The Lake

Lake Malawi is a special place. Itś home to the biggest variety of tropical fish in the world which means when you go swimming itś like being inside a giant aquarium!

Yesterday I did two dives - a deep dive and a deep night dive. The first down to 22.6m and the second to 18m... we saw lots and lots of pretty fish and some big cat fish, some cool mouth breeding fish which catch their babies in their mouths and then spit them out again (pretty cool to watch under the water!)... business is a bit slow for the dive centre in Nkhata Bay which meant it was only me diving with both the dive masters.

Back at the bar at the place I am staying I meet Ima - A british nurse currently nursing locally in Malawi. The truth about the lack of ECG machines is uncovered. Ima has an ECG machine in her office but it´s the only one in the hospital and she says she has only used it twice since she has been there. The person who had her job before she did didn´t even know how to read ECGs or to use the machine so it never got used.

Ima thought she would be using the machine every day as she has a background in ED and knows about ECG interpretation but the problem is that knowing that a person has a left bundle branch block doesn´t change much - with no cardiologist to refer people on to, very basic availability of drugs, no cardiac catheter lab, there seems little point.

Ima has also offered to teach some of the staff trauma skills... she believes a bit of basic c-spine immobilisation would go a long way. Nkhata Bay is not a trauma centre but traumatic accidents still do happen frequently (most common is drunk people getting hit by cars). If these people are lucky they get bundled into a taxi and taken straight to Mzuzu which is a bigger centre. Most just go to Nkhata Bay and sit and wait in the waiting room for hours waiting to be seen... then perhaps if they are bad they get bundled into the ambulance or private vehicle and taken to Mzuzu... more often than not these people die during transit. But getting the hospital staff to stay behind for education is a difficult mission...

I think I have discovered why the life expectancy of the average Malawian sits at a low 43 years old and I think it goes much much further than just the HIV problem.

Holidays - Nkhata Bay

Every time I visit Africa my eyes are opened more to the fact that there is such a huge cross cultural gap that both us Westerners and the African People struggle to understand each other. Yesterday while escaping Chitimba Beach and heading to Nkhata Bay on mission vacation, I see things which although do not surprise me, they still make me look twice!

I was sitting in a local minibus on my way from Chitimba to Mzuzu when an older woman gets on and sits next to me. She is holding a big bundle of thick blanket. When I look more closely I see a tiny infant is wrapped inside. The lady sees me looking and she smiles at me. ¨She was born just last night¨ I am told.

Back home I am sure the child would still be in the hospital, not crammed like sardines in a minibus.

The minibus stops every 5 minutes and every 5 minutes thereś some people tapping my shoulder through the open window wanting me to buy their bananás and sweet potatoes. One lady has another tiny infant sucking madly while she´s wanting me to buy her bananas. Another baby that was born yesterday I am told. These women seem to pop them out almost like itś something they do everyday!!!

So I´m here on holidays here in Nkhata Bay for a week just taking a break from everyone and everything on TDA... Itś a cool little spot right on the water with plenty to do. Thereś free snorkelling, canoeing and boat rides from the place Iḿ staying at, and most importantly thereś DIVING!!!

Todays plan is just to relax and explore town. I already started the day off with a nice long soak in the bath tub. I washed my hair 3 times while I was in there and I am not proud of the colour of the water when I made my exit! Needed a shower afterwards!!! I have a cheap little chalet with my own chalet for the price of a chalet with a shared bathroom.

I have made lots of friends with a heap of the local guys already... My friend Benson might give me a hair appointment - these dreads are needing a bit of attention. I met a guy while I stopped at the bank in Mzuzu called Pumpkin - he remembers Miles from when he was in Malawi in 2007! And my friends in Nkhata Bay have cool names too - their names are Happiness, Gift, and my favourite name so far - Happy Coconut! Thereś also some people with normal names here too.

Nairobi-Arusha

I managed to get the stuff I needed to get sorted at the embassy with no dramas once I was through security and they'd taken both my mobile phones, my camera, and my charging cords. (They let me take in my leatherman though!).

I have discovered that security guards always know cab drivers though and cab drivers know where to get the bus to Arusha so getting from the Embassy to the bus stop was not a drama. Now I'm just filling in time waiting until 2pm when the bus goes!

While I was wandering around I meet Teacher Joseph. Teacher Joseph is a primary school teacher from South Sudan. He is a very well educated man and asks me where I am from. He knows who the last 3 prime ministers are in Australia, and even recalls the flooding in Brisbane which happened over a year ago now. Teacher Joseph was taken by missionary workers to Kenya as the South of Sudan became more unstable. The missionary workers have since gone further south to Tanzania and told Joseph that he should be able to find work in Nairobi. He is looking but it has been 2 weeks and it is difficult. He is a friendly man and he says he is not asking for money, just for food - rice and sugar. Because he is so well educated, underweight, and dark skinned (like Sudanese people who are darker than Kenyan people) and because I still have Kenyan shillings in my pocket and I'm about to leave Kenya, we go to the supermarket and I buy him some rice and some sugar. I can tell it has made his day.

Chilling time in Nairobi

It's been 2 months of hard work. Today I am frustrated though because I stayed back a day in Nairobi to get some paperwork sorted for my next job which involves getting certified copies of specific documents and a stat dec which means a trip to the embassy. Apparently it's labor day in Victoria though so that means that the embassy is closed. There's nowhere else along our route that I can get these documents sorted though.

After I finish being frustrated I decide I am actually somewhat thankful because I am feeling a little ready for holidays!! It's the first time in 2 months I have had a bit of time to myself and I lie on the bed and sleep for 4 hours!

The African Health Care System

I am learning the hard way why the life expectancy across Africa is so much lower than it is back home.

The problem isn't simple. These people and hospitals would really benefit from many things including but not limited to:
- Better education for doctors so that they can diagnose accurately!
- Even better education for nurses so they know how to nurse
- Better plumbing so that the water always works
- Better diagnostic equipment to help with more accurate diagnoses
This is not an exhaustive list.

Today it's a rest day and there's no medical dramas. I go and check out Marsabit hospital anyway because I've never been there before and I don't know what is there. It's as I expected - basic. Not a good place to be sick in.
Facilities include:
x-ray
laboratory services
basic surgery (not entirely sure what)
maternity unit
physio

No ultrasound. No ECG machine. This is Africa.