Preparing for goodbyes

My time in Malawi is rapidly running out, with only four working days left! I can hardly believe it, and although time has flown, it also feels like I’ve been here a while as there has been so much happening, especially latterly. There is so much I would like to write about but probably never will, and even tonight the posts I’m putting up are a bit backdated… But I do hope that what I’ve written has given a bit of a flavour of what it’s been like to live and work here in Malawi.

New posts tonight:

1 November – ICT 2: We’re not alone
7 November – Motorbike Training
8 November – Are we doing anything useful here?
27 November – Sometimes I wish I could just stand and watch

February began with the arrival of Colin Dewar, a psychiatrist colleague and friend from Falkirk in Scotland, who came to see how psychiatry was done in Malawi. Colin stayed for just over a week and fitted into our busy house very well. His trip of ten days was short indeed, limited by the practical constraints of a fulltime NHS job, but we managed to pack a lot in!

The first weekend of Feb I visited Lake Malawi again, with the group of Scottish psychiatrists sent by SMMHEP to help with the annual teaching of psychiatry to medical students. All five psychiatric visitors are staying with Rob in Blantyre, his house now having become a bit of a commune. We all drove up to Cape Maclear (where I was for Christmas, almost) and shared a single large dorm room. Eight psychiatrists in a single dorm room works surprisingly well, but maybe only because they’re a fairly good-natured bunch. The Gecko Lounge at Cape Maclear was once again wonderfully relaxing, and Colin joined us on the first night straight off the airplane from freezing Scotland. I completed my PADI Open Water course, and Colin went snorkelling next to the island. Colin is a keeper of tropical fish back home in Scotland, so snorkelling amongst the brightly coloured (and expensive for collectors) Malawian cichlids was especially rewarding for him. His excitement was infectious and rewarding for me too.

P1040250_1Back at Zomba Mental Hospital, Colin joined me in ward rounds, and I found it very useful and instructive to have a fresh person’s view of what goes on. I am so often bewildered by the psychiatric presentations of patients in the hospital, and they appear so different from what I was used to in Scotland. So Colin’s comments and experienced ear were “most welcome”, as the Malawians say. I just wish he had visited earlier! Colin also took on a daily special task of tutoring the new Clinical Officers who have recently started working at the hospital. They are officially permanent staff, and they are “clinicians”, sorely needed and only just in time. I leave in a few days, and then my role will have to be taken by one of the new Clinical Officers. They do five weeks of psychiatry in their third (final) year, and that’s all. They are very keen but without any post-graduate psychiatric training. Our overlap at the hospital will be almost foP1040347-P1040348_1ur weeks – so very short! So I’ve been trying to focus my teaching efforts on any of the new CO’s I could find over the past three weeks, but haven’t had time for extra formal tutorials. Enter Colin (photo left)! He met with them (and sundry nursing and other students who wander in) every day, discussing psychiatric history taking, mental state examination and other basics. This is very valuable input, and gratifying for Colin as well I think.

P1040331_1   Colin dared to ride
  on the back of my
  bike to work some
  mornings!

  That’s our house in
  the background on
  the right.

P1040273_1 This is my favourite old lady in the market. She always has an energetic smile (except when photographed, apparently), and she takes delight in speaking Chichewa slowly to me. We have the same banter every time, and I usually buy her beans or ochra.

The final weekend we went up Mulanje, staying over in Chambe Hut on the plateau on Saturday evening. It was a big party – 15 in all I think – including the SMMHEP psychiatrists and Rob; Annie, Becca and Caroline (ABC – the English med students); Chris and Sameen (two new friends in Zomba); Noel and Denise (who is the third housemate now – moved in two weeks ago). The group worked very well, and I’ll put some photos up in the next day or two… I hope!

P1040437_1
   The Mulanje crowd at Chambe Hut.

Then on the Monday we had to say a sad goodbye to ABC, who’ve really livened our lives up here in Zomba over the past weeks. Noel and I will miss them, but I look forward to visiting them in London in March briefly. Tuesday morning saw Colin leaving early to catch a flight in Lilongwe later the same day. His was a brief but fairly intense visit, and I’ve enjoyed our discussions about natural history and psychiatry.

Which brings us up to last week. I’m sure there was some sort of party or dinner, but I can’t remember exactly which one now. I write this now, snatching a much-needed quiet evening to update my blog and catch up on some admin. I returned this morning from a little psychiatric outreach trip to Ntcheu District Hospital (invited by Ilona, a VSO doctor) and Bottom Hospital in Lilongwe (suggested by Felix at Zomba Mental), both trips doing some teaching and clinical work. I’d like to write about this trip, and it’s frustrations and modest successes, but I’ll leave it for another time. Now, I need to sleep!

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1 Comment »

  1. Rosemary Stewart said

    Dear Gareth

    I am going to miss all your wonderful accounts of life in Malawi. You should write a book! I do hope that you will add more sometime and maybe even keep us entertained with life in South Africa.

    All the very best for your future training. It was fun to meet you and I’ll always remember that delicious braai cooked out on Robert’s chicken house.

    Best wishes

    Rosemary

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