Beyond Mvuma

Margaret

There is a 12 year old girl named Maragaret who has been on the ward for over a month now. I am telling you about her not to win sympathy or to feel sorry for her. It is a ‘sad case’ and yet I want to be careful not to reduce her to yet another sad saga of life in modern Africa.

This is what I know of her: She is 12 but looks about 8 or 9. She is thin. Her right eye deviates and is clouding over with a cataract or some kind of eye disease. She has lived with AIDS, most likely her whole life. She was brought to the hospital by her ambuya and has been receiving treatment for TB. While an inpatient, she contracted meningitis and deteriorated. She was getting weaker every time we rounded. Most days, she was lying on her bed, still and weak, often asleep. I was uncomfortable around her. Sad for her suffering. In some ways hoping she would die to end it. We continued to treat her. She started to perk up. I flirted with her. Winked at her. Acted the odd white person around her. Feeling stupid for attempting to be funny on the wards while so many were in pain, suffering and very ill. Last thing I want when I am dying is for some idiot to be waving at me with a quirky smile. Wait, maybe that’s exactly what I want. Some humanity. Some humor. But back to Margaret. On Sunday, I was in the hospital for a C section, and there was Margaret walking down the hall. Not in the same green hospital gown, but a wrap skirt over her gown. And a wrap on her head. And walking. She greeted me. Makadini? How are you? Then, ‘can I go home?’ with a big smile. A smile that I wonder is a frontal release but nonetheless, it is a smile, a resilient grace exuding from her. Humanity and life. In its purest form. I know so little about her. We have not had any more than a few lines, a touch on the shoulder, a nod, or a handshake. But she is why I came here. And I intend to become her friend.

Another Ceasar, LP and Tea Time

I have taken a bit of a hiatus from writing and am now faced with writing a tome. Let's start with today. This morning started with an LP then a Ceasar of a multigravida with failure to progress. She was 23 hours post ROM. Her last birth was 9 years before. The surgery was uneventful and a big, healthy girl was delivered. Then, I accompanied Dr. Clara at the tail end of Womens Ward rounds. Margaret, the 12 year old with AIDS, TB and recent meningitis probably acquired in the hospital was asleep this a.m. Yesterday I saw her walking around and she asked if she could go home. She looks remarkably well considering what she has been through. I also went with Dr. Clara to put in another canula for the child with the snake bite. He is more alert but his leg is necrosed.

Then to the theatre for tea. Have I mentioned that we break every morning at 10 am and leave the hospital and go back to the house and to have tea? If it is a busy surgical morning, we might have tea with the staff in the theatre. Yep, there is no regulation about having food in the surgery wing, no inspectors to report infractions. Actually, I should say that there is a separate changing room with a table where we sit down to have tea. It is not as if we are in the sterile field eating crumbs off the anethetized patient’s lap. The whole country takes a tea break at 10. If you are in town trying to bank or do business, its not a good idea to try get anything accomplished at 10 am. . . I learned this the hard way while in Mashingo trying to get a visa extension.

We had a OB/Gyn district medical officer visiting today. He was rather verbose and spent at least 35 minutes complaining about supplies, government inefficiency and corruption and the general decline of care in government hospitals. While Dr. S entertained the visitor, I attempted to see some outpatients.

This evening I spent with the maternity nurses and 2 laboring women. My first time on the maternity ward not doing Cesars but deliveries vaginal. The nurses were really abrupt with the patients. If you don’t deliver within 10 minutes from the time you start pushing, you are likely to get chastised for not pushing hard enough and may get an episiotomy. As the nurse yells push in shona, she says to me, “she is not pushing hard enough so I will cut her now.” Then, after the delivery the nurse complains of the extra time it is taking now to do the episiotomy repair!

Some local boys fishing at the dam. Every time I have been there, no one is catching anything.

This is one of the shops in town. Rumor has it that it used to list a number between the 'and' and 'his wives' but since it kept changing, he just whited out the number. I am not so sure this is true but it makes a good story. Hokostore and is 6 wives. No, Hokostore and his 5 wives. . .

'How are you? I am fine?' is the standard exchange from the local kids. It's one of the first things they learn in English class and if you try any other greeting they look at you with a confused look. The older kids of course know more, but the young ones just repeat 'How are you? I am fine.'

These kids are playing a game called Nhodo. I haven't completely learned the rules or the strategy. They dig 8 holes in the ground, place 8 rocks in each hole and then start removing them alternatively. The rocks in one pocket get redistributed into the others and at some point get removed from the 'board and then it is the other persons turn. First one out of rocks wins.

When I first arrived, these ladies would wait outside the door of the house just about every day hoping to sell their baskets to Mrs. S. She has bought several hundred and is shipping them back to the states. Word spread quickly and now the supply is superfluous.

This is a 'scotch cart.' Sometimes they are hooked up to oxen, and sometimes as shown here, they are powered by people.

More scenes from downtown Charundura. The 2 block span of stores on the main dirt road contains several hairdresser's stores, 4 nightclubs/bars, 2 butcheries, a 'supermarket' that is more like the Forkland bait shop with fewer items in stock and no bait, a 'warehouse' kind of like a Dollar General store, a stationary shop, and some other businesses I haven't quite figured out.

Dirt roads and no parking spaces.

On the road to Mutare

Today I am driving with Sr. Clara to Mutare. We are first going up to Harare, then over to Mutare. From there we are going to another mission hospital named Regina Chely which is north of Mutare, past Nyanga, over the mountains and down into a hot, tropical valley on the Zim/Mozambique border.

She has a couple of board meetings, and other business to attend to. I am just going along for the ride. I won't be able to post anything current online, but will have 'the webmaster' post some pics of life here in Charundura while I am away. Hope you enjoy.

Mhoroi! Once again I am having to retro-post from my journal. The cell lines are off and on and the rates have gone up (6 times the price from last month) so it is difficult to get an email out and even more so to send pictures. Besides that, it has been very busy around here. Another doctor and his wife have arrived. They will be here for 3 years but were here just this week to get an overview of things before going back to Harare to train to do C sections. Dr. Cavanagh is from Arizona but lived in Anchorage from 89-93 so we enjoyed exchanging Alaska stories. He has a ton of experience from working in the Indian Health Service and is a great teacher. We also had a retired surgeon, Dr. Brown, visiting. He was here in Zimbabwe in the 70s and comes back periodically. With the 2 extra doctors and Dr. S back from Harare you would think things would run smoothly. In fact, major surgical procedures require more resources, staff, time and coordination. So the outpatient lines were long outside the door while most of the docs were off doing surgery. Still, it was a very busy and fun week with so many ‘brains’ around and enthusiasm for the medical ‘cases’ we saw and discussed. Beware, this past week’s entries are heavy on medicine.

The news from Mr. Chazo (the hospital matron. . . yes, the ‘matron’ is the term for the nurse who is the head of all nursing and much administration, and yes, even if the matron is a male, he is still called ‘the matron’) is that our gardener, Nicolas, was arrested for possession of ‘dagga’ (marijuana). The police even went to his home and found plants growing in his garden. Apparently they were investigating his son who came up clean, but in the meantime, the discovered the father’s stash. There have also already been a couple of fights in town because here, someone or some ancestor or spirit is always responsible for bad things. Nicolas is at least 55 years old and has 9 or more children. Since I have been here, Mrs. S has complained constantly about how Nicholas is a terrible gardener and is never doing what she asks him to and is constantly taking breaks to smoke cigarettes. But because of his many dependents, she has avoided firing him. So, now with this news, Mr. and Mrs. S called me outside to their garden this afternoon and asked me to look as some plants that Nicolas had suggested they plant a few months back. “Uhh, Angie . . . do you know what marijuana looks like?” From the porch, the towering green-leaved plants waved in the breeze. When I got closer, I could tell they weren’t the characteristic shape I have seen depicted in drawings. . . yes, I have only seen them in drawings.