Experiences...

Interesting cases and children with personality make my week each and every week I continue to live in Malawi.

These past few weeks have been no different.  I thought I would share a few of them with you as I acknowledge that I could never go back to a 'normal' clinical position again!

Firstly a young girl of 12 had Van Ness surgery or rotationplasty.  This surgery is usually performed when the individual has had a tumour of the lower leg. The ankle and foot are then reattached backwards so that there is a more functional knee joint.  My mind took a while to get around this one!

Another child comes in every 4-6months (sometimes earlier) for bilateral symes (through ankle) prosthetics.  He had the amputation as a toddler and is the most active little boy we have seen.  It is great to see his prosthetics getting so much use.

We have seen multiple burns these last few weeks too.  Some as a result of chintenji (or cloth) catching on fire whilst they are burning their maize, others from candles being left on in the house, others as a result of having epilepsy and falling in the fire.

Each day something new, interesting but most of all inspiring.  The challenges many of these individuals and their families face in their communities, we in the Western world can't even contemplate.

As I quickly approach my birthday this week I reflect on the opportunities I have had in these last 12 months.  I would never thought I would have this opportunity to do what I'm doing and I'm so very grateful.  This is definitely an experience I will be talking about til I take my last breath.  Even the small things like learning the language and the culture and being able to share these experiences with my very inquisitive nieces.  Sharing some basic greetings and food stories (some I'd like to forget about) gets me thinking about the life I have chosen to create and how many more experiences are yet to come and to share! Bring it on!

Seeing the rest of Malawi

I haven't posted for a few weeks as I had a glorious 10 days off over the Easter break.  Getting stuck in the city was not an option! It was time to escape and see the north.  Absolutely magical!  Best decision I'd made.

Living in the central region the novelty is to go the lake for the weekend yet logistically Salima/Senga Bay is the closest location.  Pay that extra fuel people and drive that extra distance as there is so much more to see as I soon discovered.

My first stop was Kuti which is just before the lake near Salima.  A small game reserve awaited and saw my first zebras up close and personal.  They came to eat the foliage surrounding our cottage.  Absolutely magical.  I am ready to take on the Serengeti and more after seeing them.  I want to see animals in abudance!  George the giraffe (later we found out it was Georgina) made a brief appearance at night.  Unfortunately I wasn't quick enough with the camera before she hid behind the trees but her magestic walking speed was something to admire.

Whilst in Kuti I tackled a bike ride or 2.  Those that know my history with bikes will be pleased to know that there were no injuries (my first attempt at a run in a year however didn't end so well).  Even when encountering Mr & Mrs Camel and not knowing whether we should leg it out of there or stay and be spat on, I survived unscathed.  I'm even contemplating purchasing said vehicle.  One step at a time.

Next stop was Nkhotakota followed by some well needed R&R at Kande beach.  Absoloutely picturesque.  A definite must stop.  Charlie & Ewan (Long Way Down) had stayed here and camped.  I don't think they had quite the same experience as us in the thunder and lightening stop where we feared for our lives and subsequently found out that the tent and car both leak profusely but hey what's a camping trip without some adventure!  We'd hoped to ride the horses whilst there but one of my travelling companions is severely allergic - epipen and all.  Despite my love of horses and desire to get back on one I wasn't prepared to have to do CPR all the way to the closest medical facility which was some time away.  Whilst at Kande we were privy to a gospel music video being made.  All I'm going to say is watch the music videos coming out of Malawi this year.  I may have made an appearance is all I'm saying!

Next stop was Nkhata Bay.  So very different to Kande but equally gorgeous.  We had lunch at a backpacker lodge that was set in the cliff face of the bay.  A definite must and bring the togs and snorkel next time!

Final destination was Mzuzu.  A small town in the hills in northern region of Malawi.  On the way we drove through a rubber plantation.  Absolutely fascinating.  I am so naive when it comes to such things.  I'm not sure how or where my tyres, erasers etc came from but definitely a place well worth a walk.

Mzuzu was much less hustle bustle than Lilongwe and good to see a different way of life.  Instead of driving back along the coastal road we decided to venture on the more direct route and the views through the mountain ranges definitely didn't disappoint.  Sunflower fields helped to keep us happy without thinking about returning to reality!

For those contemplating a trip to Malawi....DO IT! You will not be disappointed!

AEP to Sport Scientist….

Well ex-pats in Malawi certainly know how to put on a good show for St Patrick's day.  I was not expecting to see some excellent Irish craic in the middle of Lilongwe!  A tent packed with at least 1000 mzungus.  Who knew that there were that many of us here! Some flash mob appearances of 'Boyzone-reincarnated' kept us entertained whilst I reminisced of an interesting St Patrick's day in Dublin 9 years ago!

From a clinical perspective every week the tenacity and determination of the clients that we see continues to astound me.  From mothers who continue to carry their 12-14 year old boys with CP, to cancerous limbs that one should not ever discuss again, to burns contractures which could have been prevented had they had treatment post burn to those that have been 'treated' by traditional doctors with scars, blindness and other interesting 'cures'.  No 2 days are the same.  CP kids still win the day with me.  One small look has me entertaining them all day.  A pipe dream would be to set up a CP clinic in the villages.  Any willing benefactors and potential rehab staff willing to volunteer get in touch!!!

On a slight change in career path here I was approached by one of the top Malawian teams to assist with rehab, fitness, strength, flexibility and who knows what else!!!  Who knows FIFA may see me yet!  You may make a sports scientist out of me yet (I say that very loosely old colleagues of mine).

2 weeks before Easter and I'm looking forward to the new cases potentially coming through but also a week off to explore some of Malawi! Stay tuned!

Lake, complex clients, CP fun and melting..in a good way

It has been a full couple of weeks.

Finally got to see some of the scenery of Malawi the last couple of weeks managing to spend some quality days with amazing friends at Salima, Senga Bay and Dedza.  Malawi is truly beautiful in the rainy season.  Having a couple of days at the lake, although over cast, was great to sit and watch the world go buy and have a sneaky G&T or 2.  Sunsets in Malawi are like no other!  You can see why African sunsets has such meaning!

My social life also took me to the Malawian Music Awards.  That was indeed an interesting experience.  I lasted a few hours but did not witness much music!

Another week of interesting cases with CP kids winning my heart again!  A young boy with significantly mobile knee has been an exceptionally puzzling case for all clinicians this week.  The royal 'we' are trying to come up with an interesting knee brace to serve some purpose while we await a surgical review.  He is exceptionally bright and has been home schooled by his dedicated father.  When the boy asked if I would teach him daily my heart melted.  We are hoping to find a children's centre near his village so he can at least get some education.

We had an outreach with a new partner this week and all clients were children with CP or spina bifida.  All children were under the age of 6 and of varying severity.  Whilst I love being a fascination and them playing with my hair, skin and earrings, I'm not so keen on the face slap or vomit!  My heart did melt when a gorgeous young girl with spina bifida said in English to me 'see you tomorrow'.  I tell you I am just a melting pot these last few weeks!

We have however seen some excessively confronting clients this week too.  Some include neck burns, leg burns and a cancer of the heel that I do not want to discuss or see again.  Some things are better not said!

The next couple of weeks we have some more outreaches and we're hoping to see more interesting clients come through.  Whilst some days are particularly Malawian (eg being in the bank for 2.5hrs for them to produce a form for me to sign) other days like outreach days consolidate why I'm here.

Landirani days….

Landirani days will always be my favourite days in Malawi.

I have volunteered for Landirani since 2010 and they are the reason I found myself living in Malawi. 

Now working for 500miles I am able to work with Landriani regularly and these outreach days are spent reviewing clients I have seen over the years as well as new ones hoping that devices will be their answer.  Sometimes yes and sometimes we have to refer on to a more appropriate solution.  The clients we see on these outreaches from a 500 miles perspective have a variety of conditions eg cerebral palsy, post stroke, burns victims, leg length discrepancies to name a few. 

Today I wanted to just let you see the joy that is brought to their faces and mine when we work together on these days.

To check out Landirani's other projects go to www.africanvision.org.uk

Job love, nature and all things in between

I know I’ve said it before but I will say it again…it is so nice to love your job!

This week I did a round of the children’s orthopaedic ward with a brilliant Norweigan surgeon.  I am sure he thought I was exceptionally blonde when I looked at what I thought was a catheter bag hanging from the foot for drainage and asked have they not got any proper catheter bags left and we have to resort to shopping bags?? He looked at me strangely for some time and then said that is the traction equipment because there are none here. I.e. the bag was full of rocks holding the broken femur in place! Well of course!!  In my defence a catheter pipe was holding the bag to the bottom of the foot with strapping tape!

We have re-established a connection with the hospital’s physiotherapy department and I am hoping that this connection is maintained to aid with more appropriate and consistent gait training.  The challenge however is for those clients that are from out of town. Gait training often has to occur within a 4 hour window so they can catch the bus home as accommodation is limited.  Our fingers and toes are crossed hoping they will adapt well in the village and also hope they will return in 6 weeks for a review to ensure there is no misalignment occurring and that the device still fits appropriately.

I have on an important girly note found a second hand clothing store! Who knows what vintage collections I could find?!  I have also been told there is a second hand book store with a coffee shop attached – this weekend’s plan.  I am trying to contain my excitement!  Ensuring work life balance is paramount!

Nature news this week I have had a hedgehog in my garden, somehow my flat mate and I have acquired a dog “Bessie” and the cat “Mr Darcy” is becoming all too friendly for my liking. I may have also heard hyenas last night…I can’t be sure…but when in Africa!

Another clinical highlight

Another week has come and gone. I’m never sure whether the weeks are long or short! No 2 days or 2 weeks are the same!

In some respects it has been a typical Malawi week i.e. no electricity, shops not having supplies, some shops shut, basic administration issues that could take 5 seconds take 3 days, goal posts changing and the list goes on.  But life would be boring if every day was the same. Right?!

A car (who is now named “Rocky the Rav”) has now been purchased and freedom will ensue.  Life in Lilongwe can often get stagnant and so having the freedom for day trips is very exciting!  This weekend saw me playing with the big boys in their land rovers, land cruisers and pick ups on the dirt roads just outside Lilongwe.  My heart was beating fast at certain parts of the day and I would like to sincerely apologise to the poor children playing by the side of the road that may not have been able to get out of the way of the mzungus and may have been covered in mud.  We aren’t 100% sure as they can move very fast when they see vehicles coming into the villages.

The clinical highlight this week was working with another transfemoral (above knee) amputee.  This reasonably young man had been involved in a motor vehicle accident in November where he lost his left leg and one of his fingers. His quiet determination and the support his family gave him was exceptionally humbling.

After working with him on his first steps of utilizing a prosthesis and booking his future appointment for more gait training, I followed him and his family to his car to observe some basic activities of daily living such as getting in and out of the car.  Once we completed the tasks his brother shook my hand in the traditional Malawian way and said ‘God bless you and thank you for your kindness and support’.  Whilst I have faith to a degree, the passion and belief they have in God but also in the services we provided and the exceptionally gratitude his family and he had for what we have so far achieved, was overwhelming.  Tingles ran through my body when he shook my hand.  I am looking forward to seeing the progression of this man’s walking ability as well as seeing him return to some normality.  It will be exciting to watch.

We also ran a small workshop for the other NGOs we work with to assist them in identifying appropriate clients to visit the centre.  Creating ‘the same page’ will aid in reaching out to the wider community of Malawi and ensure more people are accessing our services as well as other rehabilitation needs.  Our goal is to hopefully see an increase in numbers walking through our door for 2015.

Outreaches will also start soon and I am looking forward to working with our team as well as the partners will be servicing.  There will surely be some great cases and photos to come of the events ahead.  Watch this space!