June 19, 2003
Embangweni #10
Hello to everyone!
It has been a very long time since our last general email. I
guess that indicates that life here is getting busier and busier
for us. We did have an opportunity last weekend to go with Dr.
Sommers (Martha) and a Malawian nurse to Kasungu National Park
to see wildlife and to rest. It was quite beautiful and we did
see many elephants, hippos, antelope etc. Not as many as South
Lwangwa in Zambia, however.
Today we were reminded in a big way about the dangers of driving
in Malawi. Sara, Lara, and Aillie (from UK) were in an accident
driving Dr. Maclean's car on the Perikesi Road. They are OK, but
the car is totaled, I think. They lost control and flipped the
car. Sara needed stitches in her arm and all were bruised and
scratched. When we saw the car, we realized that it was truly
a miracle that they survived. Tonight, Bill has taken them to
Mzimba to the police station to do a report on the accident. Sara
and Lara are here doing volunteer work with children. Their term
will be up in three weeks. Aillie is a guest of one the Scottish
teachers, and she is due to leave soon. Bill and I have felt like
parents to them at times. They came over this afternoon and just
curled up on a bed and tried to get over their shaking. We think
that the steering malfunctioned as it was a very old LandRover
and has had many problems. God has indeed protected them. Malawian
friends have been coming over to see them or to see about them
and several men went with Bill to bring the vehicle back.
Mr. Zgombo, the head of maintenance, which includes the ambulances
and other vehicles, went with them to Mzimba just to help out
if translation was needed and the Embangweni policeman went too.
Everyone has been so concerned for them. In fact, it has not been
a good couple of weeks on the road. Last week, Dr. Lungu, from
Ekwendeni, wrecked his prize little red pickup truck down near
Blantyre somewhere (no one seriously hurt) and at the weekend,
Rev. Mwale, on his little red and white motor bike, collided with
a young kid who was flying down the hill on a bicycle with no
brakes. Rev. Mwale was only bruised up some but the kid had two
broken bones in one leg and a cracked rib.
Every day when we get up to go to work we wonder what new and
different thing God will find to use us for. Today it was as surrogate
parents. Yesterday it was to sort out budget problems or to fix
problems in a difficult mobile clinic. Next week, I will have
to do a presentation to medical staff on antiretroviral medications.
There are women and children camped out all day in the grass all
over the hospital grounds and just speaking to them and seeing
their smiles (that this nurse noticed them and tried to talk in
their language) is a very rewarding thing. The children are beautiful
and so shy of people with white skin. Sometimes, however, one
can get them to answer when asked muli uli or how are you? I would
love to pick them up and do sometimes if they seem like they will
not scream in fear!
In clinic last week, I had a very sad experience with a patient
who was expecting her first baby. After measuring the height of
her fundus, I found that she had not grown in size in the last
seven weeks. Then I was unable to find a fetal heartbeat even
with the dopler sent by St. Andrew Presbyterian. She felt fine,
but admitted that she had not felt her baby move for a long time.
It was obvious that the baby had died and I sent her to labor
and delivery where labor was induced and the baby was born dead.
If she went a lot longer without being seen, she would have had
a major infection problem as I remember from a surgery I scrubbed
in for in Congo with my father-in-law many years ago. These things
happen far too often here and are so heartbreaking.
For those who may have been put off by our last discussion of
setting up long-term trust funds for anti-retroviral (ARV) drugs
for hospital staff, we have a bit of good news. There seems to
be some general feeling that such trust funds are not really necessary
and that anyone who wants to help underwrite $20 per month for
somone—even in the short term—could still make a wonderful
contribution. In fact, we have already received one such pledge!
The thinking seems to be that ARV prices will continue to drop
and may eventually be provided free of charge, making the long-term
commitment unnecessary.
Hospital administration has been all about finances lately. We
are working on the 2004 budget (the fiscal year begins in July),
which we are currently projecting at about 27 million Malawian
Kwacha. At a 90:1 exchange rate, that is about $300,000. Last
year it was 20 million Kwacha. Imagine such an annual budget for
a hospital of 80 beds! The biggest chunk goes for salaries for
a staff of just over 100; the next biggest chunk goes for fuel
and ambulance operating costs in this country where diesel is
62 Kwacha per liter (about $2.75 per gallon) and so much of our
work is done through mobile clinics to the villages. Drugs come
in a poor third. We are budgeting only about $25,000 in hopes
of receiving many of our supplies through donations, but past
experience has been that drugs and supplies should run about double
that number. At the moment we are elated because we actually have
prospects for a total of about $37,000—for the whole budget!
Loaves and fishes, anyone?!
Reverend Joseph P. V. Mwale
We will close this over-long and overdue letter now with another
of our little bio-sketches. This one is on Reverend Mwale—he
of the red and white motorcycle mentioned above. A picture of
him and Mrs. Mwale is attached. |
