking as we do. But I think it's a kind of cooping mechanism. There are so many terrible things here, and so many deaths compared to home. So I think that people who live here all their lives have to make a bigger distance between themselves and the patients than we do at home. Im also feeling it.. Iif I would take everything in and take it with me home, i would never sleep or relax...

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Yesterday we got a patient with poisoning. He was almost dead, I couldn't feel his pulse and I couldn't decide wether he was breathinng or not. We got iv in, gave him fluides and atropin to get his heart to work faster. I took his blood pressure and it was 60 / 30 (VERY low). He had a lot of secretion, and needed oxygen immediately. We took him up to the ward, and as of now he has still not woken up. Blodd pressure is better, but it is very uncertain if he is going to live or not..

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In OPD, as far as the triage is being done it actually works well. Yesterday I located at least three small babies in line that where in immediate need of attention to survive. One of them was only 1 week old and was basically not breathing. Fever up to almost 40. I took the baby from the mother and ran up to pediatric to put the baby on oxygen. He is still there, hopefully he will be allright. But it is very uncertain. The onlöy oxygen concentrator available was the one in the isolation ward, where we keep all the measles cases. the baby allready had malnutrion, and probobly pneumonia.. And being in the measles ward.. he will probobly end up with measles as well. But the alternative was to let him die from hypoxia... So sometime here you just have to choose the least bad out of two bad options...

Oh, right now there are a lot of people passing the office. A child just died in pediatric ward. First the mother of the baby walked alone all around the hospital, singing and crying out loud that her baby died. Then she went to get her baby, and everyone at the ward, all the guardians to all the other patients are following her in a sort of cortege.. Some are crying and some are singing. Everyone they are passing either joins them or starts singing. I really think it is a beautiful thing. They care about each other and they show their respect for the mother and the dead baby.. In a way, this is a complete contradiction to what I just wrote about.. But i think that it is the hospital people who needs to make a distance, not others.

Aa I need to ask Link what baby that died.. She is on pediatric today, so she got up all the babies I sent there. I really hope it is not "my" baby, the one I had to put in the measles room...=(

Ok, enough bad things... Good thing!!:

CHRSITIAN IS COMING WITHING TWO WEEKS!!!!!! =)=)=)

it will be amazing to finally have him here... I won't let him go back home! <3

Åh, just det.. Mamma, kan du kolla upp flygbiljetter till mig för julen? Måste boka nu innan det blir för dyrt. Internet här är fantastiskt segt, det går inte att genomföra några internetköp... =(  tack tack! =)

As you can see, I have got my hair done! =) It took 12 hours and was very painful. But it was really nice, I was in the home of a young lady who made them for me. Her house was about 6 square meters, and there lived 5 people in there; Grace (who made the braids), her mother and her three children and her sister. Her husband was dead. They where all sleeping on the same mat made out of grass. They cooked  directely on the floor on burning char cole, but she made a delicious meal, Nsima with meat stew. I think she made the meat especially for me, the malawians have a incredible hospitality. even though they have nothing, they want to give you the best they have. We ate with our hands (the way we actually always eat here), sitting on the floor. No plates. But it was really cozy. the only light source in the house was the burning char cole.  And they taught me a lot of chichewa =) For the 12 hours of work making my hair, she wanted 1500 Kwatcha. That is about 5 dollars. I payed her 6000 kwatcha, about 30 dollars. That is enough to feed her family for a month. At home, the hair saloons take 300 dollars to make hair like this... That would be...  53 000 Kwatcha.
On this picture is Agogo (= means grandmother in chichewa) in the background, Grace's sister and two of her children, Alice and Esther.



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Today I've been 25 years for four weeks, and I've been in Malawi for exactly 2 months. That's actually 20 percent of the time! Only 80 percent to go... ;)

I think it might be time to give you an update on our project. The project team consists of myself, Link, Dr. Morton, Mr. Sam, Dr. Ter Haar, the Matron and Florence. Florence is a nurse who is in charge of OPD, where the new emergency ward will be located. We have in the group decided all the pracical things; what rooms to use, what equippment to put where, what renovations needs to be done etc... So we are really starting from scratch. And it actually feels really good, because we really get to litterally build something.. From nothing into Something. Something that will work and save lives. That's what will happen. And it's really cool to be such a big part of it. Without me and Link, this wouldn't happen because there are no people to do it.

Me and Florence have this week and last week started to introduce a triage system. As of before, the patients that came to the hospital where organized from what time they came, and everyone was taken in according to time. This resulted in a lot of unnecessary deaths in the queue. What we have started now, is to stand outside the hospital reception and examine every patient that comes, and assort them according to their condition.Allready this small change is making a lot of difference. Monday for example. I found at least 3 infants with 40 C fever in line. One of them where gasping for air, and another one severely anemic. The kids are tied to the mothers backs, so if you don't look closely, you won't even see if the baby is alive. Anyway, I got the babies immediately to the medical assistens who admitted them, so we could start immediate treatment. These babies would probobly be dead today if we hadn't started this.

Ok, over to other updates..

Last week I came in to maternity, looking for something, and suddenly a patient fell on me. She hit her head in a shelf but I was able to catch her before she fell down on the floor. She had just delivered, and was not supposed to walk. She had severe bleedings, it was blood all over the floor. She was confused and had really low blood pressure. All the beds where taken, so we had to treat her on the floor. I put in an IV cannula and hung up some ringer lactate. Two nurse student took over, because we also had a woman delivering on the floor (Yep, when there are no more beds, we put the patients on the floor. No mattress, no nothing. A black plastic bag, if they're lucky). So me and Rebecca (med. Student from england) started examine her. She was in heavy labour, and 9 cm open. But the babies head was not coming down. We worked with her for about an hour, but in the end we had to take her to theater for a c-section. I was acutally a litlte proud, because both these ladies had really difficult veins, and I managed to give both of them grey cannulas... Those of you who work as nurses know what that will say... but for everyone else: Grey is the biggest cannula you can find! I've never done the grey cannulas before, so that was cool.

Do you remeber the girl a wrote about long time ago, a 13 year old girld with kidney failure... It was my first day at work here, and she was almost dying. We took her in ambulance to Lilongwe to get her on dialysis, and it was kind of an adventure.. I really experienced that things takes time, and it was really frustrating.. We had this really sick girl, and noone at the hospital in lilongwe seemed to care ann it was really difficult to get her help.

Anyway, she did get help that day, and that was really good. She got a lot better.. But now, last week I think, I got the messsage from Dr. Rhona who had been in cantact with someone she knew at lilongwe hospital, that the girl had died. She had not been given dialysis as often as she needed, and a kidney transplant is not even to think about in Malawi. Her name was Olivia... She was a girl who died because she was here, she would not have died at home. She died becasue there is no resources here, no money, no nothing. Everything is so easy in a country that has money. Sweden, Norway... We complain over the healthcare, money, taxes... But really, we have no problems. Not compared to Malawi.

The people here are so poor. Our gardener for example. He earns 6000 Kwatcha a month. That is 240 norweigan crowns, about 20 dollars. For those money, he supports his entire family. Three children, his wife, his father, his mother, his parernts in law and sometimes his brother. Could you imagine that? We give the people that work for us extra money from time to time, and when they need something like hospital care or new boots, we make sure they get it.. But they need so much, and I really feel bad when they see everything we have. And everyone you meet asks you for assistans. Mostly money, but some asks for food, or clothes.. childrens asks for toys, cause they don't have any toys. Most people here have never seen a movie, or used a cooking plate.. things we take for granted. If we could just look beyond ouselves and our egoistic needs, we could all help countries like Malawi. It is so easy to support for example a child. You can send 10 dollar every month, and actually improve their lives A LOT. 10 dollars is 2500 kwatcha. For that a family can eat for a month. Or buy school books for their children for a year. For them it is a lot of money. But for us, it's so little...

I would really encourage everyone to help.. It is so easy to fall in a trap of comfort at home.. At home, we know, we are very aware that people are starving and dying in a lot of developing countries. But we choose to close our eyes, cause if we can't see it, it eon't hurt us... If we accept that there is messery and poverty, and starts thinking about it, we feel pain and we get sad. That's why noone wants to really acknowledge what's happening. We choose to not see and listen. But I tell you, I am down here now. You all know me, and I can tell you, that people are suffering. I see it with my own eyes, and I tuch it with my own hands. Everyday, It's impossible to escape from it here. And I want you all to try to look beyond yourself. Have you seen the movie (or read the book) ”the beach”? Anyway, there is a guy who gets bitten by a shark. And when he gets really sick, the inhabitants of the beach bring him out in the woods and leave him there to die, alone. And then they continue their lives as if nothing had happend. This is exactly the same thing we all do, also me, at home. We turn of the TV, or we say ”to bad” and we don't do anything. We continue our lives as if nothing happend. It the same thing, we leave people to suffer, even though we actually can help. With very little effort. If everyone just came out of their nutshells and actually reacted so much could be different, But we can't wait for someone else to do it, we must all help.
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AND OOO I FORGOT! =) We have got border cllie puppies!!! =D Mr. Ter Haar came back from his vacation with a pregnant lady border collie. She delivered the same day they came home, so noww Spot has a new wife and 7 steph children!!! I so much wants to bring one home, they are completely adorable. Does anyone know the price to bring a dog to norway?

First of all, CONGRATULATIONS to Link who turns 29 today! =D Hipp hipp hurra!!!

And to my english readers... If I have any(?) could you give me a comment? Otherwise I wll start writing in swedish i think... ;) To make it easier for my dear swedes who might not understand english... ;)

What has happend since last time?? To far between the internet times..... ;)

Saturday I attended a traditional wedding! IT was really nice, the bride was beautiful and everybody danced all the time. Most of the time it was all about people throwing money att the newly  married, to helt them start their family. and everyone who gave money had to dance, hehe... ;) It was quit fun!
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On Sunday i visited a friend of mine in her home. Her name is Tivious and she lives in a little house with her husband and their daughter christina. she cooked Nsima with meat stew on burning charcole. She actually took the burning cole in her hands without making a sound.. Aaa you should see these women here! The malawian women seriously don't feel pain, or they have really learned to control it.  You should see the labourward in the hospital. None of the women makes a sound while giving birth. Not even the first timers. They just bite their cheeks together and delivers a baby. That's so cool.  I told them, that at home everyone SCREAMS out loud. And they couldn't stop laughing..


 Tivious making Nzima =)

And I was "helping" ;)




AND I have a new nursing uniform!! =D Norway, sweden, read  and weap... Our uniforms here are so LOVELY! Skirts and dresses, nice little hats and epilets! =)  At home we dress in... pyjamas!! There is nothing wrong with looking nice at work! You don't have to be ugly to be professional =)








Now she 7 pm, and im knocking of from work. going home to celebrate Links birthday with pizza and cake!!! NICE!

Mogonebwiono! =) (goodnight!)