7 am - preparation. Last minute packing. Breakfast. Get the taxi, return to the Lodge to pick up another traveler, drop her off, taxi, to the hospital to find my pediatric handbook, can’t find it, finally make it to destination: MSF Blantyre.
9 am - why are they paying me? A quick briefing of the situation: MSF headquartered in Nsanje, a hard-hit southern province. Clinical teams going out as mobile clinics to the west bank and east bank. The east bank is flooded into two connected islands.
10am - head out for Nsanje with a motley group of Italian photographer living in Cairo, Malawian coordinator, pharmacist, and health officers, Belgian flight coordinator, and Kenyan logistician. Stop for groceries, stop at the hospital again (light goes off) so I can buy a new handbook, stop for the bank, stop for photos, stop for more groceries, stop at a mobile clinic, for more photos, speed up when the Nsanje operations director calls wondering where we are.
The mobile clinic is a van with two benches in the back and boxes of medicine. Well, previously stocked boxes of medicine. Now all remains are large amounts of well needed malarial parasite rapid tests all administered by an RN. Five of 35 people tested for malaria were positive at this smaller site.
2pmish - Discovery Lodge. A run down (nice for the area) white conglomeration of low buildings boasts a bustle of MSF vans, MSF water containers, a meeting tent, kitchen tent, maps and computers huddled into one temp office, and electricians working desperately on the foregone electricity. After a brief briefing more for the photographer than any of the other four medical people, I bring out my coffee and oatmeal cookies while we shoot the breeze. The ops manager is from London ex 20 years ago and sounds more like a South African Malawian cross breed. He sports thick tawny locks, a matching tan, and a healthy dose of humour. The Kenyan speaks five languages including 3 buntu dialects, has worked mostly in Kenya and is not new to MSF. Outside of one other in the van we are all MSF newbies. In fact, as we gather together later perhaps only three are MSF seasoned.
7pm - dusk has come, and we gather in between the two housing buildings for a daily meeting. Team leaders (a nurse leads a team of a clinician either MSF or department of health provided or both) x 2 describe their statistics and problems for the day. The health promotions leader urges again the need for mosquito nets, a problem which no other organization has stepped up to, and for proper installation of the nets. Child protection and social services are discussed, logistics chimes in with plans for a new office space in the former dining area, the engineers summarize their successes with reestablishing clean water through repaired and pumped out bore wells, and Alfred, the new chef, introduces himself to loud applause.
As we gather and systematically share, including introductions of us (surprise, Suzanna, you’re actually going to work in the district hospital, not the mobile clinics or the helicopter-accessible pseudo-islands), the moon fades into existence from behind a sheer veil of misty clouds and the light fades into puffy clouds. The stars fall down in front of us - or is it lightning bugs that have curiously flown amongst us? Not to be outdone, one enlarging cloud advances from a distance with brilliantly silent lightning. As darkness falls, I feel a sense of peace. Work will be hard and perhaps problems not all solved, but here one finds the earth talking back.
The situation here remains extreme. Many still without mosquito nets, clean water, sufficient food, medical attention, and many at risk of losing their temporary crammed shelters of standing Churches and Schools. Pride runs deep and fertile land calls strongly. Many resist moving to higher ground even temporarily for fear of losing their land when the waters recede. The waters receded then began to rise again. Camps swell instead of slim. This is a true natural disaster.
After a delicious dinner of goat, rice, and beans and package of three large boxes for the teams tomorrow, we settle down to an early bedtime. Soaking wet again despite two showers, the air still, and the window lit by dramatic displays of frequent lightning, I find myself loathe to sleep. The lightning intensifies into a grand show of flashing power accompanied by frequent thunder. Out of nowhere, a very spooky melody in minor loops over and over again. Have I landed in a horror film? Is this real? Will we sleep enough to work the next day? Perhaps we will drift off to a land of ice and snow, perhaps the thunder will interpolate itself into our dreams as the roar of a rapids splashing cool against our faces and arms. Where we will navigate I know not. How we navigate the ultimate Physician knows. Lord, increase our work. Bless our minds, bodies, and hands. Ease the suffering of your people, and bring them comfort and peace.
I have arrived.
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