Mary in Malawi

9 july

One week at peadiatrics have passed, and it has been an interesting week. I think I've admitted hundreds of children with measles.. As I wrote earlier, we have an epidemy here right now and people are being mass vaccinated. Unfortunately, that doesn't help the ones already sick. In sweden and Norway we all get vaccine against measles when we are little, so me and Link are safe. Wich is very good, 'cause it is impossible to isolate people here and I probobly have measels organisms everywhhere on my body and clothes.

We also have a lot of malaria, tuberculosis and burn wounds. In malawi, it is very common with grass fires, and a lot of children play close to the fires and easily gets burned. Also, a lot of them gets injured from boiling water.

What most children die from on this ward, is dehydration and malnutrition. We had a little baby coming in, a 2 years old girl. No body could give her an iv canula (venflon), it was completely impossible. So she couldn't get any fluids, and she died a few hours later.

I have 3 children on this ward I care extra much about.... They are all very sick; a girl with pneumonia + malaria, a boy with measles+pneumonia and a little boy with HIV, malnutrition, dehydration, tuberculosis and malaria. The girl, Joyce, has had to little oxygen in her blood the last week, so her brain is probobly injured. We saved her life yesterday. She couldn't breath and everyone thought she was gonna die. But I convinved a doctor to give her furosemide (diuretika/vätskedrivande) to get the fluid out of her lungs, and he let me do it. And she got much better. Now she is no longer dying, but we have to figure how to treat her and with what. She has been on iv antibiotics for over one week, and she only gets worse.

The boy with measles and pneumonia is almost the same story. The problem with this boy is that he needs oxygen treatment to survive. And to get the oxygen, he must be in the same room as the other kids, because there are no oxygen machine on the isolation room. So he is now contaminating other babies. And we xon't know how to solve it. We can't sacrifice him, but we can't let him spread measles among the severly sick childre, like Joyce. So this is a problem. We are now trying to get a oxygen machine moved to isolation, I hope it will be there on monday..

The third baby, named Akim, is 1.5 years old. He weights only 4 kilograms. He is so tiny, you could almost think he is a premature baby. He has a lot of wounds over all his body caused by HIV and malnutrition. He also has a severe vitamin A deficiency, which you can tell from his eyes. They are covered with a grey layer, almost like catharax (starr.) I gave him vitamin a and called for the doctor to check on him. The doctor says he is most likely going to die very soon. It is so sad, he is such a sweet baby. And his parents and grand parents are there all the time, praying by his bed.

There are so much sad things here... And everyone is so poor. Some patiens refuse treatment because they dont have the money to pay for it. I've seen mothers refusing treatment for there own children, cause they can't afford it. It feels so terrible inside, I could in theory pay for them... But not for everyone, and if we payed for one, everyone would come and ask... Thats the worst part herer, that you can really see that money makes all the different. If you have money, you survive. Simple as that. And it is a terrible insight, especially if you have money yourself to pay, but in the same time you know that you can't...

But I think I can try to help those I get to know, like our gardener and our maid and house guard. They are also very poor and hard working people, who tries to support a big family.

The internet is not working now, so I'm not sure when i can post this.... well well.. Tomorrow it's saturday = Lilongwe day! =) And on thuesday... tada! I'm 25! Half way to 50. Yey! =D

10 July

Eeeeeeeeeee.... Ick. Been up all night, vomitting. High fever. I didn't check my temperature, but i guess it was pretty high.. After vomitting in a plastic bag, I was so convinced that the vomit was poisonous, so I walked out in the middle of the night, trying to find our gardener (??) so he could help me burn the bag..... After walking around for a while, I realized that our gardener didn't workk during night time and that I acted crazy. So I went to bed again. Couldn't sleep though... Spent most of the night on the toilet, prepared to puke... But I didn't puke anymore. Luckily. It is really nasty.

Considered not going to lilongwe, but I felt perfectly fine in the morning so I went. It was OK, but maybe I should have stayed at home... Got really bad fever again. Took two paracetamol and went to bed at 5 pm, immediately when we came home from lilongwe. I also took a malaria test. But it was negative. Talked to doctor Rona about it, and she says that everyone who has been working in peadiatrics had been very sick, even malawians. And where do I work? Peadiatrics! =) So she said it is probobly something viral, but nothing we can do anything about. Just sleep and drink lots of water. So thats what I will do...

I would also like to make an announcement; Goats are the most stupid animal on earth. When a car comes, driving stright against them, the goat acknowledge the car and starts to run around confused in the middle of the road, and then stops in the middle. And gets hit. Everytime! They never realize that they can run away from the road. They just stays in the middle. And sometimes they stand by the side of the road, watching the cars. And just when a car passes, the goat runs out in front of it. They're extremely stupid. Or maybe suicidal... I don't know. As you can guess from this blog entry, we have A LOT of goats in Nkhoma. They're everywhere! And people transport them in hideous ways... They lay them on top of each other, and ties them to the back of their bikes. And bike like that, with the goats screaming. For hours. It's really sad to watch... But here, goats are food, and thats about it...

Also I think we had a big pig sale yesterday.. People where coming from the hospital with live pigs on their backs... We stopped and said hello to a lady with a pig, and I petted the pig. Og, how they laughed! Musungo, musungo.... hehe. Musungo means ”white people”, and we hear it a lot when we do something considered strange....Like petting the food, for example...

11 July

Sunday! Felt much better today, think that the long hours of sleeping and the (too?) high doses of paracetamol and ibuprofen cured me.. So we went to Dedza. A village about one hour car drive from Nkhoma. They had a pottery there, where they sold hand made ceramic pieces. It was really nice! And they had a good restaurant. We also went up on Dedza mountain, about 2100 metres above sea level. Nice!

I also went back to the hospital to check on the little baby with malnutrition.. But he was dead. He died the same day we admitted him. His mother had taken him home. This means, she ties him to her back and she walks. No matter how far. They always carry their dead. It is very rare that anyone can pay for a special transport, and it is not allowed to bring dead bodies on the minibuses. So almost everyone has to walk. This baby came from Dedza, and as I mentioned before, it is one hour car drive... Imagine walking.. with your dead baby on your back. Terrible.

And they also carry their dead adults... It is difficult even to imagine...

But when they die here, at the hospital, it is pretty amazing.. when we confirm that someone is dead, all the guardians starts to cry loud and open. And the other patients and their guardian also join. So everyone kind of shares the sorrow.. Then we clean the body, and wrapps it in blankets the guardins have. And then everyone in the room has to be quiet, and we pray together. One of the nurses prays loudly, and everyone else joins her och stays quiet. It is actually really beautiful.. And then we take the body to the morgue, and everyone we pass on the way there, rises up and either follow or bow and pray. Some starts singing. I remember a lady who died two weeks ago.. She had about 5 guardians at the hospital. But when we reached the morgue, about 40 people walked behind her body. Singing, praying or crying. A lot of them didn't even know her. It felt worthy, it felt like everyone showed their respect and shared the burden.. This is something that would never happen at home..

Aaaaa the internet is unusually slow today... one hour to open an email... gaaah.....

I must excuse myself, I've not been very good at answering emails.. Sorry about that. But that is because it takes so long time. Today my focus is to check my internet bank... And that takes all my energy... Hopefully I get to post this.... Would be lovely to check my facebook. I can see that i have some messages there. But i can't open them. It is extremely frustrating... Does anyone remeber when internet was new, very few people had it?? I remember it... But I can't imagine it. Strange, huh?