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Posted Jan 27 2009 8:23pm
This entry is long overdue. So much happens on a daily basis that sometimes I feel I’m standing in a windstorm just holding out my open hand, not really grasping anything fully but only briefly considering the random pieces of life as they land in my palm before they take flight again.

One of the current fragmented themes concerns the way life beats people here and then returns for another lashing (ok, not an uplifting theme). A few examples (1) Cromwell’s younger brother Jobson was in a minibus accident about three weeks ago. Jobson cared for Cromwell during the particularly difficult early period of his convalescence and now, by a stroke of luck or misfortune – depending on how you frame it – he is also limping. Jobson was on his way to Salima by minibus (about an hour out of Lilongwe) when the driver lost control. Six people died on the spot and most of the other survivors sustained severe head trauma. He escaped with only a broken scapula and broken hip. (2) The man who works in Dana and MacPharlen’s home has been out caring for his ailing wife. His current wife is his second wife, his first wife died sometime back and then, within a year of each other, all six of his grown children – who lived in different parts of the country – died from different illnesses. (3) Last week another friend lost his older brother, the fourth sibling to die in his family. This friend told me flatly that the responsibility and hope of his family now rests with him and if he fails, it will mean absolute devastation for his family. If I weren’t living in the middle of these stories, sharing friendships with the principal characters, I might find them difficult to believe. The disparity of suffering (or perhaps “ability to pursue happiness”) between the average Malawian and the average American (to broadly generalize) is incredibly vast – even for those Malawians who are not affected by personal poverty or disease. Such painful inequalities increase the appeal of disengaging, deadening the senses, and trudging on. But I am learning, experientially - and by being near the smiles and kind eyes of the activists here that I admire and trust - that hope is born in the conscious struggle to improve life and in conscious living.

On the upside, I now have some financial support and a vehicle – both of which instantly improved my quality of life (I’m eating more fruit and am minibus free). From now until December I have a contract with an Italian NGO (CESTAS) whose mission is to promote safe motherhood by sponsoring technical trainings for clinical staff and procuring much needed medical supplies. My job is essentially to help set up the trainings and then to provide feedback as a clinical consultant. Personally, I have very mixed feelings about the trainings but at the moment I am supposed to carry out the previously approved workplan. My hope is that I can help restructure the trainings and that they will lead to other work that may be more deeply beneficial and gratifying. I have already been told by numerous Malawians that trainings like these don’t work. The same people are trained and retrained and frequently content is flawed - some information is repeated, other important items are omitted, and often information in one training conflicts that given in previous trainings - in the end people often revert to their old practice. Trainings also remove staff from their sites for extended periods of time, thereby further taxing an already frail system. Despite these problems, trainings are welcomed as concrete steps taken to improve the atrocious maternal morality rate (the 3rd worst in the world, behind Sierra Leon and Afghanistan!!!) and because the clinical staff depend on the per diems to supplement their paltry incomes. Thus placing an emphasis on action and valuing it above results.

From the two eyes I peer out of, it seems that so much development work is undertaken with god-sized enthusiasm of foreign donors, wanting to fix and solve seemingly black & white issues (i.e. hunger) but in the rush to cure, little is done to understand; the perpetual sense of urgency seems to justify the means. We need more critical discussions carried out with sufficient humility to at least temper the blinding effect of power. As a foreign privileged “do-gooder” (and now as a consultant on this project) I recognize that I am not outside the group I criticize. I am trying to move forward with my eyes open - remaining engaged and self-reflective.

As for the driving, well, it’s getting better. It’s not easy to learn to drive manual on the left side of the road while dodging goats, chickens, and dogs, avoiding wobbling bicyclists with loads of charcoal or firewood stacked to twice their height or straw mats protruding well into the already narrow road. The first day I got the car I watched a very green clinical officer student conduct a delivery and had to smile at how nervous and clumsy he was (nothing dangerous – just things like trying to put the baby on the mom’s belly while one leg was still inside the mom). I just stood by and tried to reassure him to be calm and move slowly. Then a couple hours later I laughed when I found myself, equally nervous and clumsy, sitting behind the wheel of the car, grateful for the medical student who sat next to me reassuring me and reminding me to stay calm and move slowly. I’m no longer breaking out into a cold sweat every time I envision myself behind the wheel so I believe that’s progress.

The labor ward has been not parsimonious with emotional lows but I’m finding enough joys both inside and outside the walls to keep me smiling and coming back for more. Within the past couple of weeks I met two women around town who remembered me from the ward and proudly showed me the chubby babies on their backs, that’s all I need.
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