Wednesday, April 4, 2007

Malawi; the warm heart of Africa!

The final phase of our journey began as we left Australia for Malawi. The route took us via Johannesburg where we were entertained by Prue and Mike Baker. Prue whom we first met on our tour of South Africa with the Harrow School Colts Rugby tour has been exemplary in keeping in touch. They looked after us generously and with warmth, and talked without bitterness but with realism about the security situation in South Africa. It certainly affects your view of the world if you have to live behind gates and seldom venture out at night.

On arrival in Blantyre we were met by Pat, a consultant paediatrician who was using Olly’s car. We were taken to see the town, the hospital and Olly’s house, where we are staying. The bright sunlight and the verdant vegetation give a disarming backdrop to the evident poverty and relative disorder of the landscape.

The house is plain, but well equipped, both with servants (house boy, gardener and night watchman) and stuff. It is rather pleasant to be our own masters, though with no phone and no internet connection we feel slightly bereft. This is an interesting and very recent phenomenon and shows how quickly we move from regarding things as luxuries to essentials, TVs, freezers and dishwashers all have become essential, as has air conditioning in cars. The fact that one persons luxury is another’s essential has challenging resonances here..

After arrival Olly had booked us into Mvuu Lodge. Mvuu means hippopotamus in Chichewa, Malawi’s language. This was inspired and inspiring. The drive across was pleasant, with the scenery reminding us of bygone days in Kenya. We were met by the Shire (pronounced Sheerey) River and sped on a boat to the lodge, passing raft after raft of hippo and seeing several crocodiles, as well as being given a foretaste of the feast of bird-watching that we were to experience over the next forty eight hours.

The lodge was a dream, five separate chalets, set in the bush alongside a lagoon, with a central dining area, a terrace for dining in the open and a small swimming pool. All this was approached over a wooden walkway from the jetty. There were three others in the lodge and we all joined together for game drives. There were plenty of baboons, monkeys, wart hogs, impala and water buck, fewer bush bucks and sable antelopes, and the occasional jackal and buffalo. We only saw elephant, of whom there are plenty on our last morning. The real delight is the birds, we saw over a hundred different species, not all remembered or recognised by me. However I did learn a lot, not least about sorting birds into types and looking for likely places for them to perch.

The quality of guiding was outstanding. The hospitality was personal, and the food excellent. In fact of all the places we have stayed in on our trip it is one of the two that I can thoroughly recommend, the other being the Peace and Plenty Inn in Auckland. This was a privileged way of seeing wildlife.

After these delights real life would be a problem. Being in Malawi we had to visit the Lake, and looking at the guide books it seemed that Cape Mc Lear was the closest and had the most choice of accommodation. The drive was interesting, it had rained the ni9ght before and part of the road was flooded. This was a popular event and hundreds of local villagers were on hand to give advice and guidance. We were adopted by a few young men, who ran in front and alongside and gave instructions, it was a hair raising experience, having to keep the momentum of the car going through the flood waters avoid the young men running in front and listening to instructions coming at me from all angles. We managed it without mishap.

Then Cape Mc Clear, despite its remoteness and the approach roads being like farm tracks, it is a popular place with the travelling backpacker, WIFI on the beach! The place where we elected to stay was situated on a perfect beach, with our chalet giving on to the foreshore. Somewhat surprisingly the menu was pretty ambitious, and though there were not many mistakes simple fare might have been more appropriate in this setting. On the Sunday we set off for home, noting with delight that there were large numbers of smartly dressed villagers going to church, what a testimony to the early missionaries who planted a church here late in the nineteenth century. The journey home was in driving terms untroubled, the floods had receded and good progress was made. However any journey of this length in Africa always provides incident, the first was a “matola”, a minibus filled to the brim with paying passengers. This overtook us recklessly, lost control and bounced into a ditch on the other side of the road, after a number of alarming ricochets it came to rest on a grassy mound in the upright position and the doors opened disgorging the passengers, shaken but not as far as we could see broken.

The next incident was when were waved to a halt by a North American maiden in real distress. She was driving a hire car, having lost her driver and had a drunken and bruised motorcyclist in the back, who she had rescued when he fell off his bike, and had planned to take to hospital. However he was belligerent, as were the crowd at the scene and she had taken flight. When we me her she was beside herself. She posed quite a challenge to the ageing gappers. However they have their strengths and with the help of a passing ambulance crew sense and pastoral care were introduced. We took her to the police station in Blantyre and the whole matter was resolved, including getting her escorted home. Phew! We were so grateful that Olly had a small and discrete stock of wine to calm the troubled spirits!

We came to Blantyre because we wanted to see where Olly was working, however when it was clear that we would be out of phase, Olly being interviewed in the UK, whilst we circle the globe, we arranged a series of meetings with the senior staff here. So today I went to the post take hand over, and Paediatric Surgery ward round and talked at length to Eric Borgstein the Professor of Surgery. I felt rather sorry for him, because not only had he to deal with me ( a self invited guest), he also had a team of Plastic Surgeons from Southern California, doing their “pro bono” bit for mankind and a delegation from St Andrews enquiring into undergraduate education. It is rather like Uganda ten years ago, it is difficult to move without bumping into a well meaning western well wisher. What was really impressive is how the surgeons have been quietly developing a robust surgical curriculum.

Enfin

After this posting we will be homeward bound. It has been a great experience and a real privilege to have been given this amount of time to think about surgical training in the UK and look at other systems. I hope to write something of use and to get a platform from which to share my insights. A time away like this is excellent for its physiological, psychological and social value. It is to be recommended!
Australia south and west

We flew from Melbourne to Adelaide moving from the hospitality of old friends to the hospitality of old friends

I have known Bill and Ros Hague since we were at Cambridge together in the late 60’s, they then came to Thomas’, Bill for his clinical and Ros to do the graduate nurse course that was just starting. They have three young, roughly contemporaneous with ours and so there was much to share.

Adelaide is a gentler city than most, apart from a Saturday night when the town is busy, boozy and boisterous as we inadvertently discovered when we were returning late from a concert. They were wonderful hosts and arranged some meetings with the local educational leaders and some worthwhile outings. We had a bush tramp seeing a koala at close quarters in the wild, many birds; laughing and blue winged kookaburras amongst others. We had a highly informative visit to the marine and immigration museum. This explained the manner of immigration to Australia better than any other account I have seen in our whole trip. It explained what happened in a graphically, with old photos and contemporary film strips to colour the picture. There was considerable hardship involved and in our age of material sufficiency one wonders at the privation and poverty that the immigrants were escaping from, to seek a better life in what was a pioneering situation, as recently as fifty years ago.

The social highlight of our visit was a trip to a concert in Bundaleer forest. This was an enormously engaging musical festival in t a the woods of northern South Australia. A contra punctual element was added by my tooth, which chose to ache on the day. It was a severe ache which engendered sympathy, which in turn led to action. We were driven to the concert via a winery in the grounds of a Jesuit monastery; the others were hungry and suggested lunch which was bacon, egg and sausage sandwiches, good in their place but a mistake for the sore of tooth. My beloved seeing my anguish enlisted the help of the paramedics, who did not have much else to do and we experimented with penthrane, which I am sure is good for some sort of pain but not this particular variety of toothache. It was then decided that I should be bundled in a truck and driven to the local hospital, by one of the charming paramedics. This is one of the spin-offs of relative misfortune, it opens avenues not normally available. We were told that Jamestown, the site of the concert was a much safer place to bring up children than Adelaide, and Charlie’s, the paramedic and local builder proudly pointed out his son who was playing cricket on a pitch we passed on the way to the hospital. His daughter was taking part in the concert, which had a mixture of local input and internationally famous performers. The hospital was neat and welcoming and under threat! We were given the medicine necessary to alleviate suffering and returned, with the accommodating Charlie to the concert. Pain in temporary abatement we had a pleasurable two hours hearing engaging performances as we walked from glade to glade, al capella singing, oboe and cello solos, then supper and, what do you know, more anguish So I was taken to the coach, where, a useful discovery, there is a bed. When the pain was under control sleep overtook me, and I was awakened by some wonderful singing, by Simon O’Neill a tenor from the metropolitan in NY and Teddy Tahu Rhodes. They are both New Zealanders and we were treated to a masterful display of the most wonderful singing. Whether it was therapeutic or not it marked the beginning of the end of the self absorption that pain leads one into.

The next day, before church I was seen by a delightful oral facial maxillary consultant who deemed the tooth worth persevering with and with that Bill and I went to church. They worship in the oldest Anglican church in downtown Adelaide. It has several services on a Sunday. Ros and Jane had been to the early one and Bill and I went to a lively family service in the next door cinema. This use of secular venues has some virtues, not least in putting the Christian message into a place where it is not normally expected to be heard. The message was a good one, and we have learnt a lot from the various service we have attended on our trip.

One of the privileges of this trip has been being involved with our hosts’ families; we have sat down to dinner with the children of all our hosts, and what a delight it has been. They are all confident, polite, the girls beautiful and the boys handsome. They all do different things, but often one can see glimpses of their parents as one used to know them.

We left Australia via Perth, a place I have longed to visit as it is the home of David, my brother in laws’ family. It too is a gentle city; we walked rapidly around the centre that is possible downtown in Australian cities. Perth has a unique site for city viewing, in Sydney the harbour is the place, in Brisbane the river, in Melbourne the south bank on bicycles and Adelaide the northern parkland, in Perth it is a concrete staircase, much used by joggers and those hoping to get fit. We strode up it in the gathering dark and had a glistening view. Too little time to do anything more than walk eat and sleep, before we set off again to another continent for the last phase of our journey, today Australia and today Africa!