Tsala

It’s the middle of the day. The visitors at the gate arrive without warning, piling onto the porch in a wet, tired heap. A mother, nursing infant, toddler, 8 yr old and grandma. We recognize (barely) the toddler and realize with dismay that is Tsala (pronounced Sara). Tsala was discharged 3 months ago, a happy, healthy 14 month old.

Today Tsala is crying, miserable, wet and cold. Her hands and feet are swollen, as is her belly. The rest of her looks puffy. She is suffering from kwashiorkor, a protein deficiency. She has been fed nothing but a small amount of nsima , a maize flour mixture, for several months. Nsima contains no protein, no fat, nothing that will nourish a growing child. Starving is a long, slow, miserable process that causes a child to suffer horribly. Tsala is starving

Her family has walked a great distance in the rain to get here. Tsala’s father has remarried (her mother is dead) and his new wife has a new baby and several children of her own. These children got fed, but Tsala received little. Seeing her desperate condition , her aunt took her in. But Tsala’s aunt has problems of her own and can no longer afford to feed Tsala herself. She receives no money from Tsala’s dad. As a last resort she brought Tsala to our nursery, hoping for some help.

We bathed and fed Tsala and gave her clean , dry clothes. The family was given food while we deliberated. What to do? We were full and could not take Tsala back. And all our admissions have to come through social welfare. We can’t provide Tsala’s aunt with food for the foreseeable future. Whole villages would be at our doorstep.

We decided to take Tsala and her grandma to Central Hospital, which has a feeding program. They will keep them there until Tsala is better. They have a nutritionist who develops a feeding program for each child admitted. It includes high quality porridge and lots of milk. Tsala was admitted the same afternoon.

But then what? Tsala’s father is refusing to provide money to feed her. He refused to see us when we went to his home to talk to him. He didn’t even visit Tsala in the hospital or provide food for his own mother who was staying with his child while she was there. This is a difficult situation that for us is hard to even comprehend.

Tsala is recovering now but we don’t know what is going to happen to her. The story is so common here – no food, no money, no one acting responsibly toward their own children. It’s heartbreaking. We hope Tsala will be better cared for in the future. But we just don’t know.

Valentine's Day

Valentine’s Day is barely noticed in Malawi, but we were determined to celebrate anyway. So, we made plans to go out for dinner at the “MzoozooZoo”, a local hangout where you can actually get a hamburger—a real meat hamburger on a real bun with real Heinz ketchup! This is a rare treat.

Saturday dawned bright and fair and we worked at home all morning. In the afternoon we would take a walk to the reservoir, then go to the “Zoo” at around 5 p.m. for an early dinner, rounding out the day by watching a romantic episode of “24” on DVD. (?!)

At 2 pm the nursery calls – sick baby. Alick has a temperature of 102.8 F. and is not eating or drinking. Sounded like malaria. No Malawian management staff is on duty at the Nursery this weekend. We are on our own. I drive to the nursery, pack a bag for Alick, and drive to the hospital with Beka (our 19 year old U.S. volunteer who is working at the Nursery and living with us for 5 weeks).

The clinical officer attends to Alick after a remarkably short waiting time. He orders blood tests and then leaves to try to find the lab technician. A drive to several locations around town fails to turn up the technician. The substitute is away as well. After 45 minutes the "doc" returns to say he will treat the baby as if he has malaria and not worry about a lab test. Fine with me!

The hospital pharmacy is closed, so I am given quinine pills in a little bag and paracetamol liquid. There is no Amoxicillin and the nurse (without asking anyone) substitutes Chloramphenicol instead. (Yikes!) We drive home. Setting up the medication chart, giving the medicine and instructing the nanny on how to continue Alick’s treatment, takes another hour.

It is now 5:30 pm. No problem. Beka and I go home, change, pick up Paul and head out for dinner.

We arrive at the Zoo to find a group of 8 travelers waiting for food. Not a good sign. An hour later our food has not arrived at the table. Then, just before it is to be served, the power goes out. No problem, EXCEPT that our computer back at the nursery is plugged in!
Now in Malawi, when the electricity returns, sometimes it is with an enormous power surge that renders the average “surge protector” useless. We cannot risk leaving our computer plugged in. Immediately we decide to return to the Nursery so the cook packs up our food and off we go.

Arriving back at the nursery—surprise, surprise! The power is on. In fact (uncharacteristically) it had never gone off! Ahhhh yes! I check on Alick (still feverish), go over the medication schedule with the nanny once more, and we go home. Beck stays to use the computer to call her family in Washington State.

At home I light some candles for effect, and we eat our cold burgers. Just as we finish, the power goes off, and with it our romantic background music. Paul returns to the nursery to collect Beka while I stack the dishes in the sink. It is 9 pm, our usual time for lights out anyway. So, I go to bed with my Valentine.

(I did not sleep well that night because I was doing a lot of praying for little Alick. Good news. After several days of medicine and TLC his is fully recovered and flirting with all the nannies. Alick is pictured here)

The Dresser

The Nursery has just been given the gift of a new dresser. This is no ordinary dresser, as we designed it ourselves. Nice!!

We wanted big drawers to hold big toys. The drawers needed to be easily removable so we can take them out and use them as toy holders in the play room. But what if one of the older babies started using it as a jungle gym and got crushed under mountain of toys and drawers? Above all we needed the dresser to be BIG to avoid the inevitable.

We waited four months for our dream dresser. It was worth the wait.

Monday the dresser arrived. It’s even bigger than we imagined. Made from some of the hardest wood in the world, it is so heavy that tipping over will never be a problem. The wicker drawers are hand woven and sturdy enough to take plenty of use and abuse from the little ones.

The babies love their new dresser. Maybe that’s because all their toys are in there. They play in the boxes and use them as a train or car. They empty them out and get in. They push them around. It’s a blast to watch all the playing going on.

At last, we have been able to organize the play room and we love it. No more storage problems. Best of all, I’m glad to report that we are all having a good time.

Malaria

It was late Saturday evening at the end of a long weekend of meetings and supply gathering in the capital city, Lilongwe. All our “Katundu” was packed and ready to go for our planned departure early on Monday morning. At midnight I (Darlene) awoke with an uneasy stomach. No big deal – must have been something I ate. However, the queasiness persisted until I finally vomited. OK – now I can get some sleep. Since Paul & I had both eaten the same thing over the past 24 hours he began to worry that his turn was next.

But soon Paul was sawing logs while, for me, sleep refused to return. As the night wore on I began to vomit more and more frequently. Vomiting was soon accompanied by diarrhea. Each episode got worse, more intense. Then sweats and chills started. Paul mixed up some oral rehydration salts for me to sip but they wouldn’t stay down. By 7 am I was weak and depleted, barely able to stand.

On the advice of the nurse at the Lilongwe Crisis Nursery we went to the City Center Clinic – a private health care facility in Lilongwe. Paul helped me get to the waiting area where I lay down on a bench. A nurse came and brought me to an exam room in a wheelchair. It took all my effort just to sit up.

After being seen by the doctor I was given anti nausea and anti diarrhea medication. Then I was admitted to a private room with a bathroom! Soon a nurse came in to start an IV. After cleansing the site with purple alcohol from a dishwashing soap bottle, she began a very fast glucose drip. All I cared about was to get some sleep.

Before long, the lab work was completed and the doctor returned to inform me that I had contracted malaria—“plus two.” (It goes from +1 to +4). He said they would administer a quinine drip and I would feel much better soon. Good! I hoped he was right.

Soon after he left, I vomited again.

But after that, I slept and dripped all day long. By evening I was feeling better. I managed a few bites of supper with Paul’s encouragement. I could even walk by myself, although I felt fuzzy, out of it. As the nurse lowered the mosquito net and hung another bag of IV fluid I was thankful to be so comfortable and well cared for. But then I realized that I couldn’t hear the fan running in the corner, or the bugs trilling outside. I couldn’t hear anyone coming into the room. “Oh yes, that’s the quinine.” said the nurse. So I began to worry about going deaf. Nevertheless, I slept all night as the quinine dripped.

In the morning I ate a small portion of oatmeal and was discharged. My medication was changed from quinine to LA (lumefantrin and artemether) which does not cause hearing loss. On the 5 hour trip home to Mzuzu, I sept.

So far, I have missed a full week of work and a lot of meals. The Malaria itself is cured but has left me anemic. It will no doubt be at least another week before I am back running on all cylinders. In the meantime, I am more thankful than ever for modern medical care, and that I am privileged to have access to it. I am ever grateful for a loving husband that stays by my side no matter what.

Malaria is nasty business. In fact, malaria is the number one killer in Africa. Number ONE—ahead of AIDS and TB. And it affects everyone. It strikes people in the bush sleeping on mats, as well as people living in well built houses, sleeping under bed nets, and taking preventative anti-malarial drugs. It is a huge economic drag on sub-Saharan Africa, causing incalculable loss of work time. Malaria can snuff out the life of a baby in less than 24 hours. It is a devastating disease. Research being done to develop a preventative vaccine for Malaria needs our financial, political and prayer support.


PS
Pictures are of a baby room with mosquito nets up, and Darlene at work.