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  A letter from Beth and Bill Rule in Malawi  
             
 

July 2003

Dear Friends and Family,

We have just returned from a trip to Lilongwe by way of the lake to take our friends the Bennetts to the airport for their return trip home. Diana and Michael were here for two weeks and in that time managed to accomplish a great deal although, I suspect, not in the ways that they had planned. They both were flexible and adaptable, which are the two requirements for a good experience here in Malawi. Diana worked in clinics, mobile clinics, NRU, and went on rounds with both Dr. Sommers and Dr. Kumwana. Michael spent most of his time with Mr. Soko working on the plumbing and water problems at Embangweni. He was able to map the pipes all over the station and to find some problems, leaks, etc. Now there is a plan to correct some of the problems. We have been having very unhappy employees who have no water to their houses. It is hard to keep nurses when they are living with more primitive conditions in addition to being isolated at this station as compared with other hospitals.

 
             
 

"[I] have been very concerned about one of my co-workers whose daughter is dying of AIDS. She has been in the hospital with some sort of AIDS-related meningitis."

  Today Bill has driven a group from Embangweni to a meeting at our sister hospital at Livingstonia. It is a long drive so they will spend the night in Mzuzu and travel the rest of the way on Tuesday. Livingstonia is on top of a mountain. The road is steep with 19 or more switchbacks in it. A true test for our new “old car.” Bill was anxious to see the station there as it is older than Embangweni and has quite a beautiful church. There is a well-known tree there and stories of David Livingston meeting under it.  
             
 

I have enjoyed working with and helping Diana to have a good experience here, but have been very concerned about one of my co-workers whose daughter is dying of AIDS. She has been in the hospital with some sort of AIDS-related meningitis. My friend, D.C. (short for Dorothy C.), has been by her side day and night bathing her, trying to feed her and keeping an eye on the IV. I have visited them many times and have been very concerned for D.C., as she is completely exhausted. She doesn’t have as much family as some to help with the care. I feel quite close to D.C. as we have worked together daily for several months now and this daughter is her first born and is exactly the same age as my first born, Annie. In the clinic that leaves just two nurses so we have been a bit short again.

We are so enjoying Martha Sommers who has turned out to be a good friend as well as doctor. She has had to see about me on two occasions as my doctor as well. I am impressed with her knowledge of this culture as well as her medical knowledge, and we are so grateful that she was willing to leave her home at Ekwendeni to come here to fill in after Dr. Maclean left. Now that the young teachers from the United Kingdom have gone home, we are the only expatriates here at Embangweni.

The weather is quite cold. Warm coats are in order, but I find that my Malawian friends seem to adjust to the change without so many layers as we need. They do wear sweaters and sometimes coats, but I see the patients caregivers with just a cotton jitenge wrapped around their shoulders. They must be quite cold, but are very busy and seem unconcerned about the cold. The patients themselves have warm wool blankets on their beds. I was surprised by the cold and was very grateful to my daughter for sending some turtlenecks and sweaters with the Bennetts.

Last week as we were packing the ambulance to go to a mobile clinic at Mharaunda, a woman and her little girl climbed into the ambulance. I asked why she needed to go to Mharaunda and wanted to see her health record. She did not have it and I discovered that she was a patient in maternity waiting for hospital delivery. The conclusion from this discussion was that she had a complication and that is why she had to wait at the hospital instead of delivering in the village and that she was tired of waiting. The driver told me that “we Africans have our own ways for medicine in the villages.” She was going to the traditional healer for a potion to induce her labor. This happens a lot and causes ruptured uteruses and other problems, so I refused to take her. We took the little girl back to her village, but hoped that the woman would stay until she went into labor naturally or until she was scheduled for a C-section. The traditional healers and the elderly women in the villages who tell these women what to do are a constant problem. Our education has not reached them or is disregarded by them. We can only hope that some of the mothers listen and take our messages seriously. The power of the traditional ways is very strong.

We are well and happy here. God has blessed us with a wonderful work and a supportive community at Embangweni. But we miss all of you very much and look forward to your emails and messages. The Bennetts brought us many messages and goodies for which we are so grateful. Such things as instant oatmeal, warm clothes, letters from friends, a card from my former patients, medicine, Equal, batteries and another fetal dopler. We also received an envelope by mail from Bill’s sister Charlotte that contained Time magazines! We have read them over and over. Thank you all.

God Bless.

Beth and Bill

 
             
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