Wednesday 25 August 2010

Being like Daniel....

I love working in a Christian hospital. There is a half hour of worship and prayers every morning, we pray without shame for the patients whilst on the ward and before we anaesthetise them in theatre, there is no fear of our seniors, we can question them about anything and we will be answered with respect and gentle encouragement. There is laughter and singing in theatre, and sometimes even dancing! Today in theatre we all sang along (quite loudly!) to Delirious' tune of over the mountains and the sea :-) whilst operating on the patient.

This month in the morning bible time we are looking at 'excellence' especially on Tuesdays where both bible groups (theatre and ward) get together. Excellence is one of the hospitals core values and is displayed over the front door - saying:

'Excellence in Orthopaedic Care'

Last week we looked at the verse in Colossians - work as you are working for the Lord and not for men. This week we are looking at Daniel - an example of excellence. Daniel was chosen for 'showing aptitude for every kind of learning, well informed, quick to understand, and qualified to serve in the king's palace.' The King wanted to teach them the language and literature of the Babylonians. The idea is that we should be like Daniel and want to learn and to always better ourselves and strive for excellence.

Or as I have just thought - the army's motto - Be the Best!

This got me thinking about me being impatient at times with the length of training I need to do to be an Orthopaedic surgeon, but to be the best I can be I need to go through that training, otherwise I will not be able to help patients in the best way possible. God is definitely reminding me to be PATIENT!

On a learning note I saw a very interesting case today - osteogenesis imperfecta - I now need to go and read all about it so I can be quizzed on it tomorrow! We put a nail down his femur that was fractured due to his brittle bones. Unfortunately because his bones are so brittle we caused another femur fracture slightly lower down as we tried to place the nail, this too was fixed in place by the same nail once we had got it directly down the centre of the bone and it is holding well - it means however the patient will be in a hip spica plaster cast for 6 weeks to aid healing, whereas he wouldn't have needed it if the other fracture didn't happen.

We did make it to Zomba at the weekend - it was awesome :-) Very hot and scenic, hopefully we are going to Mulangje for this weekend and hike up an even bigger mountain. We bought fresh raspberries and strawberries on Zomba - very yummy.

Thank you again for all your continued prayers. And I ask another one of you - since Tuesday I have had upper abdominal pain every time I swallow either food or drink - nothing seems to help apart from not eating!! I am concerned it might be an ulcer, but that is probably just a medic being paranoid. Please pray that the pain will go as it is very frustrating even if it is nothing serious.

Bianca (one of the German gap year girls staying at the guest house and works as a play therapist for the children in the hospital) invited me on Tuesday evening to the bible study group she goes to. It was held at the McGrath's house. The McGrath's are 'mzungus' (white people!) in Blantyre and EVERYBODY knows them! They have 5 children and a huge house, and have been here for years as missionaries. They are extremely hospitable and their house is always open to anyone and everyone! I really enjoyed the bible study group - there were 6 of us all 'mzungu' who are here either permanently or for a short while. Ann McGrath (the mum!) has invited both me and Bianca over for dinner tonight before another bible study group - Bianca also goes to this one and the group apparently has 'older people in it'! The one I went to on Tuesday Bianca said was a 'youth' one - I like the fact I was counted as youth! I think I was the oldest one there but not by much :-)

Bye for now

H xx

Friday 20 August 2010

Pancakes and Students!

Hi guys!

I apologise if there are any spelling mistakes in this as I am typing this in the dark as the porch is the only place in the guesthouse to get internet signal and it is 6pm!

Well work is going well - Dr Sam is slowly letting me do more and more stuff in surgery - He is impressed with my suturing - he states it is very neat and I would make a good plastic surgeon :-)
I have also managed to put in K wires and reduce a dislocated shoulder under anaesthetic.

Tomorrow I have to start a series of 5 teaching sesions for the 3rd year medical students at the nearby university! I was only told this morning - eeek! It shouldn't be too bad - I have to teach them the basics of examining a hip joint and there are only 17 of them. Please pray that they will learn something from my teaching session tomorrow. I will be teaching them again next friday for their second session on X-rays. I actually quite like teaching but generally speaking only of there are 4-5 of them!

2 nights ago we made pancakes - both English and American and Emma bought marshmellows and chocolate - yummy!

Not too much else to say as yet apart from I've found a place to live in Liverpool for when I do the diploma in February - Yay!

I should sign off before I get bitten to pieces in the dark by mossies!

TTFN

H xxxxxxxxxx

Monday 16 August 2010

Sun and Cherry Plum Sodas!

Sunday 15th August 2010

So, I’ve been here a week now! In some ways it seems much longer, as over the past few days I have really settled in. In the end we didn’t go to Zomba plateau hiking yesterday as Sheila is feeling ill, with a fever on Friday, and another today, although none yesterday. She had a negative test for malaria yesterday morning but her symptoms do seem to suggest malaria. Please pray that she recovers quickly and that a further blood film tomorrow will confirm either way what the problem is so she can be treated effectively.

We did however manage to get into Blantyre city for a short wonder, which was fun. On the way into Blantyre there is an art gallery and cafe run by one of Sheila’s physio patients, so we stopped there for a light lunch and a look around – I am definitely going back there probably several times for food, proper coffee and to buy lots of local art and craft work – it’s the kind of place I could spend hours in! When we got into town we went to the fruit and veg market and also further on there is a wood craft market. The sellers tried very hard to swindle us out of extortionate ampounts of money but we bargained quite well for a few things. We plan to go to Zomba next Saturday instead – pray for good weather, good health and safe travel :-)

Last night we went to Emma and Becky's house for food and film! Emma is a physio who did her elective at Beit CURE and has now finished her university degree. Her parents are Salvation army missionaries here. Becky is her older sister who is a 4th year medical studant at Leicester Uni who was here for a few weeks and went back earlier today – hence the dinner party last night. We made fajitas and had cherry plum floats for pudding! (this is icecream spooned into a glass with the fizzy pop poured over – we used the unique ‘cherry plum soda’ that you can only get here – it is a fizzy drink flavoured with – you guessed it – cherry and plum! Yummy) I’m reckoning you could get a similar effect with cherry coke :-)

Friday at work was quite tame – a short ward round where we discharged most of our patients who had surgery on the Tuesday and then teaching – which consisted of Dr Maina (Sam the Kenyhan doctor) and Dr Harrison (the big boss) quizzing me and Dr Leonard Banza (a Malawian resident) on various X-rays. I did alright but would have much preferred the case Leonard was quizzed about as I knew all the answers! It was constructive quizzing and much nicer than I’ve had in the past!

TTFN

H xxxxxxxxxxxx

Friday 13 August 2010

Black and decker drills and chocolate cake...

Thursday 12th August

Thank you all for your kind prayers, I have felt much better since the other evening. Every morning I feel God is talking directly to me through the morning worship sessions. Yesterday we looked at Colossians where it says ‘work as you are working for the Lord and not for men.’ And todays was Jeremiah 29:11 ‘I have plans for you, plans to prosper and not to harm you.’ These are probably two my most favourite verses in the Bible and God has used them just at the right time – AMAZING!

I am still getting used to the Malawi way of things, I seem to be finished each day between 2-3pm! Which seems really strange and I have to keep asking – ‘is there anything else that needs doing?!’ They say, no, go home, relax! So I do! Apparently it can be much busier and in addition I will hopefully get stuck into some research in the next few weeks, so I will be grateful for the free time to look at that. Also I’m not on the on call rota until September as they had already written it for August before I arrived.

The past 2 days it has been much like an English September/October with strong gusting winds and rain, today the theatre staff mede me laugh by putting on anywhere between 2 and 5 (yes 5!) layers of scrubs because they were so cold. They offered me more because I only had one layer on I told them it wasn’t as cold as England and that they should come back with me in January to see what cold really is, they declined! I really like the theatre staff, they are all really jokey and friendly and like singing in theatre, very different to the UK; once the laughter subsided we got to work.

I got a bit of a shock in the first case. It is always a joke that Orthopods use black and decker drills, well today it was truth! They did actually use a black and decker drill for inserting some K wires (metal wires that are slightly flexible and about 0.5-5mm in diameter depending on which bone you are fixing) into a toe. The black and decker drill, as it is not sterile, was carefully placed into a sterile coat made from cloth which looked specially made for its occasion! In the UK we use special drills that do look similar but are stainless steel and much lighter and you can put them into the sterilisers, so there is no need for a special coat.

The next case we did was a young chap who had a car accident, which is sadly all too common here. He had an unusaul fracture of his femur (thigh bone) it was broken in 2 places – at the neck in the hip and half way down, which presented an intersting problem of how to fix it. Usually to fix the higher fracture a nail is used that reaches to about mid thigh (just where the other fracture in this chap was!) So we had to use a much longer nail with locking screws near the knee and ones further up which were angled onto the hip to stop the fractures rotating on the nail, pretty cool stuff especially since it is in Africa – we did have an intraoperative xray machine though which always helps. This type of surgery is ALWAYS done with xray guidance in the UK, in Afrcia it seems to be optional!

It was really cool to be able to pray over the patient in theatre before we anaesthetised them, no where else I thought.

Me and Sheila (the physio student) have made a plan to go to Zomba on Saturday which is a small town about an hours drive fom Blantyre, there is the Zomba plateau to walk up and hike around, so hopefully the weather perks up and I’ll get some photos of the surrounding landscape. 2 nights ago I went with Sheila to Aisha’s house. Aisha is the lead physio here, she is an American with 2 kids who lives as she call it the Beverly hills of Blantyre (i.e. the poshest row of houses EVER in Africa). Her house was posh even to British standards. We went round there to make chocolate cake and other yummy things like bana cake, and ‘caramel corn’ which in Englush is toffee popcorn! I got confused with measuring stuff out in ‘cups’ I mean how exactly are you supposed to measure margarine out in a cup? Aisha agreed it was difficult and told me 1 cup is equal to approx 250g which again confused me as I cook in ounces because that’s what my Mam taught me! We also made Reeces peanut butter cups – which I think are a gross misconduct to chocolate – why smother peanut butter in chocolate? The HORROR (I don’t like peanuts, did you guess?!)

Please pray I continue to settle in and do not become homesick again, and also pray for safe travel on Saturday (and good weather)

H xxxxxxxx

Wednesday 11 August 2010

Sunday 8th August 2010

...We know and rely on the love God has for us. God is love. 1 John 4:16.

This was the verse for my daily reading a few days ago. The writer of the study for that day tells of his time when he went back to his home country in Africa to finish his internship (FY1 or to non medics – 1st year of being a doctor):

‘At one point I thought, ‘Was God really right to tell me to complete my internship here?’ Perhaps I had been wrong to think so. Yet despite my doubts, deep down I knew that I had heard Him right. Does that sound familiar?’

Umm, yes that sounds VERY familiar! God really does speak to us doesn’t he?! As I’ll explain later I was slightly freaking out yesterday on the way here, however God has just gently reminded me of this reading I read a few days ago, saying ‘hang on a minute, didn’t I just reassure you a few days ago?’ Yes God you did, and thank you for reassuring me again, I think you’re going to have to do that a lot these next 5 months!

Anyway so, here I am, I’ve made it!
The weather, which is the first thing all you Brits will want to know about, is much the same as it is at home – about 20-25 degrees, and today it is about 20! I am actually wearing a hoodie ‘cos it is cool inside the house. This is the end of the Malawian winter – roll on summer :-)

I have to confess whilst I was on the plane on the way I was absolutely terrified – of what I am doing not the fact I was in a plane – although that is quite scary, I don’t understand the physics, but being thousands of metres up in the sky in a tin can is WEIRD! Anyway back to being terrified of what the next 5 months hold...
I can’t quite believe I have decided to up and leave the comfort of England and an NHS job where I know everyone and what is expected of me and come to Malawi, where I don’t know anyone, and I actually have no idea what I will be up to. Anyway, as soon as I was picked up at Blantyre airport and was being driven to the hospital and the guest house, all of that disappeared! I was back in Africa and I knew I was going to love it :-) Please pray I’ll settle in quickly.

Once I arrived, I was greeted by a current occupant of the Guest house, Sheila, who is a physio student from California (USA). She has another month here. Apparently I have just missed 2 Medical students from Newcastle – they left yesterday morning a few hours before I arrived.

The house is one storey – like most African houses. It has a tin roof on which the pied crows were fighting on this morning and made one hell of a racket! There is a nice big lounge and dining room, with a TV and DVD player. The kitchen is compact but has everything useful – though why the cooker is electric and not gas is beyond me (African electricity boards have what they call share loading, which means parts of the city takes it in turns to have blackouts at random times during the day!) There are 4 rooms with 2-3 beds in each. I am currently sharing with Sheila. There is running HOT water (usually anyway) which means no freezing wash in the morning to wake me up (that was a delight in Uganda!)

Yesterday I got invited out in the afternoon with Sheila by one of her many family friends (Rose). Her Dad grew up in Zambia and therefore seems to know a lot of the Indian families in Zambia and Malawi. Rose took us on a drive down the hills outside Blantyre to the river and back which was beautiful. She then took us back to her house which was full of her Grandkids and fed us very spicy chicken samosas and doughnut type bread which was yummy.

Today Sheila showed me the local supermarket which wasn’t huge but big by African standards. She lent me some local money – Kwacha, as I have not yet managed to change mine. The guest house is self catered, although I get lunch at the hospital on working days. I found the usual African goodies of Blue band margarine, mixed fruit jam in a tin can, and ‘sodas’ of all flavours (pineapple or blackcurrant fanta anyone? – I wish the UK would sell them!) Tomorrow I will adventure to the local market and pick up small bananas, tomatoes, and aubergines all totalling about Mk 150 which is equivalent to $1 – brilliant :-)

I’m not sure what’s going to happen tomorrow but I’ll turn up at the hospital worship before rounds at 7ish and meet the other doctors there and work out my timetable and on-calls and stuff. It would be nice to have tomorrow off to venture into the centre of Blantyre to change money and get a phone etc before being launched straight into work, but I’ll go with the flow! Please pray for my first working day – I always get scared about first days of new rotations, even back in the UK, I think it’s mostly the not knowing about stuff which scares me, such as where to be at what time and each hospital even within the NHS has different ways of doing things, and I hate getting things wrong.

That’s about it for now, just to say I am writing this in a word document and then will up load it onto my blog – which won’t happen till at least tomorrow hence I’ll continue to put the date at the top of each entry so I try not to confuse people.

P.S. I’ve just heard an ice cream van go past – surreal! Its tune was teddy bears picnic!

H xxxxx


Tuesday 10th August 2010

Well today has been much better than yesterday! I actually felt homesick yesterday afternoon. Feel much better today. Yesterday consisted of a short ward round with Dr Sam and then his clinic which I just sat in on. I was told by Sama that Jim (the boss) would come and find me to chat about schedules and stuff but he never did. Today I went to the early worship meeting – the singing was amazing, I love the African sound, and the message was just right for how I was feeling. We looked at Psalm 100 and how we should always praise the Lord no matter what, Allelujah! It was then time for theatre and we operated on the kids who we saw on yesterdays ward round. I helped with a tibialis anterior tendon transfer to correct club foot, excision of osteochondroma, and release of burn contractures on a teenagers fingers with full thickness skin grafts. I still need to get hold a mobile and change the rest of my money, as have not managed to do that yet. I am hoping to catch jim this afternoon after his clinic to sort out what I’m actually expeted to be doing and my on call schedule as well.

Please pray that the homesickness will stay away and that I will settle in more and more.

Bye for now!

H xxxxxxxx

Saturday 7 August 2010

Hairy moments already!


So I've made it to the Departure lounge in Terminal 1 of Heathrow :-)

Had too much weight for my checked in baggage so had to pay excess which my Mam very kindly paid - Thanks Mam you're a star xxx

Then the lady asked about my visa - I was told several times by the hospital - no problem get one at Blantyre airport for 3 months (which is the max) then you can renew it monthly after that at £20 per month. The lady at the desk wasn't sure about this - PLEASE PRAY THAT IT'LL BE OK AND I'LL GET THROUGH AT BLANTYRE.

So that all over I then forgot to take my hiking boots off before walking through security and set the alarms off :-S OOOOPS - So they then searched me and made me get in the new fangled body scanner do-dah - which is quite claustrophobic but is only for like 5 seconds. I passed you'll be pleased to know, although thinking about it I probably wouldn't be writing this if I hadn't!!

Anyways, much love to everyone, and thanks for all your prayers so far - they have been very much appreciated :-)

H xxxxxxxxx

Thursday 5 August 2010

This is not just M&S roast beef, this is Mam's roast beef!


Thanks for all the kind messages I have had from friends and family :) I have now made it back to Loughborough and have stored all my stuff (that did make it into boxes!!) at my Grandmother's house. I have a fun packed day ahead tomorrow - My Nana from Lincoln and Auntie Sandra (who is currently over from Australia) are coming over tomorrow to say hello before I start my travels. Also my Mam is going to cook a big roast dinner for 9 people (the 6 of us, 2 grandparents and and an aunt) tomorrow night for my last night on English soil - Roast beef to boot - very English! I am especially looking forward to the plum bread and butter pudding afterwards :-)

Several of you have asked about my address whilst I am out there so here it is:

The Guest House
Beit CURE International Hospital
PO Box 31236
Blantyre 3
MALAWI

Feel free to send me snail mail - Haribo would always be appreciated! ;-)

Sunday 1 August 2010

This time next week....!



Well I think I'm now pretty much set for Malawi! I have packed and repacked my bags - still can't get it under 22Kg though (South African Airlines unfortunately only give you 20Kg). I'm hoping they won't charge me extra baggage! I now have to try and pack everything else up in the flat for Tuesday which is moving day. There is currently a lot of stuff and a lot of boxes, but not much of stuff actually in boxes :/

It's kind of an end of an era - me and Vic P have been house-mates since 2nd year of University (7 years!) She is off to her swanky new flat in Birmingham with her 5 corner seat leather sofa, and I'm off to mosquitoes and drop toilets!

I'm now feeling rather nostalgic and have really loved every minute of living in Worcester and working at the hospital, it is so much nicer that Heartlands and the Children's. Everyone is really friendly and fun to work with, I will miss you all. On a similar note, I got everything signed off by my supervisor that I needed to without any fuss - he was actually in a really good mood (a rarity!)

Now for the big news:

I passed my driving test - one minor only :) Another maniac let loose on the road - but no I won't be driving in Malawi - I'm not that crazy!

I think that's all for now, apart from to say eeeeeeeeeeeek 5 days to go... and as The Doctor says: Allons-y!!

H x