Day 12 – Friday, June 20, 2008

Today was my last time of slashing with the regulars, so I asked Sandy Lu to get some pictures of us together. These three men have been the most constant workers when I’ve been there, although there have been others. Matthews is the best English speaker and the spokesman of the group when David Schaffer comes along to check on things. Emanuel is about my height, but twice as strong. One swing of his blade will fell about four times as much as what I can do. Kanean is smaller and quieter, but he can still plow through the grass like a weed eater. I’m glad to be done with slashing, but I’ll miss these guys.

Kanean, Emanuel, me, and Matthews

Die, grass!

After slashing (which was cut short due to a morning downpour) I went to the JSS to see what Deb might like me to teach this afternoon. She handed me a couple lessons on nutrition, and I set about preparing a 50-minute lesson. All in all, it went pretty well. But one thing really stuck out to me. I started the lesson by asking the girls to list some diseases (the point being to draw a distinction between diseases of infection and those of malnutrition), and here are some of the first suggestions I got: marasmus, kwashiorkor, anemia (more a symptom than a disease, but still…), goiters, cholera, and syphilis (malaria and HIV came up as well). Were I to ask the same question of some junior high girls in the U.S., I’m guessing I’d get answers such as the flu, pneumonia, cancer, diabetes, and heart disease. They probably wouldn’t ever have heard of marasmus or kwashiorkor, let alone know that they were diseases. What does that tell you about the disparity of health conditions between the America and Africa? Indeed, the JSS girls’ answers were a perfect way to start a lecture on nutrition. The first four items in their list are largely caused by malnutrition, and they were familiar with them!! The only reason I knew what they were talking about (in the cases of marasmus and kwashiorkor) is because I briefly studied them in my first year of medical school. I went on with the lesson, but today was clearly a case of the teacher learning more than the students.

Day 11 – Thursday, June 19, 2008

Most of my day was rather mundane. In the morning I slashed for about an hour (I still don’t know how those guys do it all day long) before it started to rain. I then went to the Junior Secondary School and covered textbooks for most of the rest of the day. So work-wise, it was a rather humbling day. In the mid-afternoon, one of the national teachers, Lancaster, came by to help me. He teaches Chichewa (one of the national languages of Malawi, along with English) and Bible to the girls. When I told him that I was in medical school, he said that Malawi has a shortage of doctors. This confirms my impressions from my trip to the Mzuzu hospital yesterday. Lancaster has a son who just finished high school with high marks, and he has applied to the one medical training school in the country. Admissions is very competitive which makes sense if there is only one medical school for the nearly 14 million people living here. Still, it’s a tough way to meet the medical demand of the country.

From about 3:30 to 4:45 I played with a bunch of the children at the village playground. Even though my time with the kids has been limited to mostly meals and playtime, they have no reservations about using me as part of the play equipment. That’s something I’ll really miss: tons of kids who want to be around me and play with me just because I’m there. They have a great joy about them, even though they all come from broken homes. But God has used Rafiki to pick up the broken pieces of all these families and put together a beautiful mosaic. I pray that these children and mamas will be real families for each other for the rest of their lives. The need for family doesn’t stop once one reaches the age of 20, 40, 60…

One of the girls from Mama Rose’s house (where I shared in devotions last night) asked me to come back to their table to eat dinner. How could I refuse? They tested me to see if I could remember their names, and I failed miserably. But we went over all of them again, and I think I got it down: Caroline (one of the older girls in the village, with a wise face), Ruth (BIG smiles from a little girl), Fiskane (pronounced fis-KAH-nee), Joseph (who finally gave me a smile tonight!), Judith (perhaps the cutest little girl in the village, although there are a lot of cute children here), Emily (also very young and very sweet), Rachel (didn’t finish her milk), Spencer (5 years old and actually one of the first two children in the village), Christopher (already getting his adult teeth, which he shows often with his smiles), and Ethel. This last girl was the one to invite me back to their table tonight, and she gave me her necklace that she got earlier that day in school. (All of the Standard 1 children received necklaces of yarn with a glow-in-the-dark cross pendant!) She said I could give it back to her tomorrow. I’m glad that I was able to have a little more time with these children. Last night during devotions they all seemed to have a slightly sad quality about them, but tonight they were very cheerful. They especially liked all the funny faces that I make for them—something that has always broken the ice during my time here. Nick DelVillano may be the shining star trumpet-playing uncle, but I make the best funny faces!

The end of my trip has kind of snuck up on me. I only have two more days here, and one of those days will be largely spent packing and buying a few more souvenirs. Lord, in the time I have left, please put a lasting impression of this place and these people on my heart.

Day 10 – Wednesday, June 18, 2008

Today was pretty full, and just saying that feels like an understatement! In the morning I almost completed refinishing the wood doors on several of the ROS houses. (I still have one more coat to do on one door.) Around noon Eileen took Mama Abigail and me to the Mzuzu Central Hospital. Mama went to visit her niece, and I went just to see what the hospital was like. My impressions were that it seemed like a very nice facility, but there seemed to be a real dearth of doctors and nurses. From what I’ve read in that AIDS in Malawi book, it’s was difficult in the 80’s and 90’s to keep medical clinics and hospitals staffed with nurses because they were dying of AIDS (hopefully not acquired through their work) faster then new ones could be trained. It’s now several years beyond that point, and the knowledge/experience gap is readily apparent. We met a British medical trainer there, and she stated that when she had arrived a few months ago, many of the nursing students there were working unsupervised!

This afternoon during the children’s playtime, I helped Rebecca and Nick in “gazebo time,” when they lead the children in singing and dancing. I had missed this time last Wednesday, and this time around I made sure to be there. Nick was about a half hour late, so Rebecca and I held down the fort, so to speak, as best we could. I tried my bread-and-butter song, “The other day I met a bear,” but for the most part the kids just stared while I belted out my part. The kids liked our American songs well enough, but they really got going when the Mamas led them in their own songs. It was tons of fun, and I really regret that I won’t be around for another Wednesday song time.

At dinner, we were treated to an even more spectacular scene. One of the kitchen workers, Eden, was finishing his last day here before his wedding in two weeks. As a send-off, one of his co-workers, Nation, gave a short speech in Eden’s honor. Then he asked the Mamas and the children to sing a particular song. Their voices filled the dining hall and reverberated all around in a traditional Malawian melody, and their feet moved in unison in a simple dance. We later learned that the song declared the goodness of God, but I didn’t need any interpreter to tell me that the song was sung to His honor. I found myself yearning for heaven, where all peoples will raise their voices in praise to our God and King.

Tonight, I went to Mama Rose’s cabin to be a part of their evening devotions. Her ten children ranged in age from about two to seven or eight, I’m guessing. Big, soulful eyes looked up at me as I read a couple stories from their children’s Bible (Wicked Judas and Moses Leads the People Through the Red Sea). I sensed a certain sadness during our time together, especially as Mama Rose learned that I would be leaving on Sunday. She asked me to remember them in my prayers. It was at that point that I realized how difficult life is here, even for those living in the Rafiki village. Mama Rose seemed so tired as she asked me this that I felt ashamed of my life of comfort and relative ease. It’s easy for me to think that she and I are both doing work for the sake of these children (and we are), but the reality is that her work is of much more importance. Her work also has no end in sight, and mine will be done in a few days. The least that I can do is pray for Mama Rose, her children, and all of the rest here. God is the one who will sustain the ROS, the Mamas, and the rest of the workers here. God is the one who will establish this work and ultimately raise these children up to do His will in this world. All that I can do is pray for them and obey the Lord as he reveals His will for my family and me.

What a rollercoaster of emotions and experiences today! I can’t quite make sense of it all, but I don’t know if that’s required of me right now. What is important is that I get some good rest so that I’m ready for what tomorrow brings.

Day 9 – Tuesday, June 17, 2008

Today my only job was to work on refinishing some of the wood doors. Exposure to the elements here has taken its toll, and some aspects of upkeep have fallen by the wayside. The ROS were very thankful for my work, so I’m glad that my work is helpful to them. Later in the evening, had Bible study with ROS, and realized that I’m very grateful for some defined, physical tasks to focus on. I've just been feeling overwhelmed with the enormity of things here: the children, the work to do, and most of all the needs of Malawi outside these walls. I really don’t know how to take it all in or even where to begin. Having small things to do here (like working on the doors, printing out a new recipe system, etc.) not only occupies my time, but it also makes me feel like I’m chipping away at the bigger problems.

Tonight I got a chance to see the clinic here in the village. There's only one nurse here right now, Eileen, but it's been a long time since she's worked as one, and she's never done it in a setting like this before! She prays every day for wisdom about how to diagnose and treat each case she sees among the children and the workers. As she puts it, she gets enough mana to make it through each day. Last night she showed me a microscope slide of a blood smear that she used to diagnose a malaria infection. It was pretty cool! Tomorrow, she's going to let me come along to the central hospital in Mzuzu. From what I've heard it's a decent place, and they treat emergencies for free. The only catch is that you have to provide your own transportation there, which can be nearly impossible if you're in a medical emergency.

Day 8 – Monday, June 16, 2008

There’s not much to report for today. I slashed for ~1 hour in the morning, and I think I’m getting better at it. Matthews, the chief slasher, had to redo my area only once! Still, I had to quit after my hands got too raw, even while wearing some heavy cotton gloves. (The other workers, of course, wear no gloves.)

Most of the day was spent working on organizing the village’s electronic records of recipes for the children’s meals. Food is obviously a major endeavor here. Each child gets three meals plus two snacks throughout the day. All of the recipes have scalable amounts, for between 80 and 200 servings (although the average is probably 100 for any given meal). Paul, who inherited the kitchen supervisor position (among about 3 other jobs he does), enlisted my help for organizing and printing out a notebook of recipes for easy reference. It didn’t seem like that important of a job, but when I was done the head kitchen worker, Nation (cool name, eh?), was VERY appreciative. Apparently their current system of looking up recipes is a complete mess.

I found out today that one of the children in the village has mumps. Apparently it’s been going around in one of the cottages here, despite Eileen’s (the nurse) best efforts to quarantine sick children. I haven’t learned much about mumps yet, but I bet there’s a time when the child is mostly asymptomatic but still infectious. One theory in situations like this is to intentionally expose the other children to the disease so that they all get sick (and thus acquire immunity), but I think that would be a nightmare for the mothers and workers here, to say nothing of possible complications of the disease. Plus, I’ve learned that one of the children actually does have HIV (I don’t know who it is, but I’m told he or she is doing fine with medication). Purposefully exposing that child to any disease would not be a good idea.

This brings up another thought about one of my earlier comments about poverty in this country. I stated that Malawi was probably having serious problems because of corruption in the government, and this is largely true. Foreign aid does not go where it should in most cases, and the people suffer as a result. There is, however, a second major cause of economic hardship here, and that of course is HIV/AIDS. I read in a book on AIDS and Malawi last night that the explosion of AIDS here has not hit all socioeconomic levels equally. And contrary to what one might guess, it is the people of higher education and training who are more at risk. Once I think about this, however, it does make sense. Those with more training will have jobs in the cities and have more opportunity for access to prostitution or have multiple partners who might be infected. The end result is that Malawi has selectively lost a huge number of highly skilled and trained workers. Given the rapidly evolving landscape of the international business world, this is especially bad for the economic future of the country.

International health policy also had a profound impact on the spread of HIV, or at least on the inability to contain it. Much of the foreign aid to Malawi came from organizations that decided it was an invasion of privacy to test someone for HIV without their consent. If Malawi wanted to continue receiving aid, it would have to abide by this standard. But since having HIV carries a heavy stigma, hardly anyone wanted to be tested. Thus, HIV spread silently for years, and health workers couldn’t do much of anything to stop it. When no other explanation could be given for a patient’s illness, it was presumed to be AIDS, but no proof could be obtained.

Enough on this for now. It’s a highly complex issue, and one that I am just beginning to understand.

Day 7 – Sunday, June 15, 2008

Happy anniversary, Maria! And happy Father’s Day, Dad and Dad-in-Law! It was tough being so far away from family today, and I’m anxious to get back home. This morning I opened up a few presents that my brilliant wife, Maria sent along with me. Why brilliant? She thought ahead to what I might be missing most after one week here, and packed it away for me: some sour gummy worms, a packet of beef jerky, and my favorite cereal, Craklin’ Oat Bran. The coup de grace, so to speak, was a Hallmark card with Maria’s and Will’s recorded voices! What a great woman!

Today was also the only Sunday that I will be here, so I was very curious how church would go. Rafiki makes a point of not having a church or chapel on the grounds. Thus, the ROS and the children get a good deal of exposure to the body of Christ in the community. There are three churches go to, and today I went to Katawa Presbyterian. For many reasons, it was a very interesting experience. First, there is often a power outage on Sundays, and today was no exception. They did have a generator working, however, so there were working microphones and speakers. Second, they had FIVE different choirs perform! Each choir sang a sort of “entrance” song, which was sung while they moved and danced to the front of the sanctuary. My favorite songs were the ones sung completely acappella, but most of the time a keyboard (with drum beat) was used as accompaniment. The sermon was quite bizarre, consisting of the (visiting) pastor shouting into the microphone (and thus getting all distorted) about how the people there needed to be practical Christians, not nominal Christians. That’s all well and good, but I don’t think he ever went into any depth on what it means to be a practical Christian. Plus, the topic for the sermon had nothing to do with the scripture readings for the day. As he was preaching, I realized why Rafiki was starting to set up periodic pastors' conferences for training some of the local ministers on biblical teaching.

For lunch, Debbie and Susan took us out to A1, one of the two restaurants in town that the most of the ROS trust (although David warned me that his last trip there resulted in two days of intestinal issues!). I ordered a dish that Susan highly recommended, even though she said, “It looks like creamed Kermit.” Indeed, it was a deep, vibrant green, but it was also very good (after I added some hot spices).

In the afternoon, one of the choirs from Katawa came to the Rafiki village to record some video of them dancing in a beautiful setting. They also gave dance lessons to some of the 6 and 7 year-old girls, and got some video of them dancing too. Sandy Lu helped out, and according to her it was absolutely heavenly to combine two of her passions: children and worshipful dancing! I got a lot of nice photos, which I’ll try to share at some point.

At the end of the day, I realized that it was exactly one week ago that we arrived at this village. Hooray for making it this far! I know that God has a lot more for me to see and experience before I leave, but looking back at this past week shows me that I’ve already learned and been exposed to a lot.

Day 6 - Saturday, June 14

Today we saw a great example of the physical beauty of Malawi. Ralph and Bonnie took the five of us mini-missionaries to Lake Malawi on the eastern border between Malawi and Mozambique. We drove through beautiful hills and forests on our descent of ~1500 ft. from Mzuzu to the Lake, including a forest of rubber trees. It’s against the law here to ‘harvest’ the rubber, but that doesn’t stop the local boys from stripping the bark away and winding thin strips into rubber balls that they sell on the side of the road. It was kind of entertaining to see these boys appear from seemingly nowhere as we drove through the forest, running to the side of the road and holding up their wares.

Also on the way to the lake, we stopped at one of the biggest wood carvers market in Malawi. The Marrons warned us beforehand that these vendors were very skilled in the art of haggling, but nothing could have prepared me for what I experienced there. I decided first to look very briefly at what each stand had to offer, say “thank you” and move on. Then I went back to one of the stands selling some things that I liked and bought a couple items for what I thought were reasonable prices. Up until that point, the vendors were kind but not overly so. Once I made a purchase, however, the word went out that they had a BUYER in their midst! Every person I visited thereafter was now my best friend. I must have told someone my name at some point, because all of the men called out to me, “Andy, my friend! I will give you a good price!” The merchandise was really cool, though, so I kept shopping. In the end, I bought several items, but they had completely cleaned me out of money. Still, looking back on it, I got quite a few nice pieces for roughly a total of $60, and they definitely needed the money more than I do.

At the lake, we went to the Chinteche Inn, a posh establishment for foreigners to enjoy the beauty of the lake with a nice glass of wine in a little bungalow. The seven of us sat at a table on a lawn about 20 feet from the beach and dined on chombo (essentially tilapia) caught fresh that morning. We then spent a few hours enjoying the beach and each other’s company and conversation. It was absolutely beautiful—kind of a combination of my experiences with the eastern shore of Lake Michigan and the coast of California.

All of the experiences today showed me just how much this land has to offer. I see industrious, skilled people and a gorgeous countryside, and I wonder how this could be one of the poorest nations in the world. I’ve heard that there has been significant corruption in the government, so that could explain a lot of it. I’ll have to ask some of the ROS about that.

Tonight, the five of us from TCBC had a little meeting to talk about our experiences so far—the good, the bad, and what we’ve been learning. I praise God for how he put this team together. We all have different skills and strengths, and I think we compliment each other very well. It was interesting to hear about some of our expectations and hopes before we came and our actual experiences here. For example, I hoped to be involved in the clinic in some way, even though I knew that they wouldn’t be holding one of their quarterly open clinics for the surrounding people. (Actually, the clinics are nowhere near that regular and depend greatly on the availability of physicians to come in and run it. There hasn’t been one here since January or February, I believe.) To this day I haven’t done a single thing involving medicine, except for the first night when I pointed out to the nurse a child who appeared to have pinkeye. I hope that aspect of my time here will change, but even if it doesn’t I know that I’m meeting some real needs in the village through what I’m doing.

One thing we all agreed on as a group was that these children here are amazing. Their joy and excitement in life is unrivaled, and the educators among us have commented that they rarely see such a combination of joy, togetherness, manners, and love in children in the States. The most profound thing to me is that these children are a very clear picture of the potential of every child in Malawi. Rafiki children are given almost everything: a family, food, clothing, shoes, education, health care, and biblical training. The fruit of all that is evident, especially when seen in contrast with the children just down the road. I haven’t spent any significant time with non-Rafiki children, but my limited exposure has painted a picture of poverty, hunger, and a severe lack in education—both in terms of access to and resources of Malawian schools. The mission of Rafiki is to change that, even if it’s for a relatively small number of children. Part of their philosophy is that you can’t do everything, but what you do you should do well. In that regard they are succeeding. Only time will tell how their approach will pan out, but I have to believe their positive influence will be dramatic, both here and across Africa.