England

As some of you know, I received some very sad news from my family whilst out in Malawi.

I consequently left Mulanje Mission somewhat earlier than planned and returned to England. Although it did not seem appropriate to continue my blog at that time (this is the reason for the hiatus following my last post), I still have lots of interesting things to write about my time there. I'm quite aware that, hitherto, I haven't mentioned anything medical at all, despite that occupying a large majority of my time.

I expect to start writing some more posts in a few days' time now.

The best laid plans of mice and men

As is often the case, my great plans for catching up with my blogging over the last week went awry.

Much to my pain and displeasure I came down with a case of the local version of the Katmandu Quickstep (Mulanje Mimba?) and spend the latter part of the week... well, you get the picture.

Although blogging was obviously not at the forefront of my mind during those days, I'm now going to exude optimism and predict that I'll again have caught up by the end of this week.

Watch this space!

Because it's there

Apologies for being tardy with my blog posts recently. I have a lot to write about but somehow I didn't manage to find an efficient way of doing it. I'm going to try to catch up this week. Wish me luck!

The most dominant feature on the Mulanje Mission skyline is Mount Mulanje. This is a granite massif that rises 2,000m out of the surrounding countryside, and includes several peaks, the highest of which is Sapitwa (which, it is rumoured, means "don't go there" in Chichewa) at 3,002m.

Mulanje Massif, as seen from the tea plantations near Mulanje Mission

A bunch of us decided that we would climb to the top of the Mount Mulanje plateau last weekend. Sadly, but perhaps fortunately, we didn't have sufficient time to attempt the Sapitwa peak, for which mere mortals must allocate a 3 day expedition.

We were due to leave on Saturday 12 April but when we gathered first thing to set out, the weather on the mountain looked terrible (the weather in Mulanje in general had been terrible that week) and we decided to postpone.

Not dissuaded however, on Sunday 13 April we again gathered and this time it was sunny weather with a reasonable forecast, and so we set off.

Setting off for the bottom of the trail in a trusty land rover.

The climbing party before starting out.

The task ahead.

The first river crossing.

The first bit of the hike up to the plateau was gentle and fun, albeit with weather a bit too hot for my liking. It was punctuated by the crossing of a river (the first of many) which is tackled by a barefoot leap across a set of large boulders, while trying really hard not to wreck our cameras/become dinner for a crocodile by falling into the water below!

Beware of the crocodiles.

The weather closes in.

The hike up was tough. It's fair to say I was amongst the slower of the climbers, although this effect may have been slightly accentuated by the climbing party being primarily composed of the overseas contingent of the wedding party, including inter alia a professional rugby player (Hi, Tom) with a certain, rather entertaining musical ability, who seemed to run up-and-down a yard for every step I took!

Anyway, our path up the mountain seemed to mostly follow the rocky beds of several streams. In better times, these would be dry and give you a fairly good purchase on the rocks. However, the recent weather had been very wet, and half way up we climbed into a rain cloud, in which we stayed all the way to the top. Consequently, these streams were anything but dry. In fact, many were in full flow, and on these sections, and many others beside, the rocks were extremely slippy. A couple of the slippy sections were also very exposed, right where a slip would throw you down a vertical kilometre or two to the valley floor below. These bits were not so fun!

After six hours climbing, we made it to our destination --- a mountaintop hut operated by the Central Church of Africa Presbyterian, the same organization who happens to run Mulanje Mission.

By this stage every one of us was soaked through with sweat and rain, and also caked in mud up to our ankles. Only a minority of us were wearing waterproof hiking boots, and those who weren't had soaking feet also.

So our arrival at the hut was an amazing relief. The place turned out to be more mountain chalet than hut. It had comfortable bunk sleeping for a couple of dozen people, and a nice sitting room heated up by a large fireplace in which we burned cedar wood cut from the surrounding woodlands by a live-in warden. In fact, for the princely sum of MK750 (about £1.10) you could buy Coca Cola or Carlsberg beer in bottles painstakingly carted up 2,000 vertical metres by some poor body or other.

The CCAP hut, seen in the morning's good weather...

... and what passed for its latrine! Inside here is a rather uninviting hole in the ground.

The warden's accommodation. The warden's apparently work shifts, spending a fortnight high on the mountain at a time.

After changing into clean clothes and drying our shoes and socks on the fireplace, I think we all began to feel a bit more human again. I certainly did. Alas, our peace was soon spoiled by the arrival of a party composed of a German and an American couple and about a million of their kids. The German woman promptly announced that, since she had booked essentially the whole hut and there were not enough beds for them and all their kids to have one each in addition to us, that we could not have booked (not true), that we were mistaken or lying about having booked (neither true), and that she did not intend to share (completely true), despite the fact that her kids could easily have doubled up on beds without any discomfort.

Fortunately, magnanimity was not in short supply on the British side. We kindly offered to give up several of our bunks so that her kids could have one each, with some of us doubling up (we luckily had a couple of couples amongst us) and the overspill sleeping on the floor.

Shortly thereafter, the German woman and her children invaded the sitting room and took it over. Wishing again to procure peace in our time, we agreed to let her annex the sitting room in addition to the bunks she wanted, and we beat a hasty retreat to the freezing cold, pitch black, mountain-top veranda. In return, we were promised the use of the cedarwood fire to heat up our food, but only once they had heated up their pasta. They spent the next three hours just boiling water.

Fortunately, the warden of the hut took pity on us, and helped us construct a cedarwood brazier on the veranda, despite (or more cynically, on account of its present occupants, because of) the obvious fire hazard: flaming embers were ejected from the brazier several times and had to be stamped out before they set his hut ablaze. Nonetheless, following the sage advice of the old scouts amongst us, we managed to heat up our food. We also found some chairs and blankets and had a jolly old time sitting around our brazier, telling tales and solving riddles produced by Tom's phone.

Sadly, as is often the case with these things, our dearly-bought truce was not to last. We arose in the morning and entered the sitting room to find that an act of glorious criminality had taken place: a single empty bottle of Coca Cola stood on the counter top in defiant testimony to its theft from the warden's stash during the previous night.

Despite the fact that (at her insistence) the bunks in the sitting room had been occupied solely by her offspring the previous night, and furthermore that one amongst our party had actually seen one of her children with a bottle of Coca Cola, our Teutonic friend insisted that her children do not and would never drink Coca Cola, and therefore it could only have been drunk by one of us, and by implication, that we were dishonestly trying to pass onto her the outrageous charge of MK750 (£1.10) for quenching our thirst.

In a last ditch effort to avert the outbreak of war on the Mulanje mountain top, again our magnamity shone through, and we offered to go halves on the price for the stolen Coke. In spite of her initial protests, our German interlocutor eventually agreed to this, before proclaiming sotto voce that she now didn't believe that we had pilfered the Coke after all, and that she now believed the warden had stolen it from himself in an attempt to scam us for the lofty sum of a whole quid, and that in light of this conclusion, she intended to deduct her half of the cost of the Coke from his payment.

Since our conflict had now been resolved to her entire satisfaction, she further proposed that, to cement our new friendship, we should all descend together as one big climbing party, kids and all. Never, in the field of mountain climbing, has so much climbing gear been donned by so many, in so few minutes. We were out of that hut and scarpering down the mountain side before our new friends had even finished their breakfast.

The Mulanje Massif plateau, as seen from the back of our hut. It didn't seem nearly so flat when we were walking across it.

Fortunately, the weather had improved dramatically overnight and we managed to get some really good views from high on the mountain on the way down. The fearsome slipperly sections proved not to be nearly so fearsome as I'd feared when setting off from the hut that morning, and very soon we were all down the mountain and relaxing over a Coca Cola and a pizza at the infamous Mulanje Pepper restaurant in Chitekale.

On the road, once again.

Clouds on the mountain top.

A peak on the Mulanje Massif plateau.

The climbing party.

Yours truly, atop the Mulanje Massif.

The mountain plateau was above cloud level as we set out from the top, so rather than see the valley floor below, we had this fantastic vista of being on an island surrounded by a sea of clouds.

Samuel, our trusty guide for the climb.

Well on the way down, we're just peeping out the bottom of the clouds surrounding the mountain.

Just to prove what a small world it actually is, who should I bump into right at that moment in Mulanje Pepper, but some of my friends from the Oxford medical school, who unbeknownst to be --- and by strange and happy coincidence --- had been on the mountain at the same time as us? They had gone up the day before us and made an attempt on Sapitwa peak, the same day that we made our ascent, but they had been caught by the same weather as us, and unluckily they had to abort their attempt. It was really nice to meet you, guys!

Oxford unexpectedly invades Mulanje Pepper

Relaxing over pizza and Coca Cola at the Mulanje Pepper restaurant in Chitekale, after our descent.

after the storm

So, last time I blogged was before the weekend, the wedding, the presidential rally and the storm.

The presidential rally was probably the most worrisome, especially given the recent history of violence at such events. The rumour is that at the Thyolo event, the police ran out of tear gas while trying to deal with a riotous audience, and therefore saw fit to resort to live ammunition. That decision surely ranks highly on the Hillsborough scale for effective police crowd control.

The rally was held on the recreation area which abutts the hospital grounds. We had made preparations for safety should things have gotten unsafe for us, particularly since the azungu are predominantly British around here (yours truly included, obviously) and there is some anti-British feeling surrounding President Banda and her election campaign. We had a landrover at-the-ready to make our escape over the tea plantations at the back of the hospital, and many of us prepared an escape pack with our valuables inside, to quickly grab on the way to the jeep.

My bail out bag, fortunately never used!

Fortunately, the rally passed off peacefully. Many Team JB supporters came in buses and tractor-trailers and all manner of vehicles to the tiny outpost of Mulanje Mission, probably increasing its population by a factor of ten or so. Opposition supporters were nowhere in sight, although incredibly but probably inescapably one of the Team JB bus drivers was sufficient enamoured with Manchester United to paint its name on the front of his bus.

The president's election rally. The people on the field are her supporters. The people sitting in front of me, on my side of the road, it is fair to say probably were not.

Despite claims to the contrary, I somehow doubt this is the express coach Mulanje Mission to Old Trafford.

The weather threat also turned to naught, as the storm deviated from its predicted trajectory and mostly dissipated over Madagascar, although I think we might have caught the tail end of it, since it rained basically non-stop from Sunday through today.

In any case, the wedding went off without a hitch, which is the most important thing, despite a good attempt to kill on the way there, by means of a minibus (which belongs to the nursing school at the Mission) with no brakes which the driver didn't realise until shortly before driving at full speed into a ramp in the road near the hospital. The minibus was literally thrown into the air (as were its occupants) but fortunately it landed squarely on its wheels and apart from a few bruised heads there were no serious injuries.

This ridiculous minibus could have killed us all. The brake lights are lying, in fact, it turned out to have no brakes at all. This minibus belongs to the nearby college of nursing, also operating under the banner of Mulanje Mission, so it really ought to have been maintained. The driver is also partly to blame. He pulled away at an unsafe speed for the road, and didn't touch the brakes until the last moment before the ramp, when he had no time to do anything else. It just wasn't good enough, like many things you find in Africa it seems. The reaction of the locals was amazing, they simply shrugged it off: this reaction to such things is also common around here, which I suppose helps them cope with it all, but also inhibits anything getting done to improve matters. On the whole, the British on the bus weren't nearly so accepting, it might be fair to say.

The occasion of the wedding itself was quite wonderful and the traditional dancers and the church choir were particularly fantastic, in fact, like nothing I'd seen before. I've got a couple of videos of them, which I'll post as soon as I have a somewhat faster internet connection.

That's all for now.

I've now finished my first week at the Mulanje Mission Hospital in Malawi. I'll write more about that later, because this weekend is looking to be rather busy.

Firstly, one of our staff members is getting married, a long planned event with a big party that by some accounts has been the talk of Mulanje for weeks.

Then it was announced that Malawian President Joyce Banda will be visiting Mulanje Mission on Saturday---the day of the wedding party---to hold an election rally. This is already proving disruptive to wedding preparations and should the election rally spark any kind of trouble, like it did last time, then the hospital will likely have to pick up the pieces. Unfortunately, Mulanje is opposition heartland so trouble is a distinct possibility.

Then it was announced that the Indian Ocean had begotten a tropical cyclone, since named Hellen, and that this was headed our way. Malawi is far inland so this storm will have weakened to heavy rainfall if and when it reaches us, but unfortunately the weather proved insufficient to dissuade President Banda from making her visit, and so now the wedding will have to contend with both.

Watch this space.

Muli bwanje, Mulanje

On Sunday night I left beautiful Michal and beloved Dinky for my medical elective attachment in Africa.

Dinky the Magnificent

The subsequent flight was mostly long and boring and the connection in Addis Ababa airport revealed it to be a foul place. It stank of stale cigarette smoke and was more like a souk than an airport. I didn't take many photos there because it was so grim. However, I didn't have to tolerate it for long before I was off again, and in daylight this time. Several hours of this:

Africa from 40,000 feet

were then followed by this:

Lake Malawi, as seen from the stratosphere. The country looks tiny on a map of Africa, but in fact it's not at all: it's still 750 miles from here to my destination.

Blantyre district, viewed from the air. It's quite hilly. The aeroplane was weaving about the hills coming in. The geography looked amazing but it was impossible for the camera to capture it all.

I then landed at Chikewa Airport, which serves Blantyre, Malawi's main commercial city and the largest town in the south of the country, on the 33rd anniversary of my birthday. The airport is a cratered runway accompanied by a concrete shed. The hospital had kindly arranged for one of their drivers to pick me up, who I met in the shed, and I was soon on my way to Mulanje.

Seen from the car on the road from the airport to Mulanje

The road from the airport to Mulanje

The famous Mulanje Massif, with the peak of Sapitwa (3002m) hidden in clouds to the left, which I fully intend to climb. Taken from the road from the airport.

The abrupt change in language and weather were the most immediate culture shocks when coming in from abroad, as they often are. I was particularly awestruck by the scenery which is obviously very different from England. The camera on my phone barely does it justice.

The driver helped me pick a few things up in Blantyre and then took me straight to my accommodation near the hospital. It was dark by the time I got there, but there was another elective student from the UK who had arrived a few days before me there to greet me.

Very soon, a welcome party of three of the four doctors at the hospital, all British, and a volunteer carpenter from Scotland, turned up and helped me settle in by cooking dinner.

Everybody---the welcome party, and the locals---were so overwhelmingly kind and helpful and friendly that I'm sure I will have a great time here.

Muli bwanje, Mulanje.

Greetings.

This time next week, with a whole lot of luck and a bit of tarmac to soften my landing, I will be in Malawi. Specifically, near the town of Mulanje at the Mulanje Mission Hospital.

I'm not entirely sure what to expect.

I mean, I've prepared how I can by reading the guide books and learning a bit of the local dialect. The hospital staff have been very kind and helpful so far and I've no doubt they'll help me to settle in just fine. Everyone says the locals are friendly and the photographs I've seen of the nearby geography are nothing short of stunning.

However, we're talking about a country whose every metric for economic and healthcare provision ranks in the bottom 5 per cent of the entire world. The clinical situation I'm consequently expecting inspires abject terror at approximately the same level as this. Hope I'm up to the job!

Anyway, I will let you know all about it next week, because I've decided to succumb to la mode du jour and "blog" my elective.

I very briefly considered claiming some deep literary inspiration for this decision from the time-honoured tradition of travel writing. Perhaps from this guy, or this, or maybe him. The truth of the matter, however, is that a friend of mine did it for his a few weeks ago and now I've copied him.

Hope you enjoy.