Posts Tagged malawi

Guest entry: Colin Dewar

Colin Dewar is a consultant psychiatrist and friend from Falkirk in Scotland, who came to visit recently for ten days. I asked him if he wanted to contribute to my blog, and I’m delighted to say that he agreed! A new person’s eyes and observations are always interesting and welcome.

When people say that Malawi is a beautiful country they don’t say whether for mountains, lakes or plains, even though it has all of these. My first impression was of greenness, much of it from maize that surges from the ground during the rainy season. There are a few trees left after deforestation, wherever the land is not cultivated, as on a few rocky hillocks where goats graze. P1040472

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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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Minibus capers in Lilongwe

While I’m in Lilongwe visiting the psychiatry wards at Bottom Hospital (so called because it is not the Top Hospital), I’m staying again at Paul and Sarah’s, a lovely hospitable Irish VSO couple. The minibus this afternoon from town centre to their house in the suburbs was interesting. In the taxi rank next to Shoprite I walked up and down looking for the bus with the “49” sign in the front window, indicating the area the bus is heading to. All of Lilongwe is divided into areas, like any city, but instead of giving them names, like Newlands or Marchmont or Hampstead, they’ve got numbers, which are difficult to remember. Are Paul and Sarah in Area 49, or was it Area 47?  Easy to make a mistake. And the numbering system is fairly random, with no apparent ordering. The general consensus is that each new area which was populated got the next consecutive number, as there is a trend for the lower numbers to be nearer the centre. But Area 49 and Area 47 could be on opposite sides of the city, so the distinction is important. Anyway, as I walked up and down the taxi rank, I saw one minibus which was especially decrepit, banged and dented, with dirty smeared plastic sheeting hanging over the door in a poor attempt at a window. Read the rest of this entry »

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The Greening

When I first arrived in Malawi in September, it was nearing the end of the dry season. There had been almost no rain for six months, and the ground was dusty and dry, hard and hot. I’ve written previously about the rains, and now as I approach the end of my time here, they are already on the wane. But they have transformed the landscape. Ground which I thought was hard and barren has proved its fecundity by shooting forth exuberant explosions of plant life. Brown roadsides are now wild and untamed with all shades of green, all shapes of leaf. The landscape from a distance looks soft and springy and inviting. Maize erupts from the ground with astonishing speed, and will feed the country for the next year. Ironically, despite all this fertility and life, January and February are the so-called “hungry months”, as last year’s stores are used up, and the current crop is not yet ready for harvesting. The country is green and beautiful, and below I’ve put some photos up which I hope will show this. There are lots of photos – don’t get bored. (If you click on the smaller photos I think you should see bigger versions of them.) Read the rest of this entry »

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What can be carried on the back of a bicycle?

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Christmas at Cape Maclear… well, almost.

As I sat eating my Christmas lunch on Christmas Day I considered again the events which had led me there. It had all started with my motorbike, really.

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Buying a motorbike in Malawi…

… is not as easy as it sounds. Almost all the bikes are 125cc off-road bikes, with Yamaha being the most popular, followed by Honda, Suzuki and a few lesser known makes. There are some 175cc and 200cc bikes, but they’re rare. So the choice is not very large, but in fact the small-engine off-road bikes are the best choice anyway, as one is bound to be riding in the dirt at some time or other. The challenge is not to fall into the dirt! A new Yamaha DT 125cc, the bike we learnt on with VSO, costs a cool K850,000 at the only dealership in Malawi. That’s about £4000 – and more than twice the price of the same bike in South Africa. The import duties in Malawi apparently almost double the price of vehicles, though I was still shocked that a new very basic bike could cost this much. VSO have suggested that I apply for a grant for up to £1000 to buy the bike for work transport, in which case it is theirs once I leave. This is fantastic, but it limits my budget to something much more modest.

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