Tuesday, October 26, 2010

The Mango Fly


It started as a tiny itch in front of his right ear. No big deal. Who doesn't itch in this hot, dry place? But then it looked like a small pimple.And it didn't go away. Gradually it got bigger. After a few weeks it looked like a hard lump on the side of his face. Not inflamed, not dark. Just a lump. Sometimes itchy, occasionally painful.


Paul has had growths like this before, and they turned out to be fly pods. There are mango flies (tumbu flies) here in this part of Africa that lays eggs on clothes drying outside. The eggs then burrow into skin when it comes in contact with the cloth. They pupate in the skin and then crawl out when they are done. (eeeew!) Or they die when you apply Vaseline and tape for a few days. Then they dry up and fall off.


Ironing everything that comes in contact with your skin or 10 minutes in the dryer kills the eggs. But in spite of our taking care, Paul has had a few fly pods develop.


However, this one was different. There was no drying up. In fact, there was no change after several months. Bathroom surgery to remove the offending resident didn't help. It just made a black scab on the lump, which didn't get any better. What to do??


I emailed a dermatologist who had worked in Africa for many years, and included a picture of the bump in question. Diagnosis – mango fly.


So, since the fly was making no move to exit by itself we made an appointment to see the surgeon in Ekwendeni. (a mission hospital 25 minutes from here). She is from Holland and is here for 5 years. She looked at it and was glad to remove it. The appointment was made for the next week. On the day of the appointment the O.R. schedule had become so crowded that surgery was postponed another week and a short-term visiting surgeon from Holland was recruited to to do the job.


On the morning of surgery Paul was “prepped” by having his blood pressure taken. Then he had to remove ALL his clothes and wrap in a sheet. He reminded them that this was on his face, but the staff was insistent. He then had to take off his glasses, and walk outside around the building to the operating theater. Here he lay on the table and the surgeon took off the fly pod. It took 15 minutes, and since the doctor had done plastic surgery, it was a small and neat incision.


After surgery, Paul had to walk back outside around the building again, to the dressing room where he could dress and retrieve his glasses. No one had even asked him how he felt or taken his blood pressure after the procedure As we were getting ready to leave, a worker wanted to know why Paul wasn't headed to the recovery room. I guess you have to walk there, too. No one had said anything about a recovery room. Since he had only had a local anesthetic he felt he didn't need to recover, so we passed on the offer.


Instead, we went to billing to settle up. Total cost for surgery....$32.00. And by a plastic surgeon! You can hardly see the healing incision line after a week.


We will travel with our own pillow cases from now, which we know have been in the dryer or have been ironed. You never know what hitchhikers you will pick along the way.

Monday, October 18, 2010

Amaiz-ing

N’sima makes you strong.”

Like the Nike swish or the mind manipulating mantra “For everything else use MasterCard”, the popularity of n’sima is a testimony to the power of advertising.

N’sima (or fufu or ugali) is THE main staple here in Malawi. In fact Malawians consume more n’sima per person than any other sub-Saharan country. This reality is often credited to a nationwide advertising campaign back in the 1960’s when maize was cheap & plentiful. A successful government campaign convinced the vast majority of Malawians that “N’sima makes you strong!”

N’sima is a chubby flour pancake that has no flavor and less nutrition. Nevertheless, n’sima does fill the belly, keep you alive, and is still relatively inexpensive.

N’sima begins it’s journey to the belly when the field corn ripens and is harvested. Usually the kernels are painstakingly removed from the cob by hand. At the Nursery we purchase maize kernels in 50 kg. bags (110 lbs.) for around $8.50 each.


Next we take the maize to the mill where the kernels are rinsed and shelled. Then we take it back to the Nursery to be winnowed, washed, and dried in the sun. Finally we return to the maize mill to have it ground into fine white flour.

Put water in a pot, add flour bit by bit and stir, stir, stir. When the n'sima becomes really thick and your arms begin to ache you know that the n’sima is almost done. Scoop it out with a heavy wooden spoon so it makes the pancake like shape and serve with a “dende” of greens, as well as a small “relish” of beans, beef, chicken, or fish, as available.

That’s it. N’sima is on the menu every day, twice a day, 313 days a year.(We serve rice at least once a week.) Even if a Malawian has eaten a full meal, if N'sima was not part of it they will tell you that they have not eaten. And to watch some of our Malawian friends at work, I’m almost beginning to believe it myself. N’sima makes you strong. It’s a maize ing!

Monday, October 11, 2010

SOS

Here in Malawi they simply say “sose”.

SOS is the world’s largest orphan and abandoned children’s charity. They sponsor orphanages in 124 countries, including Malawi and the United States. There are 126 orphan villages in Africa alone. One of them is located right here in Mzuzu.

The Mzuzu SOS village recently expanded and there was now room to welcome several more infant orphans. But, they needed help compiling a list of eligible babies. So, SOS put out an S.O.S. Accompanied by Social Welfare, they came to a place they trusted—Mzuzu Crisis Nursery.

And did we have a list for them! When they left the Nursery that day, they had a referral list and a stack of files for 6 babies who we believed would benefit from a move to the SOS Village.

Chawanongwa
In Malawi, moving a child to an orphanage is usually a decision of last resort. Family is first, fostering second, and orphanages last. Most orphans here are not what we normally imagine. They are not usually the abandoned, isolated, social outcast street urchins we often picture in America. The Malawi extended family system functions as a social safety-net. Most orphans do have some connection with a relative who takes charge of them.

This does not mean they have an easy life. On the contrary, they are often treated poorly and literally find themselves at the bottom of the pecking order. Nevertheless, most orphans receive enough care to at least survive (except for vulnerable infants during the crisis period of their first year or so). And of course, some orphans grow up in situations where they actually thrive. However, where poverty is widespread life is a struggle for everyone.

The SOS village is an excellent model. The children live in a house with a “mother”and 7 brothers and sisters of differing ages. They eat, play, laugh and squabble as a family. They also have regular contact with their extended family in their home village.


Elvin at SOS
After home assessments were complete the decision was made. From our list of 7: Alick, Rejoice, Chawanangwa, and Elvin made the cut. Chawanangwa (12 months old) and Elvin (17 months old) were discharged directly from the Nursery to SOS. Rejoice had been discharged from the Nursery in January 2009 and Alick was discharged in December 2009. Both were languishing in their home village and the families agreed to send them to SOS.
All “our” babies received a V.I.P. welcome when they arrived at their new home in SOS Village. We are still working on behalf of those babies who did not make the cut.  Hopefully they will be placed in a better situation soon.  For they too are V.I.Ps.