Pictures of the House

Hi, friends! We thought we'd post some pictures of the exterior of our house. Currently the inside is being repaired. This is the entry:

This is the back of the house:

 A view of the backyard:

One of the three very tall jackfruit trees in our yard:

Five grown men and three little boys had fun one day by throwing bricks into the tree to knock down a ripe jackfruit. They succeeded in harvesting two unripe ones, but the yellow one swung tantalizingly, as if mocking their efforts. A December tradition has begun: Jackfruit Harvesting Competition, Malamulo versus Blantyre. I think we'll win!! :)

Hungry

                                                                                                                     December 24, 2012

My son ran inside several days ago, saying, “Mommy! The boys outside are catching flying ants and eating them! They tried to give me a few!”

“Did you eat them?” my obvious question.

“No way!” he replied with a big grin.

This conversation followed one of a few days before. An excited little voice called to me from outdoors, “Mommy, come see this!”

I ran outside to see Jedidiah surrounded by the same older boys; one held two tiny, delicate birds by the feet. He held them together with his thumb and forefinger, and they hung limply. One was brown, the other had beautiful irredescent green feathers with a black beak.

“What will you do with the birds?” I asked.

A man came over and grabbed a large, fat-rumped termite in his hand. He said, “Do you see that cornstalk over there with the 'Y' in it? This boy puts a stick through the termite and fastens it in the 'Y.' Then he applies pitch under the bug. The termite flutters its wings, and when the bird comes to eat the termite, it gets stuck and the boys catch it.”

I looked and saw a termite suspended in ceaseless flutter. “What do they do with the birds?” “They put them in their stew to flavor it,” he answered.

But that's not all they do with the birds. Sven, a Europen medical student who is currently at Malamulo, told me that he tried one of the little birds. With his teeth he tried to pick the pittance of meat from it, but was told to put the whole thing in his mouth and chew it down. This he did, only to be told that the birds are not well-cooked. “I have not eaten another one,” he declared in his wonderful European accent.

While waiting for a ride back to the house one day after work, Jamie saw a man dressed in two scanty rags walking back and forth in the pouring rain. He was looking at people, gesturing at times to them and at other times to nobody in particular, silently pointing and waving. Finally, he settled on Jamie (he does kind of stand out here) and took off his drenched rags, threw them on the ground, and looked at Jamie. Then he mingled in the crowd, naked. Again he came back to Jamie, picked up his wet heap, and threw it on Jamie's feet. He stood there with goose bumps on his arms, so Jamie said, “You look cold.” Considering the situation—with the damp rags soaking into his shoes—Jamie felt immensely grateful to be “dressed and in his right mind.” He took off his dress shirt and placed it over the man's shoulders.

This Christmas season, as we think about God's gift to us, we want to give in gratitude for His love. He said “Whatever you do for the least of these brother of mine, you have done it unto Me.” He also said to “feed the hungry, clothe the naked... .” In Malawi, the needs are everywhere, and they are obvious. However, I hope we remember that nakedness, hunger, and thirst touch not only the body but also the soul, and we help others to meet “the Way, the Truth, and the Life.”

Queen Elizabeth Central Hospital

                                                                                                                    December 22, 2012

By Jamie:

As part of my orientation to Malawi medicine the Medical Council has mandated that I spend six weeks orienting at Queen Elizabeth Central Hospital, or affectionately “Queens”.  Queens is the largest hospital in Malawi with over 1200 beds.  You are probably imagining a multistory complex with shiny windows, but on the contrary the whole hospital is single story.  It is a labyrinth of large brick rooms connected by covered corridors.  I said 1200 beds, but it may be more appropriate to say 1200 mattresses, or some form of bedding.  Most of the wards are a large room with 60-80 patients in them, some on beds some on the floor.  

There is a well established benchmark at Queens that 75% of all admitted adults are infected with HIV.  Most of them are admitted with AIDS or an adverse reaction to their HIV medication. Tuberculosis, Cryptococcal meningitis, Kaposi’s Sarcoma, and HIV related cardiovascular disease are everyday admissions in the hospital.  You probably know that AIDS has been the scourge of Sub-saharan Africa dropping the life expectancy to well below 40 years in many countries including Malawi.  Thanks to international donors including the United States treatment for HIV has become much more accessible, and in the last five years life expectancy at birth has already increased by over 10 years to put Malawi back around the 50 year mark.  The sun appears to be rising again in the “Warm heart of Africa”.

This is not to say there are no other hurdles.  Currently the country is in an economic downturn with inflation and instability.  In the last three years the local currency (the kwacha) has devalued by over 100%, and continues to inflate.  A relative drought has left an estimated 20-30% of Malawian families with marginal to insecure food stores.  With growing treatment for HIV, an aging cohort of chronically ill individuals is emerging.  Treatment for HIV is well established to promote the metabolic syndrome – increasing cholesterol, blood pressure, and insulin resistance.  Stroke is already the third most common cause of death at Queens, and the next decade will witness a dramatic shift from infectious to non-communicable diseases in this poor country.  This will pose new challenges to the current system.  At Queens (the largest Central hospital in the country), it is currently not possible to measure a patient’s cholesterol, and medical treatment beyond aspirin is not available.  Diabetes care is a little more developed with availability of random/fasting blood sugar tests, metformin, glimenclamide, and insulin (sometimes).  Recently, the hospital pharmacy ran out of insulin which resulted in a dramatic spike in admissions for Diabetic Ketoacidosis (DKA).  Treatment for DKA amongst other things includes insulin, how are you supposed to treat it without insulin?  Creativity and ingenuity.

Death is common in Malawi.  I suppose it is common all over the world, but it is common at a much younger age in Malawi.  Most patients who die leave behind young families with on average 4-6 children.  Critical care at Queens consists of the “High Dependency Unit” or HDU.  In the HDU you can have access to an oxygen concentrator which will concentrate up to 5 L of O2 by nasal cannula.  Ventilators and CPR are unknown in Malawi, and for those needing more than 5 L of O2 there are no other options.  In the last week cases who I saw die included Fulminant Hepatitis (likely from ART), Lactic Acidosis (probably from ART), Sepsis, and of course, TB.  Average age was 35.

I’ll be honest, all of this can be a little overwhelming. The tyranny of the urgent infectious plague on the backdrop of a mounting non-communicable epidemic makes prioritization of necessity precarious. I think hard-working problem-solving Westerners like myself can easily burnout as bad outcomes are so common.  It reminds me of the message I need to hear, “Come unto me and rest”.  Beyond bad news and statistics there is a loving Creator seeking a wounded creation. My job as long as I am here is to help the next one.

Fever

                                                                                                                       December 22, 2012

From Jamie:

I’ve been dreading this since we planned our move to Malawi, but I knew the day would come.  Jedidiah is laying next to me kind of sleeping – I can feel him from several inches away – radiating.  I know I should just sleep, but instead I count respirations and pulse. He is hyperdynamic.  I knew this would happen, I was just hoping we would be a little more settled before it did.  We rustle through the rest of the night rolling back and forth – him with a fever, me with worry. 

Fevers are common in children all over the world.  In Loma Linda it was either a cold or a cough, or vice versa, and sometimes I even worried then despite an artillery of vaccinations and medical care.  Now a fever in Africa lengthens the list—Malaria, typhoid, viruses…strange viruses, deadly viruses, on and on. I think back to discussions we have had.  Missionaries losing children, should families move to malarious areas?  What prophylaxis to take, if any?  When to pray, when to act…

We have taken all the precautions against Malaria that I can think of besides staying home.  We stay inside after dark, we sleep under bed nets, we use mosquito repellant for the children, and we are all taking appropriate prophylaxis (medication to prevent malaria).  Almost like our life revolves around preventing malaria. Somehow that doesn’t help right now.  Last week I heard a presentation about cerebral malaria – the most serious form.  Thirty percent die, brain swelling, happens spontaneously after a day or two of fever, and children with no acquired immunity to malaria are at higher risk…this is really not helping me sleep.

Trust God.  I’ll be honest, I am afraid of malaria for my children.  No other issue threatened the possibility of us coming to Africa more.  We have friends who have lost their children to malaria, and while I want my faith to be strong, it’s not.  Not as strong as it was in those days – the good old days?—when I had a quiet hour with God, when I told Him I was not afraid to go, to suffer, to die...  Now that we are here a decade later, I am far less exemplary.  I am doing good to make it to work with deodorant (which really doesn’t matter here) and a prayer for wisdom while I run out the door. 

“He will gather the lambs in His arms and carry them close to His heart” Isaiah 40:11.  I long for God to gather up my little lambs and hold them close to His heart.  There is no greater desire in mine.  But sitting here in the dead of African night it’s clear to me that I am the little lamb. I am the little one in need of a shepherd to carry me.

Why?

                                                                                                                                December 8, 2012

Fog rolled across the land in seconds before rain pounded the earth. In the distance we could hear the drums and sounds of dancing. My children squealed with delight and twirled in the refreshment sent from heaven.  

When the rain slackens, the frogs sing and the ants march. Two days ago Jedidiah inadvertently stepped into a swarm of marching ants, biting as they climbed him. He screamed, begging for help. The ants reached his naval. As we wiped him down, he smiled sweetly and spoke of happy things. I love the innocence of children. He had no need to dwell on the hurt.

Now he and his daddy are having “church” upstairs while I sit with my sleeping, precious girl. I hear his sweet voice singing, “Rejoice ye pure in heart!”  A crop duster drones by, and I hear the sounds of many new and melodious bird voices. Across the valley I see clouds just above the hills.

Why are we here?

Yesterday we bought bananas from the women who sell them very close to where our future house is. Jamie asked, “How much for this bunch of bananas?” The woman said, “250.” Jamie replied, “Okay. Here’s 250.” The women smirked at each other. I didn’t like it. I said to Jamie, “They just overcharged you.” He said, “But they’re good bananas.” It is true that my children like them, but I don’t appreciate dishonesty.

I met a woman who has worked in India and has been working in Africa a few years. I said to her, “I think India would be a very difficult place to work, because honesty is not a core value of their culture.” She said, “I find that to be truer in Africa.” 

When I spoke to Ken, the builder who is working on our house, he asked me, “For how many years will you stay in Malawi?” I responded, “Five. But if my husband is still needed here, we may stay longer.” He replied, “Five. For you, it is enough!” Then we spoke of the other missionary family here. He said, “For them, five years is not enough. They are good people. They help many Malawians. Five years is not enough.” Oh! I’ve been here ten days, and they already want to send me back! What have I done? I’ve wanted to have a house without holes into which to move our family.

Why are we here?

Yesterday a man came to the guesthouse. He placed wooden souvenirs by the front door and waited. He said that he made them himself, but we did not buy any. He waited all day there by the door, until I felt sad for him.

A few days ago we were walking down the street. I saw a young girl walking with her mother. Both looked so happy, but the girl’s bald head was covered in awful looking sores. I shuddered.

We went into the town of Makwasa yesterday. The people sat in the dirt selling vegetables and fruit. A little girl had a brown dress full of holes. She and her dress matched the dirt, except for her big smile. I wondered what color the dress had once been.

Two days ago I met Patty, a woman whom someone wanted me to interview to be my house-helper. She hardly looked at me and didn’t understand much English. When we shook hands, her hand felt dirty. I was told that I must teach her how to be clean.

So why am I here?

Not a missionary

                                                                                                                            December 6, 2012

I miss my home and the best peaches in the whole earth, which grow right outside my bedroom window—white peaches. The yellow peaches on the lower level are nearly as good. I didn’t get any this year because we were travelling, and we won’t eat any for five years…and who knows if they’ll be good anymore without care?

I miss my lemons…I hope we can grow some quickly here. I miss my glider and my pergola with our baby swing and our oranges and blood oranges and our cute backyard and our picnic tables that my husband built for me…and did I mention the peaches?

I miss going to the store and buying berries, and whatever I want to buy. The children are using up the tape on nothing. Where do I buy more tape? I wish I had some duct tape, and some packing tape.

I want to go home. There are biting, stinging bugs everywhere. Today there was a small scorpion in the mosquito net. The net was open, and I hope that’s why. I think that those flat spiders and the scorpions could get in our nets even tucked in. 

We are not “in” here. No one seems to care about us much, and I don’t feel connected to any of them, either. I’m not trying to endear myself to them, and I wouldn’t know how. They are all very different from me, and not one of them understands my fear of bugs. Not one. I don’t want to be a thorn in the flesh.

So that’s it. I’m not a missionary. No missionaries have bug-o-phobia like I do, and they are content to have houses with holes and rotten roofs. Before I had children I was okay, but now, I don’t seem to be missionary material. Let me go home.

Malawi Entry

                                                                                                                          December 4, 2012

The ticket agent at LAX was helpful, and we tipped her generously. Our aircraft departed at 9:30 pm. The flight was uneventful, except for the fact that we were crammed into three seats and Abigail was overtired so she cried the whole way. I darted glares from the girl in front of me and silently dared her to say anything.

When we arrived at JFK, we transferred from Delta to South African Airlines. The good news is that we did not have to pay again for our excessive baggage. The bad news is that the very helpful ticket agent at LAX had entered Abigail’s ticket incorrectly, so we had to wait while they worked out a solution. At boarding time the SAA ticket agent gave us our boarding passes and said, “Go quickly. You have a long walk.” He also told us that we would need to repeat this process in Johannesburg. During the flight, we had eight seats for the four of us!

As we went through security at JNB, they confiscated Abigail’s toddler fork (which had been Jedidiah’s.) That tugged my mother’s heart, but thankfully I didn’t have to burst into tears because Jedidiah did it for me.

At last we arrived in Malawi—the warm heart of Africa. We were the last to disembark the aircraft and at the end of the line outside the building. A lady who worked there told us to go in and sit down, because the sun was too hot for the baby. (Whew! Thank you!) We wheeled our ten carry-ons and sat on the only chairs. A woman whom seemed to be the head of customs took our passports and waved us through. She then ordered a man to gather our ten checked bags and to take them to our vehicle. Interesting cultural experience that was! The man took Jamie’s carry-ons and placed them on the cart. He didn’t even look at mine. When there was extra baggage to be carried, he handed it to me, loaded down with a baby and a son and six carry-ons! The lady in charge obviously did not approve for she grabbed my bags and told him to put them on the cart! Two young girls loaded our seventy pound suitcases into the Land Cruiser.

A volunteer here at Malamulo, took us to the bank to exchange some money. When Jamie was handed a large stack of kwacha, all the heads in line turned to look. (At the time, 325 kwacha = $1.00)

So here we are at Malamulo Mission Hospital. Since our home is not in livable condition, we are staying at the guesthouse in a room with four bunk beds until it is ready for us.

The first few days all we wanted to do was sleep. Jedidiah and Jamie adjusted to the time difference quickly, but Abigail and I have taken longer. At 2am she developed this (obviously) hilarious game of jumping on Mommy and blowing raspberries on my arm. She giggled so hard that she woke up her brother.

We’ve seen some large spiders and cockroaches. We’ve been told that those racquetball sized spiders are “little” and “won’t hurt you.” Thanks?? It’s amazing how something so small comparatively can evoke such strong feelings.

Jamie is learning Chichewa, and most Malawians seemed pleased. He even drank their fermented corn meal drink, and is so proud of himself that I think he’s told every Malawian to whom he’s spoken! Next week he begins a six week orientation at the government hospital. After that, he’ll begin work at Malamulo.