Mary in Malawi

The workshop continued, and we had a lot of subject to go through. It was very exhausting but I think it was good. People learned a lot. The most important subject of the workshop was CPR and TRIAGE. We made exercises and role plays conceringng both subjects. The staff loved it and it was amazing to see how everyone was attending and listening. A lot of things that seem soooo normal to us, that we have known since childhood, these people had never heard before. They had never tried CPR before. Can you imagine?? Heath workers without any clue of CPR.
But they really loved it, it was for sure a sucessfull workshop!! =)

And yesterday, THE GRAND FINALE! There were going to be a ceremoni. And what a ceremoni!!! The chiefs were invited, from all the villages close by, all the staffmembers, the whole management of the hospital and the team from norway, Solveig and Vigdis. There were a lot of speaches and celebration with traditional dances! And in the end, me and Link and bertha and nyathipa got to go up to the stage, and the chief and Solveig and the medical director and Sam Kabota held such a wonderful speach for us, about what we had done. It was... I cant explain it. Winning an Oscar maybe would feel like that.. Everyone was applauding and smiling, the whole staff! I never thought there would be such a big ceremoni! =D The medical director said

 "You didn't just help us start emergency care. Maria and Linn Kristin, you have been making changes in our way of thinking, and you have been changing our hearts".

It was so wonderful said! That has been our biggest task, to make the staff understand and care about the patients. We have been trying to change their attitudes, and It looks as if we are succeding! =D

Anyway, It was a Beautiful ceremoni and I think.. I will never experience something like it again. I wish I could show you the ceremoni!!  The dances were so amazing, and they were drumming... aaa! Amazing! Im Euforic!!!!

:D:D:D  Now I want to go home to Chirstian. Now Im done here. But weeeeell, seven more weeks... But that is not very long though. Soon I AM HOME!!!!


JAA!!!!!!!!!!!!!!!!!!!!!!!!!!!

21/2

A 10 year old girl died today. We were trying to resucitate her, but without sucess. I felt guilty, cause I was the one recieving her in the ER. Than I had to go to the workshop, so I left over to another nurse. Than, I went back to see if everything was ok, and I found the child unconscius in the childrens ward. The staff had allready started resucitating her. I joined with our new heart starter (defibrillator) but without success. The doctor in command did not want to listen to the heart starter, but just wanted to do her own way and then the heart starter wont work.. So everything got a bit confused. This doctor mostly seems to consider it more important the BE right than to DO right. Anyhow, the child got over all good assessment, but she died anway. But she would have died whatever happend today. She had an Hb of 2 (20, in sweden) and she had been at the traditional doctors place (witch doctor) for a whole week. The mother didn't want to take the child to the hospital, cause she thought tha child would then die. And well, she was right. She took the girl here, and she died. But that was because she was to late, and not because of anything done in the hospital. The child was bwyond rescue. It was very sad, the girl was beautiful and strong, good health.. I just felt... I should not have left her in the ER with the other nurse. I know she was very sick, but I didn't think she was that ill that she would die within an hour.. Maybe I could have realized the severity of her condition earliet, maybe I would have decided not to move her from the ER and started the nlood transfusion right there and then... But on the other hand, maybe not. And In any case, so would most likely have been dead no matter what...

I remember she cried when I put the cannula, which is a good sign. But unfortunately, I think that cry was her last. Imagine her last moments in life. Pain, and horror. A strange white face leaning over her little body, causing her pain with sharp needles without understanding why.. Fuck. I remember the mother was really stressed, and she was really worried... Aaa I dont know what to feel. If the mother had come earlier to the hospital with this beautiful, big, well nurished child, she would have been alive now. So Im feeling anger towards the fucking horrible witch doctors. I wish they could be forbidden and banished, for ever. Imagine the harm they do! Innocent people, children, die because they trust these fucking hypocrits... I am so angry there are no limits. If I could get my hands on one of these withc doctors..... I would strangle him in a heartbeat. I see all these people dying because they believe in something hurting them.... Aaaa.... Fuck!!!!!!!!!!!!

Anyway, the workshop is working well.... Solveig (our boss) and Vigdis (midwife) has come here from Noray to attend the workshop. It is very nice to have them here! Also, I last week had Sofia and Daniel here for a visit. We went to the lake (Norman Carr!!!!) and to safari in Liwonde. Good as always! But not many animals as in the dry season, but well, we saw a lot of elephants anyway. Now, Sofia and Daniel are travelling to Victoria falls. I bet it will be amazing!! I hope I can go there before I go home... It was nice to have them here... =) It feels strange showing your life here for someone from home.. It's like.. No one can really understand it. You know what I mean?

And now... SOON Home!!! Only 7 weeks left here now... Can you believe it?!? I Dont know what to feel. It will be wonderful coming home, but leave all this also feels... very sad. Horrible. It has been my home for a year. Will I be able to adapt to the work and life in Norway?? Have I been africanized? I don't know... There are so many thing I will miss...Anyway, I want to go home, so that will be amazing. I'm longing to be with Christian again..

Then I guess I will see what the future will bring.

Good night.

Yesterday was a reallt hard day in Nkhoma. Around 12, a lady came in to the ER. She had been in the hospital in the morning, just to collect some medication, and then she was on her way home. She passed the market to buy some things, and suddenly she collapsed. The husband and her oldest daughter dragged her back to the hospital, and we took her in to the ER. When she came, she had no vital signs what so ever. So I started chest compression. Stella (another nurse, malawian) came and helped my with the breaths, and called for a clinician. Nyathipa came, and another doctor from USA. Together we worked for about 45 minutes to recusitate her, but with out result. At one point, she actully had pulse and blood pressure, but it was likely just from the chest compressions we made.¨We looked at each other and asked, should we continue? No one really wanted to take the decision. Because I was the one who started, evertone turned to me and asked what I thought. I didn't know, at all. But my instinc told med that we had to stop. The others agreed, and we declared her dead.

It was so frustrationg, cause there was no reason for what had happend... She was healthy, some problems with high blood pressure, but not to much. she was only 36 and had given birth to a little baby girl just 4 days earlier. Now, the husband was left alone with 4 children to care about. They had ahd 6 children, but two of them had died from Malaria. The husband was devastated. When he had left the room, I couldn't help crying.. It just came over me. And when we transported the body to the morgue, and all the pateints followed, maybe 30 people, all crying and wailing and singing, with the husband walking next to med and the body... It was so hard and I really had to bite my teeth together to not start crying again... It is such a hard decision to take, continue resucitation or not... How do you know...?  But she was dead all ready before she came in to the ER, so I know there was no more we could have done... But it feels like shit anyway.

* * *

After, I went to Lilongwe to meet Sofia and Daniel! =D Spent a night at the luxurious hotel crossroads (LOVE IT!!!) and had a wonderful pedicure and manicure for over an hour today, in a cool salon with nice music. It was amazing! Such a contrast from the some how hard life in Nkhoma. Now we are going to check out lilongwe, and then Justice (my guardian angel!!) will pick us up and drive us back to Nkhoma. Tonight it's pizza night at Isabelles place, and tomorrow Taffy from Norman Carr picks us up and  we're going to Monkey Bay for 5 days!! YEEEAHHHH!!!!! Guess I'll write again from Norman Carr.

Kisses! Maria

One more week have past, and now we are soon down to nine weeks left! =)

We are getting in a lot of patients with dehydration and malnutrition nowadays, adn the worst case i saw... was really horrible.

I was in the emergency room, and suddenly a patient attendant came, half running, into me. she just said "I dont know if the child is aliva och dead". I looked at the child, and what I saw almost made me jump back. He was 8 years old, and he was 5 kilos. I was 5 kilos when I was born! Try to picture that, an infants weight on a 8 year old. .Try to picter skin, and bone. Nothing more. His skin was tighly strechted over his face and body, his eyes were big and the tissue around them were just two big cavities. His mouth was wide open, and full of blisters and wounds. His hair was falling off his head, and his skin was so dry it looked like pergement paper. I almost started crying just by looking at him, and I even felt a bit.. discomfort when tuching him at first. He looked dead. Ha had a body of a corpse. But I could feel tiny tiny movements in his limbs, and his eyes were moving around. He was not able to speak, he could only make little whimps. My mind was mixed, i felt anger, sorrow, disgust, frustration and warmth. I just wanted to pick him up and take him home, feed him and dress him.. Anyway, we managed to give him a nasogastric tube, a tube that goes through the nose and down in the stomach. Link managed to get an IV-cannula in on his head. We gave him fluids, but we had to do it very slowly, cause he could go into heartfailure.. I have a picture of him, but i dont even want to put it up here. It was just to sad. But two days later, when I saw him on the ward he was much betteer. Still the same skeletal body, but he sat up and he was more awake. I dont know what will happen to a child like him...


Today it is sunday, and I actually climbed a mountain! =) We went up on Nkhoma mountain, that is 1800 meters high! It was a hprrible walk, and the last 600 meters where like 75 degrees steep, so we really had to climb  with both hands and feet. Spot followed us all the way to the top! He is such a good dog.

The top was amazing, we walked straight in to a cloud, and we waited for it to move on. Everything was completely white!  When the cloud moved on,  we could see everything. We saw lilongwe, the lake, cape maclear... It was really beautiful. But well, the walk was truly terrible and I will never EVER do that again!


Now, time for dinner!

Bye bye!