Marasmus

I learned about all kinds of things in nursing school that I promptly stored in the darkest recesses of my mind, thinking “I’ll never need that.” Take marasmus for instance. Marasmus is the most serious form of malnutrition; wasting caused by a protein and calorie deficiency. This happens in infants when they don’t get enough milk. It is always serious, and if it lasts long enough, the infant dies.

I had never actually seen marasmus – until I got here. Now I see it a lot. Just last week we admitted 2 new babies and both have marasmus. Emanuel came to us from a far away village. His mother died after childbirth and dad took the baby home to be cared for by grandma. Grandma and grandpa were willing and appeared able to look after Emanuel. They owned a small shop and had lots of canned milk powder available. They also had a feeding bottle. Yet when we arrived at the home, there was Emanuel—starving. He had gained only 4 ounces since his birth the month before. Why??? We don’t know .

Chawanangwa arrived yesterday, from the mission hospital in nearby Ekwendeni. She has been at the hospital for the 2 months since her mother died in childbirth. Chawanangwa’s elderly aunt was caring for her. During this time she lost more than ½ pound. Her aunt was not feeding her enough. Instead, the aunt was diluting the milk she had brought, and even drinking some of it herself. Hospitals here do not provide any food or care – that is up to the family of the patient. Incredible as it sounds, a baby can die of starvation while being a patient in the hospital. Why? God knows.

What we do know is that these heartbreaking events are not uncommon. In fact, they are all too common. Without the Crisis Nursery both Emanuel & Chawanangwa would likely be facing a slow and painful death. Watching little ones like them thrive on the good food and good care provided by our dedicated nannies is the best part of this job.

Don't Have

“Don’t have” is a common phrase here in Malawi. It is used often and in the most unexpected places. Like today. We are in Lilongwe for a meeting. We made the 5 hour drive yesterday so we could stock up on things that are unavailable, (or more expensive) in Mzuzu—like brown rice, cheese, skim milk powder, and granola. We shopped as soon as we got here. But we didn’t follow the first rule of life in Africa…”If you need it and they have it – get it.” Today, this pertained specifically to fuel. We made it to Lilongwe with over ¼ tank to spare, enough to get us around Lilongwe the next couple of days. We had some serious shopping to do, so first things first. We could fill up before returning to Mzuzu. At the end of the day the announcement came over the radio: “Fuel shortage starting today…may last up to a week.” Country wide! A week!! Last year we were stuck in Lilongwe overnight with a fuel shortage. The thought of spending an entire week here was less than exhilarating. This was supposed to be a 2 day trip.

The next day, as we shopped for a giant cook pot, Paul mentioned our dilemma to an Indian shopkeeper . He graciously informed us that owners of the station he uses has their own truck fleet. So he called on our behalf and was told there was a fuel tanker arriving within in an hour. We quickly finished up our shopping and drove over to the station, where trucks of all descriptions were lining up. Crowds of Malawians huddled around the pumps, filling up their 5 gallon drums and carrying them away . The temperature was high and emotions higher still. There was lots sweating and jostling for positions. Only one diesel pump was open. It looked hopeless.

Jumping the cue, Paul maneuvered our pick up into the line, squeezing in between 2 enormous tractor trailers and about 10 can carrying Malawians. It took the truck in front of us 30 minutes to put the 700 litres of fuel into his 2 tanks. We waited tensely as the driver pulled away and Paul edged into place. But we made it! After a few drum fill ups we had our turn. It took us 2 ½ minutes to fill and pay. We would be able to return to Mzuzu when we planned!

You never know when things will be available. In Mzuzu, stores have run out of bread, sugar, meat (for a month), jam (all types), brown flour, yeast, candles, chicken and numerous other items. They just aren’t available – anywhere. You just do without. Restaurants may have an extensive menu, but if you order anything but “chicken & chips” they will often say, “Don’t have.”

Right now our fuel tank is full and we have most of the things on our shopping list. And on our next trip to Lilongwe the first place we will go when we arrive is the gas station. You just never know.

Would you like to see an amazing picture of the gas station grid lock?

“Don’t have.”

A Time For Everything

“We are coming to your house tomorrow.” announced the voice on the other end of the phone. At the time, we were having dinner with guests and should have ignored the call. But like Pavlov’s dog we have been trained to answer when the phone rings.

“Who is this?” I inquired. “This is the St. Andrew’s Church Women’s Guild, and we are coming to your house tomorrow at 3 o’clock.” Slightly taken aback I replied in my politest voice: “We will not be here tomorrow afternoon because we will be working at the Nursery. But you are welcome to visit us there.” The caller persisted: “We don’t know how to find the Nursery so we will come to your house.”

Eventually, the Women’s Guild relented and at 3 o’clock the next afternoon a small pick-up truck, bulging with a gang of Presbyterian Women, pulled into the Nursery courtyard. As they disembarked they also unloaded a truckload of goodies—sugar, potatoes, soap, soft drink, etc.

After a quick tour of the Nursery we shared devotional time led by a member of the Guild. Then came introductions, a few short speeches, and 2 presentations. Dada Maliska (Paul) received a brand new shirt from the market and Mama Maliska (Darlene) was presented with 4 meters of beautiful material to be made into a dress. We thanked the women for the personal gifts and also for their generosity in bringing all the sugar, potatoes, etc. for the Nursery.

Only after their departure did we finally get clued in. Not only the shirt and material, but all the food, soap, etc. were gifts meant not for the Nursery but for the minister and the minister’s spouse. It is the duty and privilege of the Women’s guild to look out for the well being of all the pastors (Muliska) related to their congregation. This was not a spur of the moment drop in just to interrupt our busy day to say hello. This was a well planned care program for me and Darlene. The women raised the funds, purchased the gifts, and actually called (a highly atypical concession to us Americans) to announce their arrival.

It is the first time in my 36 years as a pastor that we have received such a visit. And the first time we received a chicken from the church.

NOTE: In addition to being director of the Crisis Nursery Paul also serves as the associate pastor of the 1200 member congregation of St. Andrew’s Presbyterian Church in Mzuzu.