Whoops it’s been a while now

Haven't written anything on here for ages now, it is not because I haven't been doing anything but rather I have probably been more busy with work and from starting off with not very much to do I now seem to have too much to do, isn't that always the way. Work wise things have certainly been getting busier; the students have all been doing their end of year exams. This meant that we had to put together exam papers for each subject for each year as well writing the supplementary exams at the same time for those that might end up not passing. These papers all then had to be vetted, at the same time there were students on the ward to be supervised. The students have now all done their exams so we are busy marking and second marking them. It wasn't only the student nurses doing exams but also the trainee clinical officers had their midterm exams and as I had been teaching them as well needed to do exam questions for them and mark those papers as well. So having marked 350 exam papers and second marked a further 300 I feel quite worn out by it all – poor me.

Some of the students have also just started their district placements so we have had to go and supervise them in the district hospitals. Once students qualify they can be sent to work at the health centres, the district hospitals or the central hospitals. The system of employment post qualification works very differently here to what I am used to, as the nurses will get assigned to these different places and don't actually apply for jobs specifically as such. The good thing though is that as part of their training they do get to work in all the different types of places they might get sent to.

So last week saw me and a colleague travelling to Chikhwawa, which is quite some distance from Blantyre. I would meet my colleague at the Catholic Institute which is the staging post for the minibuses going in that direction. This was about a 15-20 minute walk from the house. We would then get the minibus to Chikhwawa, the journey involves one of the most scenic roads I have been on so far in Malawi but also sometimes a bit of a scary journey, and is about 45-60 minutes long. Chikhwawa is at a much lower altitude than Blantyre and getting down the side of the mountain is via a long steep windy road with not much leeway on the cliff side of the road. Often there are very big trucks / lorries that need to be overtaken on a blind bend. I chose to be in the back of the minibus as didn't want to witness overtaking on a blind bend at first hand. As you went over the top of the mountain each day the valley below was always below the cloud line. Each time we went we were fortunate enough that we only had to wait for about 20 minutes at the longest for the minibus to fill up. Next time I go on that route I will have to get some photo's – it always makes me think of Top Gear and how they like to go on steep curvy roads very fast and am sure they would enjoy this road. Getting to Chikhwawa involves going through at least 4 police check points, we were stopped each time and the vehicle inspected, on one occasion we all had to get off so they could see properly inside. This is quite a palaver as there are lots of people crammed on along with all their possessions. On one occasion the driver got fined much to the hilarity of the passengers, he had too many passengers having picked up someone just outside the town, so to make 50 kwacha he had to pay a fine of 1500 kwacha. There was much discussion about this for a long time and teasing of the driver.

On arrival in Chikhwawa the difference in temperature was quite noticeable, at present it is still fairly wintery in Blantyre, so I would arrive there warmly wrapped up in my fleece only to end up needing to discard it within a few minutes of arrival. The district hospital is still a couple of miles from the main boma of Chikhwawa and no minibuses go along that route, so the only way to get there besides walking is to get a bicycle taxi. These are literally bicycles with a cushioned seat at the back which the passenger sits on. The bicycle riders have a hard job lugging everyone up and down the road to the hospital; they can make the same journey up to 20 times a day. I wouldn't fancy cycling myself up there let alone doing it with some great big passenger on the back. I have to my hat off to them, the ride was very stable and I felt very secure, they were very careful of dodging the myriad of potholes in the road and even off road were very smooth. Being more a rural area I of course was the object of attention and all along the route would hear the children shouting out Mzungu and waving at me. You often hear people calling out Mzungu in Blantyre but not to the same degree, as we are not such a rare sight here.

This is me and my bicycle taxi just outside the hospital on the way back to get the minibus. The taxi driver is called Money.

On the way home again we never had to wait too long for the minibus to be full – I did however only realise that I had had a chicken sleeping on my foot for the whole of the journey back to Blantyre just as the journey ended. The minibus was rather full of chickens that day but I had thought they were all behind me.

It was a really interesting experience going out there and seeing how the district hospitals work, and learning all about it myself whilst at the same time supervising the students.

I have also now started working on the adult oncology unit at the local hospital, this is the first proper adult oncology unit in Malawi and it is great to be working alongside the team there. There has been a paediatric oncology unit for many years, but the consultant for the adult unit is the first trained oncologist to be employed. They have been really welcoming to me, and I spend roughly one day a week there, teaching as much as I can about oncology and chemotherapy administration, writing policies and procedures for them.

We have also been handed our teaching programmes for next year, and I am the programme co-ordinator for two of the modules and also teaching on a third module as well – so currently have about 30 – 40 lessons to prepare ready for the new academic year.

I will definitely been in need of a holiday again soon – am fortunately have one planned for the beginning of September.