It’s been a while...
What’s changed here recently? We still have no running water apart from the evening ration when we fill the buckets. But this evening after filling the buckets I managed to have my first brief running-water shower in just over six weeks. Never have I been quite so appreciative of running water! I also had cheese today, proper hard cheese, after being donated a rather large quantity from someone – not likely to happen again in a very long time, hadn’t realised just how much I missed cheese!
I have run out of instant coffee and am now on the locally-available granules which purport to be coffee but which in fact taste like bits of scraped up street (not that I’m entirely sure what scraped-up-street tastes like, but I can imagine...) Laure-Anne, my French midwife housemate, last night brought out a large sachet of Carte Noir which we are rationing as much as we can and keeping ‘en cas d’urgence’ – in case of emergency – but at least the local fare is helping to decrease my caffeine consumption... The alternative is to buy fresh beans from the market, roast them over a charcoal fire ourselves and then grind them by hand with a mortar and pestle – tedium in extremis, so not something we do too often! Anyone want to post me some decent instant coffee??? The bigger refill pouches that are made to refill a jar. I will exchange for vanilla pods...
Mango season is now in full swing, just under a penny each. Lychees have also just started to begin, saw the first lot at the market this week which was very exciting.
Two weeks ago I spent Sunday in one of the smaller villages 10km away, called Ambodimadiro. We went on foot, setting off just before 7am, which was a little painful, but meant that we avoided the heat of the day. The walk through the countryside was beautiful, albeit very very dusty. We went to the small village cell church where there are about 20 members, and I was encouraged that I understood some of the Tsimihety language sermon. We then spent a wonderful afternoon in the village eating local fare, including locally grown and roasted coffee – mmmm.... It puts a whole new perspective on ‘carbon footprint’ / ‘food miles’ when you can see most of the fields and trees where your lunch was grown! I was very encouraged by the faith of the small group of Christians who meet and witness out in their small village.
Last weekend we were meant to be going to Ile Sainte Marie, a small island off the east coast of Madagascar, for a long weekend retreat. We were all looking forward to it (perhaps as much for the running water and supermarket as the tropical island...) when we heard just a few days in advance that the single MAF plane which serves the whole of Madagascar had been grounded by the aviation authority due to a technical issue. So to cut a long story short, we ended up staying right here at the hospital, but still spent the time as a team together, which was really good. It was a challenge in being ‘joyful in all things’ (1 Thes 5:16) particularly given the rather significant change in location, but we had a really good time nonetheless, and learnt a lot about God and about each other.
I have one more week of full time language learning, and then start work the following week. For a whole host of reasons, my language learning time has been cut shorter than expected, which has made it even more challenging to learn what I need to in the time available, but I’ve been encouraged by what I’ve been able to learn so far. I’m now trying to get to grips with the medical vocabulary and conducting a consultation in both ‘Official Malagasy’ and the Tsimihety local dialect – similar structures, but totally different vocabulary! Thankfully I’ll have someone with me at the start to translate from Malagasy into French though. I’m looking forward to starting work – it’s been 3 months since I’ve done much medical work. At the same time though I’m very aware of the differences with working here, and how I’ll have to get used to a very different way of working – one of the biggest changes being having no-one else more senior / no consultant to call upon. But I’ve been fast learning already that there is someone even better I can call upon who is so often the doctor here when we don’t know what to do or can’t do what needs to be done – Jesus.
This week was a good example no two days being the same and not being sure what to do. We’re often met with the unexpected, or the rather bizarre, here. One evening a lady had been referred to the midwives here by a village birth attendant because ‘something wasn’t right’. The ultrasound suggested that it was possibly an ‘abdominal pregnancy’ – a pregnancy where the infant develops outside of the uterus in the abdomen - with a term baby. So we did a Caesarean section – my first proper taster of life back in clinical medicine here. And sure enough, as we opened the abdominal muscles, there was an arm just underneath! Once we’d untangled her from the abdominal contents, the resultant baby girl was in surprisingly good shape, and 2.9kg which is a pretty good weight for here. Removing the placenta was more challenging, stuck within the abdominal contents. But amazingly, a few days later, mother and baby are both doing well. My rapid internet searching that I’m able to do here tells me that getting an abdominal pregnancy to term followed by the delivery of a healthy baby is exceptionally rare – but we seem to be fairly good at ‘exceptionally rare’ here...
I think that’s it for now. Hopefully usual blog-writing frequency will be resumed shortly. Meanwhile, it’s hard to believe that we’re on the run up to Christmas and that Advent starts tomorrow. We’re still pretty high on the thermometer settings with no sign of any relief on that front until partway into next year – but eagerly awaiting the rainy season (and maybe the return of our running water???) which could start any time within the next couple of weeks. Hoping to go out and plant rice and peanuts in the villages soon once the rains come. Happy Saturday, wherever you are and whatever you’re doing.
Vic x
Saturday, 26 November 2011
Thursday, 27 October 2011
Flying pizza
Today the Mission Aviation Fellowship flew out on part 2 of their monthly flight to Mandritsara. To cheer us up because it's 42 deg and we've had no running water for a month now, the pilot flew us up 12 takeaway pizzas from the capital out into the bush! With CHEESE and everything. And mushrooms, and ham, and things you can never get here. It was indeed an amazing sight. We're wondering if MAF flying pizza delivery could become a monthly event...
Oh, and in other news, it's now reached 42 degrees today. One could say it is a little hot. Not made any easier by the fact that it's now been a month since we had any running water and are still managing on minimal bucket rations.
Oh, and in other news, it's now reached 42 degrees today. One could say it is a little hot. Not made any easier by the fact that it's now been a month since we had any running water and are still managing on minimal bucket rations.
As well as bringing pizza, MAF also brought me my passport back after it spent a month sitting in various government offices - now complete with a 1 year, multi-entry humanitarian aid visa - hurrah, praise God.
Wednesday, 26 October 2011
Just another Tuesday in Mandritsara...
5.45am – wake up, manage to drag self out of bed, realise it’s already 37 degrees. Kill several cockroaches which have invaded my room overnight. Check to see if there is electricity – hurrah, fill kettle up from barrel of water, today will be a coffee day. Wash using 2 litre bucket ration.
7am-8.30am Malagasy lesson number one. Today Bako gave me a 50-question test on everything from the preceding week. I find the translating from Malagasy into French particularly challenging; it’s one thing to understand what a Malagasy phrase means, but to then have to rephrase it in French at 7am... All of my lessons are in French, which adds a certain dimension of challenge when I have to listen to explanations of Malagasy grammar, in French. After my test she taught me all numbers up to 1 million, the days of the week, and some grammar, and wants it learnt by this afternoon.
8.45am – Today MAF (Mission Aviation fellowship) are due for their monthly flight. There is a small field – ahem I mean airstrip – a couple of kilometres away, where the plane can land. Everyone’s really busy today, so Robert and I take the landrover out to prepare for the landing. Hi-viz vests, get the windsock out, whistles to clear the filed of local folks, goats and oxen. Get out the sole wooden bench that acts as the ‘arrivals hall’... Robert laughs at me when I try to directly translate ‘windsock’ into French and asks me why on earth I’m talking about socks. It’s a wind sleeve he tells me. Surely that is obvious?! Une manche à l’air. He then gives me a brief lesson in wind velocity and direction, and plane landing, and we’re ready.
9.30am – MAF plane arrives. Last minute panic as a stray goat decides to start eating the middle of the airstrip for lunch, and refuses to budge. Cue us standing in the middle of the airstrip trying to get the goat out of the way just a few seconds before the plane lands. Thankfully we succeed, and leap out of the way of the plane.
10am – Drive back to the hospital with MAF pilot, Debbie who’s just arrived back from furlough, and a few others. We pass long queues of folk waiting in line in front the one village tap that’s working, with big yellow water containers, the sun beating down on them – it is now 40 degrees. The water situation in the village is still pretty bad.
10.30am - Go to market to buy vegetables and rice, the staple food. It’s always pot luck as to what there might be to complement the standard tomatoes, onions and marrow. Today we found aubergines, and also a pineapple. The mango season has begun as well – people are complaining at the moment “lafo ny manga!” – the mangoes are expensive – 7p a mango?! Very soon they’ll be half a penny each... One of the big effects of the complete lack of power in town over the past couple of weeks, is that even though a couple of the small shop-huts have a fridge, they’ve not been able to use it, so there’s no margarine in town. We’re used to there being no cheese, or yoghurt – but when everything is baked from scratch, food certainly becomes more basic when you have no margarine and can't make pastry or cake.
12.00 – 2.30pm – lunch break. People have long lunch breaks here, partly to avoid the heat, and also because of the culture of everyone going home to eat proper lunch together. It’s completely impossible to get anything done between the hours of midday and 2pm, as everyone disappears!
2.30pm - start learning this morning’s Malagasy lesson. I’m not supposed to be working yet but I get a call from the ward to ask if I can come and do a neoflon (a cannula for a small baby). There are only a couple of us who know how to do them, myself and two experienced European nurses, both of whom are ill. The baby is very dehydrated but thankfully manage to get it in. I know the theory of intraosseous lines with white needles (we don’t have guns here) but haven’t had to do it yet, and I’m thankful that I can put that off for another time. I fashion a splint out of a cardboard box and a bandage.
4pm – 5.30pm – Malagasy lesson number 2. Bako tests me on everything I’m meant to have learnt from this morning, and then launches into the next thing to be learnt. Malagasy lessons are progressing very quickly, and it’s tough to keep up the pace, but I’m very aware at the same time that I only have a total of 8 weeks maximum, and it’s probably going to be less than that, before I’ll be expected to use it fluently in hospital work and outpatient consultations.
6pm – The thunder and lightening is building over the mountains and is getting pretty close with an almost constant rumble and flashes. Sadly hasn’t brought any rain with it though, and we need the rain so much. Once it’s less than 2km away we unplug all the electrical appliances including the fridge, as power surges are common and have destroyed appliances in the past.
6.45-7pm – Perhaps the most important part of the day, water time! In the evening, the hospital’s water tower is switched on, and for a glorious 15 minutes’ ration for each missionary house, water comes out of the taps. During this time we have a routine that is carried out with military precision whereby as many buckets are filled as possible, which will need to last us for the coming 24 hours.
7.30pm – Tues night Bible Study. This is perhaps a bit like a UK ‘home group’ with all of the missionaries working in the project – usually about 12 of us. I love these times, as I don’t understand any of church on Sunday, so it’s a great time to have fellowship together. It’s usually in French, but tonight’s was in English because of non-French speaking visitors, a rare luxury!
9.25pm – Suddenly remember to go and plug the fridge back in, Oops.
9.30pm – Swat a few more bits of moderate-sized wildlife that have decided to invade my room, and off to bed – it all kicks off again at 5.45am tomorrow morning, and here, you never know what each new day will bring. Which is part of the excitement and the wonder of serving God out here in this little corner of Madagascar – no two days are ever the same, and anything can, and will, happen...
7am-8.30am Malagasy lesson number one. Today Bako gave me a 50-question test on everything from the preceding week. I find the translating from Malagasy into French particularly challenging; it’s one thing to understand what a Malagasy phrase means, but to then have to rephrase it in French at 7am... All of my lessons are in French, which adds a certain dimension of challenge when I have to listen to explanations of Malagasy grammar, in French. After my test she taught me all numbers up to 1 million, the days of the week, and some grammar, and wants it learnt by this afternoon.
8.45am – Today MAF (Mission Aviation fellowship) are due for their monthly flight. There is a small field – ahem I mean airstrip – a couple of kilometres away, where the plane can land. Everyone’s really busy today, so Robert and I take the landrover out to prepare for the landing. Hi-viz vests, get the windsock out, whistles to clear the filed of local folks, goats and oxen. Get out the sole wooden bench that acts as the ‘arrivals hall’... Robert laughs at me when I try to directly translate ‘windsock’ into French and asks me why on earth I’m talking about socks. It’s a wind sleeve he tells me. Surely that is obvious?! Une manche à l’air. He then gives me a brief lesson in wind velocity and direction, and plane landing, and we’re ready.
9.30am – MAF plane arrives. Last minute panic as a stray goat decides to start eating the middle of the airstrip for lunch, and refuses to budge. Cue us standing in the middle of the airstrip trying to get the goat out of the way just a few seconds before the plane lands. Thankfully we succeed, and leap out of the way of the plane.
10am – Drive back to the hospital with MAF pilot, Debbie who’s just arrived back from furlough, and a few others. We pass long queues of folk waiting in line in front the one village tap that’s working, with big yellow water containers, the sun beating down on them – it is now 40 degrees. The water situation in the village is still pretty bad.
10.30am - Go to market to buy vegetables and rice, the staple food. It’s always pot luck as to what there might be to complement the standard tomatoes, onions and marrow. Today we found aubergines, and also a pineapple. The mango season has begun as well – people are complaining at the moment “lafo ny manga!” – the mangoes are expensive – 7p a mango?! Very soon they’ll be half a penny each... One of the big effects of the complete lack of power in town over the past couple of weeks, is that even though a couple of the small shop-huts have a fridge, they’ve not been able to use it, so there’s no margarine in town. We’re used to there being no cheese, or yoghurt – but when everything is baked from scratch, food certainly becomes more basic when you have no margarine and can't make pastry or cake.
12.00 – 2.30pm – lunch break. People have long lunch breaks here, partly to avoid the heat, and also because of the culture of everyone going home to eat proper lunch together. It’s completely impossible to get anything done between the hours of midday and 2pm, as everyone disappears!
2.30pm - start learning this morning’s Malagasy lesson. I’m not supposed to be working yet but I get a call from the ward to ask if I can come and do a neoflon (a cannula for a small baby). There are only a couple of us who know how to do them, myself and two experienced European nurses, both of whom are ill. The baby is very dehydrated but thankfully manage to get it in. I know the theory of intraosseous lines with white needles (we don’t have guns here) but haven’t had to do it yet, and I’m thankful that I can put that off for another time. I fashion a splint out of a cardboard box and a bandage.
4pm – 5.30pm – Malagasy lesson number 2. Bako tests me on everything I’m meant to have learnt from this morning, and then launches into the next thing to be learnt. Malagasy lessons are progressing very quickly, and it’s tough to keep up the pace, but I’m very aware at the same time that I only have a total of 8 weeks maximum, and it’s probably going to be less than that, before I’ll be expected to use it fluently in hospital work and outpatient consultations.
6pm – The thunder and lightening is building over the mountains and is getting pretty close with an almost constant rumble and flashes. Sadly hasn’t brought any rain with it though, and we need the rain so much. Once it’s less than 2km away we unplug all the electrical appliances including the fridge, as power surges are common and have destroyed appliances in the past.
6.45-7pm – Perhaps the most important part of the day, water time! In the evening, the hospital’s water tower is switched on, and for a glorious 15 minutes’ ration for each missionary house, water comes out of the taps. During this time we have a routine that is carried out with military precision whereby as many buckets are filled as possible, which will need to last us for the coming 24 hours.
7.30pm – Tues night Bible Study. This is perhaps a bit like a UK ‘home group’ with all of the missionaries working in the project – usually about 12 of us. I love these times, as I don’t understand any of church on Sunday, so it’s a great time to have fellowship together. It’s usually in French, but tonight’s was in English because of non-French speaking visitors, a rare luxury!
9.25pm – Suddenly remember to go and plug the fridge back in, Oops.
9.30pm – Swat a few more bits of moderate-sized wildlife that have decided to invade my room, and off to bed – it all kicks off again at 5.45am tomorrow morning, and here, you never know what each new day will bring. Which is part of the excitement and the wonder of serving God out here in this little corner of Madagascar – no two days are ever the same, and anything can, and will, happen...
Thursday, 20 October 2011
Malagasy language lessons
Tena tsy saraotra ny teny malagasy, fa tena mora!
Apparently.
It means, “The Malagasy language is really not at all difficult, but it’s very easy”. This was one of the first phrases I learnt when I started my Malagasy lessons on Tuesday. I’ve only had four lessons so far, but already we’re advancing at quite a pace. It’s challenging – as absolutely none of it resembles any other language that I’ve ever learnt – but most of you know that I love languages, and I’m really enjoying it. I’m really thankful that so far it’s been coming to me reasonably easily (mostly due to the skill of my teacher who is very patient and generally fantastic) – but God’s nonetheless not letting me get complacent with it or letting me think that I’m good at it – I regularly get total mind blocks and get completely frustrated with it and can’t seem to move forward or remember any of the words with 8+ syllables – and then God reminds me that I’m learning this language so that I can serve Him in this place, and that I’m learning it for Him. We pray before every lesson, which is such a reminder as to why I’m here, and concentrates me on the task ahead for the following hour and a half.
I also find it hilarious that the phrases I’m learning are so geared to this little corner of Madagascar. A sample from lesson 1:
Tsara Andriamanitra = God is good.
Tena vitsy ny dokotera = There are very few doctors.
Betsaka ny marary = There are many patients.
Tapaka ny jiro = The electricity is cut off (Very apt, as I'm sitting here in the dark, hurrah for Macbooks with keyboards that light up...)
Tapaka ny rano = The water is cut off
Mafana ny andro = It is hot
Apparently next lesson includes other particularly useful ones such as ‘the bridge is down’ and ‘the truck has broken down’.
Apparently.
It means, “The Malagasy language is really not at all difficult, but it’s very easy”. This was one of the first phrases I learnt when I started my Malagasy lessons on Tuesday. I’ve only had four lessons so far, but already we’re advancing at quite a pace. It’s challenging – as absolutely none of it resembles any other language that I’ve ever learnt – but most of you know that I love languages, and I’m really enjoying it. I’m really thankful that so far it’s been coming to me reasonably easily (mostly due to the skill of my teacher who is very patient and generally fantastic) – but God’s nonetheless not letting me get complacent with it or letting me think that I’m good at it – I regularly get total mind blocks and get completely frustrated with it and can’t seem to move forward or remember any of the words with 8+ syllables – and then God reminds me that I’m learning this language so that I can serve Him in this place, and that I’m learning it for Him. We pray before every lesson, which is such a reminder as to why I’m here, and concentrates me on the task ahead for the following hour and a half.
I also find it hilarious that the phrases I’m learning are so geared to this little corner of Madagascar. A sample from lesson 1:
Tsara Andriamanitra = God is good.
Tena vitsy ny dokotera = There are very few doctors.
Betsaka ny marary = There are many patients.
Tapaka ny jiro = The electricity is cut off (Very apt, as I'm sitting here in the dark, hurrah for Macbooks with keyboards that light up...)
Tapaka ny rano = The water is cut off
Mafana ny andro = It is hot
Apparently next lesson includes other particularly useful ones such as ‘the bridge is down’ and ‘the truck has broken down’.
Some of you know that my e-mail and certain internet-type-stuff has been playing up this week. Have got a temp fix on the e-mail at the moment, but things are not behaving as they should, and it's all very frustrating - couldn't even log into the blog for ages. A test in patience perhaps?
Amin’ny manaraka indray! (Until next time...)
Amin’ny manaraka indray! (Until next time...)
Monday, 17 October 2011
Learning from each other
On Saturday, I taught Claudia how to use an electric kettle. She’d never seen one before, and wanted to know how you put the water in, how you knew when it was on, and if it had finished. She thought that the instant you pressed the on switch and it lit up, that you could then pick it up and pour, and it took some practice for her to understand the sequence of obtaining boiling water. “Why not just put a pan of water on the stove? That seems so much easier,” she said.
Today, Albertine our Malagasy housekeeper showed me how to bake bread. For her it is a routine, simple, daily task. Yet she was so patient in explaining when I didn’t understand the sequence of events, when I was impatient to mix in the water too quickly or not wait for the yeast to rise fast enough.
Ever since I’ve been here, they have taught me to be joyful in the small things of life, to be cheerful in hardship, to recognise blessings, and to trust God for all things.
I have a lot more to learn from my fellow Malagasy than they will ever learn from me. But it’s wonderful to be able to work and learn alongside one another as equals.
Friday, 14 October 2011
Today’s blog post is about water.
Water, water, nowhere.
The national energy supplier in Madagascar is Jirama. Unfortunately, when things break in the bush, Jirama are pretty slow to fix them (read: weeks – months) and sometimes don’t bother at all. Mandritsara relies on an electric pump to bring its water pump to the village. Most local folks get their water by queuing at one of the communal taps in town. About two weeks ago now, something blew in a generator not far from here (please note my highly technical explanation. Effectively, something broke, and this was not good). The result of which was that there was only an hour or two of power a day, and also therefore there was only an hour or two of water per day.
This is a bit rubbish when you only have an hour to fill or your buckets for the next day from the tap in your house, but imagine if you’re a local person who’s waiting in line at the communal taps. You’re about eighty people deep in the queue, and you know that in the hour that there’s water, you’ll get nowhere near the front of the queue. You’ll have to wait in the queue until this time tomorrow. Maybe tomorrow you’ll get some, maybe not. Then disaster strikes. Jirama decide that rather than thinking about repairing the broken thing, they’re going to just cut off all power supply, and thus all water, to the village. You have no water left.
This is the situation that the village is in at the moment. There has been no water for three days. The rivers are completely dried out. People are digging deep into the riverbeds to find any trickle of water, but nothing.
At the hospital, we are lucky. We have a water tower. It’s only 16 metres deep though, which is quite shallow. It certainly can’t cope with the full demands of the hospital and also the missionary families who live in the grounds. So we have a rationing system. For all but two hours per day, the water tower is shut off. At 4.30pm, the rationing starts, and each hospital department / house gets a 15 minute time in which to turn their taps on and fill as many buckets as they can find, to last the next 24 hours. This is because the tower can only really deal with one tap on at a time, because of the poor pressure. From 18.45 until 19.00 there is a military operation by which I fill a barrel with buckets in a relay system, and not a drop is wasted.
I’m learning to wash with 2 litres, and to then reuse that water afterwards to flush the.... The water is full of bugs and beasties. We have a filter to filter some drinking water, and we’re so thankful to have access to drinking water. Meanwhile the sun is beating down, and we have pretty huge insensible losses to replace as well as what we’d normally drink. Anything apart from absolutely essential hygiene is kept to a minimum, to save as much water as we can.
We have no idea if or when Jirama will fix the situation in the village. Last night we heard that the local Jirama manager was hunted down by the local people; some say he was gravely injured, others say he was killed. It’s not clear yet what happened, but what is clear, is that people are utterly desperate.
Meanwhile, diarrhoeal illnesses have seen a huge rise. People have no water to wash their hands. They’re drinking anything they can find. Once they get ill, they’ve got no water to keep themselves clean and wash their hands, so it spreads. It’s been hitting the hospital staff too – we’re trying to wash our hands as much as possible, but equally we’re not entirely sure that the filters are entirely cleaning the murky, slightly stagnant water from our barrels.
Operations are becoming less sterile – it’s tough when you’re trying to scrub with someone pouring a bucket of water over your hands – water that is full of bugs and certainly not all that clean. We just can’t filter enough water, and so the filtered water gets rationed for priorities such as drinking.
I am learning to appreciate clean running water in a whole new way. Last week I was moaning about the bucket situation; this week I am just so thankful that I have access to a bucket of water.
The situation in the village is dire. Most local folks use no electricity anyway, or maybe just one light bulb, so they’re less bothered about the lack of electricity. But with each continuing day that they have no access to water, things worsen exponentially.
We sit and wait, and pray, knowing that our God is faithful.
The national energy supplier in Madagascar is Jirama. Unfortunately, when things break in the bush, Jirama are pretty slow to fix them (read: weeks – months) and sometimes don’t bother at all. Mandritsara relies on an electric pump to bring its water pump to the village. Most local folks get their water by queuing at one of the communal taps in town. About two weeks ago now, something blew in a generator not far from here (please note my highly technical explanation. Effectively, something broke, and this was not good). The result of which was that there was only an hour or two of power a day, and also therefore there was only an hour or two of water per day.
This is a bit rubbish when you only have an hour to fill or your buckets for the next day from the tap in your house, but imagine if you’re a local person who’s waiting in line at the communal taps. You’re about eighty people deep in the queue, and you know that in the hour that there’s water, you’ll get nowhere near the front of the queue. You’ll have to wait in the queue until this time tomorrow. Maybe tomorrow you’ll get some, maybe not. Then disaster strikes. Jirama decide that rather than thinking about repairing the broken thing, they’re going to just cut off all power supply, and thus all water, to the village. You have no water left.
This is the situation that the village is in at the moment. There has been no water for three days. The rivers are completely dried out. People are digging deep into the riverbeds to find any trickle of water, but nothing.
At the hospital, we are lucky. We have a water tower. It’s only 16 metres deep though, which is quite shallow. It certainly can’t cope with the full demands of the hospital and also the missionary families who live in the grounds. So we have a rationing system. For all but two hours per day, the water tower is shut off. At 4.30pm, the rationing starts, and each hospital department / house gets a 15 minute time in which to turn their taps on and fill as many buckets as they can find, to last the next 24 hours. This is because the tower can only really deal with one tap on at a time, because of the poor pressure. From 18.45 until 19.00 there is a military operation by which I fill a barrel with buckets in a relay system, and not a drop is wasted.
I’m learning to wash with 2 litres, and to then reuse that water afterwards to flush the.... The water is full of bugs and beasties. We have a filter to filter some drinking water, and we’re so thankful to have access to drinking water. Meanwhile the sun is beating down, and we have pretty huge insensible losses to replace as well as what we’d normally drink. Anything apart from absolutely essential hygiene is kept to a minimum, to save as much water as we can.
We have no idea if or when Jirama will fix the situation in the village. Last night we heard that the local Jirama manager was hunted down by the local people; some say he was gravely injured, others say he was killed. It’s not clear yet what happened, but what is clear, is that people are utterly desperate.
Meanwhile, diarrhoeal illnesses have seen a huge rise. People have no water to wash their hands. They’re drinking anything they can find. Once they get ill, they’ve got no water to keep themselves clean and wash their hands, so it spreads. It’s been hitting the hospital staff too – we’re trying to wash our hands as much as possible, but equally we’re not entirely sure that the filters are entirely cleaning the murky, slightly stagnant water from our barrels.
Operations are becoming less sterile – it’s tough when you’re trying to scrub with someone pouring a bucket of water over your hands – water that is full of bugs and certainly not all that clean. We just can’t filter enough water, and so the filtered water gets rationed for priorities such as drinking.
I am learning to appreciate clean running water in a whole new way. Last week I was moaning about the bucket situation; this week I am just so thankful that I have access to a bucket of water.
The situation in the village is dire. Most local folks use no electricity anyway, or maybe just one light bulb, so they’re less bothered about the lack of electricity. But with each continuing day that they have no access to water, things worsen exponentially.
We sit and wait, and pray, knowing that our God is faithful.
Thursday, 13 October 2011
Malagasy transport
Two days ago I arrived safely in Mandritsara, my home for the next two years – and it’s not lightly that I say ‘arrived safely’. I was lucky enough to benefit from a flight by the wonderful pilots of the Mission Aviation Fellowship, who do a sterling job making the inaccessible, accessible. Particularly when roads are washed away and bridges are down, at certain times of the year we can be completely cut off from the rest of the world. Even if the infrastructure is as intact as it can be, it is nonetheless a grinding 24-48 hour journey depending on the number of breakdowns (3 is an average number, any less is a very good journey, and they can vary from half an hour to ten hours in the middle of nowhere whilst someone walks to the next village, however far away that is, to seek assistance). The road is also very treacherous; ‘bridges’ that are often two planks of wood that the driver needs to align just right for their wheels – once we’re across we pick up our planks and carry on to the next gap-in-the-road... There are many accidents, and we frequently pass overturned and burnt out buses. Head-on collisions with lorries are common. There are also the bandits and robbers, especially at night.
Having done the journey myself several times, and having had a particularly difficult journey the very first time with a nasty accident, I am acutely aware of the perils of travelling by road, but also of God’s grace and protection in carrying me through each time. However it makes me particularly thankful when I am able to benefit from a MAF flight rather than having to make the journey by road. This one turned into a bit of an adventure though, but nonetheless through it we were so aware of God’s hand in the entire journey, His protection and His blessing. It started with a puncture on the way to the airport; not easy in a van carrying a lot of supplies – my driver suddenly said “I think we’re driving on the wheel rim...” and I could certainly agree with that. Thus ensued some gymnastics emptying the van in the middle of the road to get to the spare tyre. Anyone who’s been to Africa knows that generally standing in the middle of the road is not advisable – cars won’t drive round you, they expect you to get out of the way. Then the jack wouldn’t work. So we stood and prayed for the van, and afterwards, everything worked like clockwork, van jacked up, tyre changed, van refilled, and we arrived at the airport within ten minutes. A reminder that we should commit all things to God, and not ask Him as a last resort – it was clearly as though he was just waiting for us to ask, and then all was fine.
An hour later, we were taking off from Tana in the tiny MAF plane. I was fortunate to be able to sit at the front with the pilot. Those of you who know that they won’t even allow me to drive a car in the UK will be relieved to hear that I wasn’t actually allowed to press anything important – great fun nonetheless, taking off and landing with a view through the front window. The MAF plane is tiny, and doesn’t have any radar. Mandritsara is on the other side of a mountain range, and when it’s very cloudy, the flight is difficult because the plane either needs to find a sufficient gap between the clouds to come down so as to be sure not to hit a mountain, or to fly under the clouds from the start – which is difficult because the mountains are quite high, so the gap between mountains and clouds is often quite small. This time, sure enough, it was clear that there wouldn’t be any large breaks in the clouds so we went for the between-the-clouds-and-the-mountains option. The plane was weaving its way through the valleys between the mountains trying to find a good route through, when suddenly we seemed to find ourselves in a bit of a ‘cul-de-sac’. Suddenly through my headset the plane’s systems began to screech “EXTREME DANGER, TERRAIN’. At the same time we were low enough that the turbulence was horrendous, and the pilot was trying to gain control of the aeroplane. Finally at the last moment he managed to lift the nose of the plane, and over the top we went and into the flat Mandritsara valley. One of those moments when you become very aware of your own mortality, but also of the Lord’s protection in carrying that plane and guiding it through to safety. And then I was able to watch the descent as the tiny landing strip came into view, and the folks who’d come to meet us – the hospital folk and also the usual Malagasy ‘welcome committee’ – a colourful procession of about 200 people who live near the landing field and always come out to see the spectacle of the plane when it comes once a month. It was a wonderful feeling to once again be in Mandritsara.
I’ve spent the last few days unpacking and settling in. I’m living on the hospital site; currently in the guest house for short-termers but hopefully some time after Christmas will move to one of the ‘long-termer’ houses, when the building work is complete. The Malagasy are very fond of their ‘Kabary’ – giving formal speeches whenever you’re new somewhere, are leaving, if you’re a guest in someone’s home... So this week has been a week of much standing in front of large groups of people and giving speeches! Hopefully the ‘hello’ Kabary are nearly finished – I’ve just done one this evening to 120 or so assembled hospital and school workers, and have one more big one to do in front of a packed church of 300-400 on Sunday. They’re really not my favourite thing (and they’re all in French) and there is a certain etiquette that has to be followed, so I’ll be quite glad when this round is over. And one of the great benefits of staying for two years, is that it’ll be two years before I have to do the next big lot hopefully! Otherwise, all is well, except that I’m being feasted upon by some rather industrial mosquitoes – unfortunately this always happens despite trying every form of Deet / anti-bug, but this year it does seem particularly bad.
Next time, I’ll recount the saga of The Water, as that deserves a blog post all of its own. But meanwhile, suffice it to say that at the hospital we are managing, however in the village things are pretty dire; there’s been nothing at all for three days now.
Having done the journey myself several times, and having had a particularly difficult journey the very first time with a nasty accident, I am acutely aware of the perils of travelling by road, but also of God’s grace and protection in carrying me through each time. However it makes me particularly thankful when I am able to benefit from a MAF flight rather than having to make the journey by road. This one turned into a bit of an adventure though, but nonetheless through it we were so aware of God’s hand in the entire journey, His protection and His blessing. It started with a puncture on the way to the airport; not easy in a van carrying a lot of supplies – my driver suddenly said “I think we’re driving on the wheel rim...” and I could certainly agree with that. Thus ensued some gymnastics emptying the van in the middle of the road to get to the spare tyre. Anyone who’s been to Africa knows that generally standing in the middle of the road is not advisable – cars won’t drive round you, they expect you to get out of the way. Then the jack wouldn’t work. So we stood and prayed for the van, and afterwards, everything worked like clockwork, van jacked up, tyre changed, van refilled, and we arrived at the airport within ten minutes. A reminder that we should commit all things to God, and not ask Him as a last resort – it was clearly as though he was just waiting for us to ask, and then all was fine.
An hour later, we were taking off from Tana in the tiny MAF plane. I was fortunate to be able to sit at the front with the pilot. Those of you who know that they won’t even allow me to drive a car in the UK will be relieved to hear that I wasn’t actually allowed to press anything important – great fun nonetheless, taking off and landing with a view through the front window. The MAF plane is tiny, and doesn’t have any radar. Mandritsara is on the other side of a mountain range, and when it’s very cloudy, the flight is difficult because the plane either needs to find a sufficient gap between the clouds to come down so as to be sure not to hit a mountain, or to fly under the clouds from the start – which is difficult because the mountains are quite high, so the gap between mountains and clouds is often quite small. This time, sure enough, it was clear that there wouldn’t be any large breaks in the clouds so we went for the between-the-clouds-and-the-mountains option. The plane was weaving its way through the valleys between the mountains trying to find a good route through, when suddenly we seemed to find ourselves in a bit of a ‘cul-de-sac’. Suddenly through my headset the plane’s systems began to screech “EXTREME DANGER, TERRAIN’. At the same time we were low enough that the turbulence was horrendous, and the pilot was trying to gain control of the aeroplane. Finally at the last moment he managed to lift the nose of the plane, and over the top we went and into the flat Mandritsara valley. One of those moments when you become very aware of your own mortality, but also of the Lord’s protection in carrying that plane and guiding it through to safety. And then I was able to watch the descent as the tiny landing strip came into view, and the folks who’d come to meet us – the hospital folk and also the usual Malagasy ‘welcome committee’ – a colourful procession of about 200 people who live near the landing field and always come out to see the spectacle of the plane when it comes once a month. It was a wonderful feeling to once again be in Mandritsara.
I’ve spent the last few days unpacking and settling in. I’m living on the hospital site; currently in the guest house for short-termers but hopefully some time after Christmas will move to one of the ‘long-termer’ houses, when the building work is complete. The Malagasy are very fond of their ‘Kabary’ – giving formal speeches whenever you’re new somewhere, are leaving, if you’re a guest in someone’s home... So this week has been a week of much standing in front of large groups of people and giving speeches! Hopefully the ‘hello’ Kabary are nearly finished – I’ve just done one this evening to 120 or so assembled hospital and school workers, and have one more big one to do in front of a packed church of 300-400 on Sunday. They’re really not my favourite thing (and they’re all in French) and there is a certain etiquette that has to be followed, so I’ll be quite glad when this round is over. And one of the great benefits of staying for two years, is that it’ll be two years before I have to do the next big lot hopefully! Otherwise, all is well, except that I’m being feasted upon by some rather industrial mosquitoes – unfortunately this always happens despite trying every form of Deet / anti-bug, but this year it does seem particularly bad.
Next time, I’ll recount the saga of The Water, as that deserves a blog post all of its own. But meanwhile, suffice it to say that at the hospital we are managing, however in the village things are pretty dire; there’s been nothing at all for three days now.
---> As an aside, today is in fact the tenth birthday of my corneal transplant. I wouldn't be where I am today without the young motorcyclist who filled out his donor card before he died, particularly because unlike a lot of people, who didn't cross off corneas. There is a huge UK shortage right now, partly because so many cross 'corneas' off their card. Have you made your wishes known and signed the donor register? If not, please consider doing so, and please particularly consider including your corneas. "For I once was blind but now I see" is true for me in both the literal sense and also the spiritual sense.
Friday, 7 October 2011
Arrived in the capital Antananarivo - the adventure begins
So I’ve been in Madagascar just over a week! It’s so good to be back. I’m still in the capital at the moment and waiting to head north next Tuesday (11th Oct).
Leaving was quite a clatter – packing up the flat at the very last minute, moving out ten hours before I left the country. The lovely and amazing Katie and Tim helped me to clear the flat out and transport everything to their attic, which I’ve taken over for the next couple of years. And then cooked me a wonderful leaving dinner. I have no home in the UK now, which is a somewhat odd feeling, it has to be said. Somehow the suitcases went from being 15kg over, to being ‘just’ 4kg over (who needs shampoo anyway?) I blame the enormous tome of an MRCP region guide and all my MSc research methodology books... All the way up to leaving, I’d been very busy, and it was hard to believe the departure date was finally there. I spoke at a CMF conference a few days before – and got some really good feedback which was encouraging and made it worthwhile. The day before I’d got back from Cardiff from spending a week doing my Palliative Medicine MSc plenary week – a pretty intensive week, but met some great folk and feel generally encouraged about trying to do that in Madagascar this year!
I managed to get to France and successfully obtain my humanitarian aid visa, which was a relief as I was minus many of the French documents, and the embassy wasn’t easy to find. So I was very thankful that everything went so incredibly smoothly – a huge answer to prayer.
The morning of the departure, I crept out of the Roberts’ house at 4am, and at check in was alarmed to be told I could only take one suitcase, even though I had proof that I could take two. A lot of conversation ensued about the fact I was going out to the bush for two years and it was hard enough to fit my life into two suitcases. That, combined with waving the humanitarian aid visa at her, ensured that once they’d finally confirmed my entitlement to two suitcases, she waived all the other excess baggage fees. Which was so wonderful given that they’re pretty militant about that these days, even for charity work. I met the Sherratt family in Paris, who are also coming to Mandritsara. And off to Madagascar we went.
We had the usual long-winded hassles with baggage and visas on arrival , and eventually got through to find an enthusiastic customs official wanting us to empty out all ten of our combined suitcases at 2am. Thankfully we were so slow at starting to open them that they got bored and waved us through. And finally we were on Madagascar soil. It was such a wonderful feeling to be driving through the dark streets of Ivato and Talatamaty, such familiar ground these days, and to know that this is home now. We arrived at Madame Vao’s, home to the hospital office in the capital, and a small house in her garden which she uses to put up the missionaries who are travelling to and from the bush – such a home away from home, and such a servant-hearted lady. She knows exactly what folk going to and fro need, is very patient with things in European culture which are so different (such as sleeping till 10am the day after we had arrived at 3am – in Malagasy culture, sleeping till 10am is like sleeping till 2pm). And the lovely lady remembers me so well that she had a large thermos of filter coffee ready for me the following morning. These little touches made for so much easier a transition – The day before, I had been feeling surprisingly sad about leaving the UK – I think so many good things had happened just before I left – I never feel that way normally and had expected to feel similarly positive about escaping the UK and getting back to Madagascar. A week later, I’m feeling refreshed and well settled in and ready for the next bit of the adventure – but back then when I was a little on my own, she made life so much easier with her attention to detail.
This week has involved travelling around the capital, Tana, and sorting everything out for the months ahead. Buying food to supplement the rice and tomatoes we eat in the bush, getting a Nokia brick mobile phone (hurrah for old technology, this is why I like Madagascar!) and generally reacquainting myself with the capital. It’s been a few years since I’ve dared to travel on public transport here and generally go about on my own – last year I got caught in the middle of unrest as I tried to leave the country. But this year, whilst it is very clear that things are not right, they are definitely somewhat calmer. And I feel reasonably safe as a lone female in the backstreets of Tana. This city is odd – on one hand it has so much character, and so much of its familiarity these days is comforting – the rows of cream coloured taxis, the hundreds of street vendors selling China’s finest cheap plastic for extortionate prices, the hills full of coloured buildings that overlook valleys of paddy fields – such a contrasting landscape. The hustle and bustle of daily Malagasy life going by. Yet at the some time the poverty here is even more evident than ever before. There are many more folk begging at the roadside, but also just so many more folk trying to sell things at the roadside to make any living they can. Which then further impacts on other areas of life, and the traffic gets jammed around them, and everything comes to a standstill, and the jams are even worse than ever before, and at all times of day not just at peak times. The pollution is certainly worse – the air is full of smog, and the dirt and rubbish underfoot – my feet are black at the end of each day. Yet I can’t help feel compassion for this city, the capital of the country I now call my home. I feel a need to walk the streets alongside the folk trying to live out their daily lives here. And I can see the character of the Malagasy culture beyond the initial impression of pollution and poverty. I never feel alone here – I can talk to strangers in the street, people will help me out if I get totally lost or don’t know where to get off a bus. Yesterday it rained and I sheltered under the closed doorway of a church, and someone came to join me. I asked him if he had a faith, and totally spontaneously, had a fantastic hour long deep and spiritual conversation. You can do that here. People have time to sit and listen and talk and discuss. They want to. And perhaps I feel a bit bolder here, too.
Last night the rains came down heavily, battering on my tin roof to the point where I couldn’t make myself think, lightening flashing away and the lights flickering very ominously – amazingly the power didn’t go off in the end, but we had the candles all out ready. This morning as a result, creepy crawlies everywhere. Including a giant 15cm spider with hairy stripy legs – arrgh! The Malagasy folk laughed at my horror and told me it was harmless, and in fact quite delicious when roasted. I think they were trying to be reassuring. I however was not reassured and was not going to let this thing continue to crawl around my vicinity. This is one thing I am really not looking forward to, although the fact that the wet season is some months away in Mandritsara is more reassuring – fewer crawling beasts when the land is as dry as a crisp. There is no running water and minimal electricity in Mandritsara at the moment, and unlikely to be any improvement for some months until January, and the months ahead are going to be very tough. But there are mercies too, such as the lack of enormous spiders, and I need to learn to be grateful for the mercies rather than fret and complain about the problems. Yesterday I was sighing over the rain, and it resulted in a fantastic opportunity for a discussion – so you never know.
Today I managed to go and visit the Catholic sisters and their homeless project that I first visited 18 months ago. That day in May 2010 had started as such an insignificant, if not rather negative one – I was on my own at the periphery of the capital, waiting for my flight out of Madagascar later that night. There was fighting and gunfire in town. I decided nonetheless that sitting around moping was not good, and took a risk and made it into the middle of town to visit this project, which I’d read about. There ensued one of the most amazing afternoons I’ve had in a very long time, talking with the sisters, discussing faith and spirituality, and learning so much from them and their humility, desire to serve, and the way they live day to day without worrying about tomorrow but just dealing with each day as it comes and trusting that even in the most adverse of circumstances, God will provide. We were able to support and encourage each other, and I’ve stayed in touch with them ever since, which has been a real encouragement to me. Today I went back to visit the project, and had a really good time again.
The next few days will be finishing off the preparation, taking advantage of the last restful time, and generally packing up to move north. Apprehensive about the challenge to come, but looking forward to it and excited about what God has planned.
Answers to prayer over the past few weeks:
· My visa, which went so smoothly
· Managing to do all the moving and last minute organising
· Fitting in all the extra things I had to do, such as Cardiff and the CMF conference
· Safe travelling so far both internationally, and locally here – both vehicular and pedestrian travel here takes a certain degree of faith / life in one’s hands
· A wonderful and relaxing place to stay this week
· A major problem with my bank card got sorted very quickly
· The amazing folks of the Mission Aviation Fellowship, who are coming to rescue us on Tuesday with a charter flight so that we don’t have to go by road.
6 weeks to go - heading to Madagascar
Off to Madagascar… 28th September. As it’s officially six weeks today, this seemed like a good time to start the blog. Why am I going to Madagascar? To serve God. More specifically, to spend two years with the Tsimihety people of Mandritsara in a rural area in the north east of Madagascar, at Hopitaly Vaovao Mahaly. HVM – or “Good News Hospital” is a Christian missionary hospital with 40 beds, which cares for an area of the country the size of Wales, and has the only surgical facilities for a 200 mile radius. It is a place where all are welcomed and cared for, irrespective of background, religion, or ability to pay.
A few facts about Madagascar:
Population: 20 million
Location: Indian Ocean (it’s the big blob off the coast of Mozambique!)
Languages: French, Malagasy
80% of the population live in rural areas
Only one in ten people have access to clean drinking water
One woman in 50 has access to facilities for a caesarean section
One woman in 4 has access to a ‘skilled birth attendant’
A child born in Madagascar has a one in 8 chance of dying before age 5
Most children die from preventable conditions – malaria, pneumonia, diarrhoea, malnutrition.
I was trying to decide on the title of the blog, which got me thinking about how to describe what I’ll be doing there. “Medicine” in Madagascar just doesn’t capture it. Ministering in Madagascar? Maybe slightly closer. But that still sounds too one-sided, as I know the Malagasy always give me far more than I ever give them. Sharing, serving, loving, caring, discipling, standing beside the broken… I think all of those fit. HVM is a place where whole-person medicine happens – physical, psychological, spiritual. It is unashamedly a Christian hospital, where Jesus is shared openly, but where all are free to make their own mind up.
I will spend the first two months in Madagascar learning the local language, Malagasy. As Madagascar’s official languages are French and Malagasy, I’ll be learning Malagasy via French, and also conducting all my clinics and ward rounds in French until I master the Malagasy sufficiently. After language training, I’ll start full time work at the hospital – mainly in medicine and paediatrics. However when there are fewer staff, and also when I’m on call, anything goes – and I’ll have to deal with anything.
I finished my job in the UK two weeks ago, and since then it’s suddenly begun sinking in that Madagascar is getting ever closer. I’ve been lucky enough to keep up with lots of paeds locums at SWBH, which has punctuated the packing and organising, as well as funding all the unexpected last-minute costs that seem to be arising everywhere. Meanwhile, the organising progresses slowly but surely. Following the closure of the London embassy, I am due to fly to France on 8th Sept to obtain the specific visa I need. This has been a source of much stress, not least the telephone French when discussing bureaucracy and equivalent documents. We’ve established that I just won’t have equivalents of all the French documents – so far, they seem typically African in their laid-back approach to this; hopefully this will continue to be the case when I arrive in person. Booster rabies jabs, wind-up torches, my surgical hat with geckoes on it… And the big job of packing up the flat. Since moving from Worcester, my life seems to have expanded to fill the space available, so I’m now once again sorting through everything and boxing up my life for two years. This is proving to be a big task, as I won’t have a home in the UK whilst I am away – so everything needs to go somewhere, distributed between various friends’ attics. I have a week to spend in Cardiff for my MSc (how terrifying) just before I leave, and a CMF conference to speak at, three days before I leave the country. Time is going to fly. This afternoon I have my interview with “Living Stones” – the international mission ministry at St John’s Church in Harborne, Birmingham, and next week another meeting with the hospital charity in London.
There are times when I can’t wait to go, and be back with my Madagascar ‘family’. And times when I feel utterly terrified and wonder if I’ve made a huge mistake and should have stayed in the UK. Times when I feel very inadequate for the task ahead. But then I remember that throughout the Bible, God used inadequate people to do His work. He used then despite their weaknesses, so that people would see that it was God at work and that he would be glorified. Nothing done in our own strength is worth doing. I know God told me clearly four years ago that this was his plan for me (a story for another post) and my Christian walk to date has been a testimony of God’s incredible faithfulness to me. So I once again go in faith. Last week during paeds nights I read Helen Roseveare’s book, “Living Faith” – and her honest and candid description of her journey of faith was very humbling and encouraging.
Micah 6v8: “Act justly, love mercy, and walk humbly with your God”
Here’s to the two years ahead…
Answers to prayer last week:
- Provision of enough locum work to fund rent etc during these two months of UK preparation, as well as all the unexpected last minute costs
- Safety in travelling to and from nights during the Birmingham riots (most of you know I’m not allowed to drive, and it was a bad time to be a public transport commuter.) I got caught right in the middle of it on the first night, but managed to get away unscathed, and for the rest of the week God provided for me fantastically.
- Visa woes – everything is getting there. Flights to and from France are booked, all of the Madagascar paperwork is completed, just the new CRB check awaited now.
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