Med Bay: Saw the same patients with nephrotic syndrome, encephalitis, anemia, hydrocephalus, liver failure, etc. We finished rounding at about 11am so I went down to A&E (ER) to see if there was anything there.
A young girl came in with abdominal pain, fever and vomiting. The differential diagnoses was obstruction vs constipation vs gastroenteritis, as her MPS (malaria parasite blood smear) was negative. I put in my first pediatric IV (it went in her hand) on the first try and started my first drip.
The other patient I saw had a pneumonia that was ok enough to be sent home with oral antibiotics.
During this time I had been speaking a few Chichewa words (which I was butchering, I'm sure). The nurses overheard my feeble attempts and said: "You need to learn. We'll find you a Malawian man so you can learn Chichewa during the day and the night. hahaha."
Apparently nurses are the same here as in the US. I chuckled and was going to tell them that the guy I left back home wouldn't be happy about it, when they asked me if they could take my blood. Seeing the look of confusion on my face they explained that they needed a control sample to compare lab results to for that day. So I held out my arm, watched them use a sterile needle and draw 5mL. Note: If you ever need to have blood drawn, pediatric nurses are awesome. She got me the first try, probably because she's used to itty-bitty veins.
When I got home, the guys had bought 4 chickens. They are hoping for eggs. The rule is that they just have to be gone when we leave (aka chicken dinner). There are a couple of "farm boys" in our group who are up to the task. Going to try and not name them. Although one looks like a Ginger and another a Raven...While the guys were explaining the "chicken facts of life," the eggs were called a "daily ovulation." Which I am going to have to add to the list of "You know you're a medical student when..."
The beard contest continues, as the guys are seeing who can go the longest without shaving. Only 3/5 remain. One of the remaining said that the last time he grew out his beard a little girl went up to him and said, "Do you have a home?" Apparently that was what got him to shave.
Day 26: Hanging on a cliff
After handover in the morning, 6 of us went to go and climb Mt. Mulange for the weekend. We hired 1 guide (Gravy) for the guys. My Scottish girl friend and I hired a separate guide (Eleison) because we knew we would take longer. Also we decided to get a porter each to haul our backpacks and sleeping bags up the mountain and down. Which turned out to be possibly the best $20 I have ever spent. Why? Well you see, I was told that it was a difficult and sometimes dangerous climb if it was raining and if you did not have a guide. I was also told that "older people and heavy people do this all the time."
The first hour was good. We were on your average uphill hiking trail, crossing little streams and were mostly in the shade. Then we stopped for water at a stream and after that it became a real hike. We would step up big boulders that were sometimes high enough that my leg lifted to my thigh. From there it got steeper. And as we got higher, I promised myself that whatever happened I would not look down. Fear of heights, remember? The worst hour for me was an actual climb up slabs of rock with the occasional grassy bits. It wasn't quite vertical, but it was close.
I was on all fours using my arms and legs to climb. I would look ahead for small bits of moss to plant my feet, because when I was on the rock, my feet would slide backwards. I remember thinking, I like rock/wall climbing, but that is when I have a rope to catch me if I slip. What kept me going forward was the knowledge that there was no way I could go back down the way I came up. Then I literally and figuratively hit a wall. I was halfway up this piece of rock when each foot was planted on an outgrowth of moss. I couldn't find another piece of moss within my legs' reach. I tried one too high, but slipped, so went back to where I was. I started slipping as my muscles tired. It was terrifying, especially due to my fear. The guide came back for me, lent me a hand and pulled me up.
After that the rest of the climb got better as we went till finally we reached flat land. My friend and I high-fived each other. I asked our guide which way we would be going back down and if it was steep. And he said a different and less steep way. Our last hour we walked through tall grass on flat land as the sun set. We were just starting to have trouble seeing the path when we saw the light the boys had put on for us. And we met them at CCAP (the cabin) 5 hours after we began the trek. They too apparently thought the climb was difficult (which was validating). I was just pleased to see that everyone made it and no one was injured. They had pasta waiting for us.
We had a nice hot "shower" which was a bucket full of water. Then stayed up sitting on the porch and talking until heading to bed in our bunks.
Day 27: Mt Mulange

Woke up, found the bathroom (i.e. an outhouse with a hole in the ground). The cabin was situated in between two peaks on the mountain and the view was striking. The group went to go and climbed one of the peaks. Two of us opted to stay at the cabin to relax our muscles and read. It rained throughout much of the day. Lunch was grilled cheese sandwiches and tomato soup which was made over the fireplace.
In the late afternoon, the rain cleared and we decided to go and check out the natural pools. On our way there we hit a river. I slipped on my "arse" (as my Scottish friend says) and went right in the water. We saw a beautiful view and I realized how far up we actually were. Then we found a pool of water next to a waterfall that looked out onto the countryside. Another surreal view of Africa. Not sure how we can keep topping them.
Went back, had rice and beans for dinner. Met another group who made the climb to the cabin. Stayed up talking around a single candlestick.
Day 28: What goes up, must come down
Climbed down, which was easier than going up. There were a lot of rocks that we had to step off of, but other than that we didn't have too much difficulty. AWhen we reached the bottom, the guys had a flatbed truck waiting for all of us. We piled in the back and drove around the mountain back to our car. Ate some lunch, then went back to the house where we heard the others' stories of their trip to Majete (spelling?). We were then told by our host that they took us up the steep way and that there is another way up that most people use instead. Figures. Still glad I had the experience, but don't think that I could ever do it again.
Oh my- we were "hanging" on every word! It is quite an insight to the Malawian/African culture.
ReplyDeleteGreat job Sarah- glad you are feeling better too.
Love Mom and Dad