100% CHALLENGED

Lucas left Lilongwe at the beginning of June travelling to Valencia with his cousin Abigail to spend five weeks with his 'Papa' I was able to make full use of the following two weeks to concentrate fully on the coordination of the furnishing and equipping of the new Bwaila maternity unit. The procuring, ordering, confirming and delivering of each and every item necessary for the setting up of a unit of this size is a huge task. It has been and still is a challenging and often very frustrating process but I feel confident that it is now all 'coming together' and we will be ready for its opening during the month of September. I left Malawi on 18th July for my planned holiday break in Europe. After spending five wonderful days with my eldest daughter, Katy, in Leeds, UK, one of which was spent relaxing and being pampered in a health 'spa,' I flew to Valencia, Spain, to meet up with Lucas and my other two children, Alasdair and Fiona. Needless to say I have enjoyed every minute in the company of my children and friends. The love and support of these people, who are so important to me, reaffirms my conviction that my decision to stay in Lilongwe to continue the work I’m doing with the women babies and midwives at Bwaila is correct. Being in a first world country during these past weeks has not always been easy. It is difficult to completely forget the poverty and conditions from which I have come. It is especially difficult for me when I am in one of the many large, busy, shopping centres. My mind strays back to the villages, the hospital, the people of Malawi and it just all seems too much. How can some have so much and others, just a few hours flight away, have so little, have nothing? How can some people be so preoccupied by material trivialities when others are struggling to feed, clothe and educate their children. How lucky you are that you were born into a rich world that your worries are mostly about the extras and not about the basics, about luxuries and not about survival. I wrote the above soon after arriving back in Lilongwe at the beginning of August. Since then I have often thought about you all and needed to communicate with you but have quite seriously not had the time nor the energy to do so. These past four weeks have probably been some of the most challenging of my life. On my return to Bwaila I was hugely disappointed to find that, despite the huge efforts I made before leaving to assure that outstanding work would be finished or at least well underway for my return, practically nothing had been done in my absence. The jobs that needed to be done ‘on site’ and that I expected to be finished had not been touched and the suppliers of various pieces of equipment and furniture had achieved very little. It was then I decided to dedicate myself full time to pushing and shoving, nagging and pestering, phoning and visiting with a determination that all those who know me will understand. The official opening date of the unit has already been set. October 7th.The unit has to be up and running before that date and I for one was prepared to move heaven and earth to achieve it. And that’s what I have and I am still doing. Moving heaven and earth! Or at least it feels like that. If you’ve never lived in Malawi, though they tell me other African countries are the same and to be honest I guess pulling together this sort of project anywhere in the world would not be easy, maybe you wouldn’t understand, but the Spanish ‘manana, manana’ takes on a whole new meaning here in Lilongwe. I remember back more than 15 years ago when I was involved in setting up a new business venture with my (ex) husband, Andrew. New to Spain and with very little of the language and less knowledge of how the Spanish system worked, the job of sourcing and procuring every little piece of equipment, nut, bolt and curtain hook, for the farm, was my main job. I still remember the huge frustrations of never finding anyone when they were needed, of waiting days and weeks for things that were promised for the following day and finding that many items were just not available. I think that experience has helped me infinitely for the challenges I am facing now. My knowledge of building work, bricklaying, guttering, plumbing, electrics, drains, sockets, taps etc. increases daily. Not to mention the more specialized areas of autoclaves, theatre lights, piped oxygen and anaesthetic machines. Then there’s the procuring of furniture and equipment. I mean, just how many chairs are needed for a 146 bedded maternity unit? And stainless steel trolleys? And why does all the locally made equipment, beds, swab racks, bed pan racks have to be ‘epoxy coated’? and anyway what the heck is ‘epoxy coating’? Just ask me any of this now and I have the answers!I was very happy when the District Health Authority agreed to take on some tasks such as the building of concrete wash tubs for the women to wash their ‘chitenges’ The making of ‘curtain boxes’ for all of the windows and the building of a new road. The unit has been totally funded from outside of Malawi. Mainly from Ireland through The Rose Project but also with Norwegian partners. It will be given to the Malawi government to be run as a public, non paying District Hospital. It was therefore encouraging to see them show their interest in this way. My enthusiasm was somewhat dulled after the new entrance way collapsed and had to be remade. During that time we could not let any vehicles on site for 7 days. I started to panic thinking that I would have to cancel the delivery of materials and equipment which could delay everything. Silly me! The delivery trucks continued to arrive. They parked at the entrance and as if from nowhere there appeared more than ten very fit looking guys who carried the boxes, bags etc. sometimes on their heads, into the unit making several trips with often very heavy loads. But this is Malawi and I shouldn’t have worried. Then when finally they could drive in the lorry carrying the bricks and materials veered off the road onto the pavement smashing the recently laid paving slabs. Not once but twice! I had always been a little Sceptical of the driving skills or lack of but this was just amazing! However I think the best example of the hospital maintenance standards was when I passed by to see how they were getting on with the construction of the wash tubs. Now I am really not an expert but I do know that the water and drains are normally laid before and not after the concrete base. I respectfully enquired but was assured that they knew what they were doing. It was only once the tubs were built that it became clear that the plumbing would now have to be with external piping! It doesn’t look so good but I am assured it works! But that wasn’t the end of the story.... The following day I ’caught’ them on the point of connecting the permanent water pipes to the contractor’s temporary water supply. (An over ground piping that will be removed once the builders leave.) At least I got to that one in time and the proper connections were made. These are just a few stories of the many I could tell you which have caused me to laugh and despair. There are also many more that have been so very encouraging. We have a wonderful site foreman (George) who has always been at my side, listening, understanding, organizing, laughing, despairing, building up and knocking down, putting in and taking out, but always good humoured and willing to help. I have built up a lovely relationship too with many of the workers on site. The only female brick layer, who does a beautiful job, greets me every morning by name and with a huge smile. The gardeners who brought roses to plant just because I wanted them. Not to mention Fyson,the guy who holds the keys. There are more than two hundred keys, two for every door and cupboard on the unit but somehow he knows them all. Actually he’s the second guy to hold the keys and only since July. The story of Andrew, who I have known for over a year since I first started became involved in the new unit, is a long one which is definitely worth telling. This is part of a mail that I wrote to Tarek, soon after the incident, that I thought I’d share with you.... ‘’It’s a huge job I’ve taken on for The Rose Project and I often just wish I was back on labour ward. So much just doesn’t depend on me so I have to cope with the frustration of not getting things right because of someone else. As you said, I can’t change anyone else I can only change me. So I’m having to learn how to cope with so many things that are totally out of my control. I know that’s what you have to do and I am appreciating how hard that is. I have so much more to learn. But that’s not why I sat down to write at this hour. Maybe I’m putting off the moment as I’m not sure if I did the right thing. When I went on site this morning I couldn’t find the guy with the keys. He’s a young lad, always very friendly helpful and we have struck up a relaxed and fun relationship over the past year. I don’t know much about him but I have always had a good feeling about him. I eventually found out that he had been taken to the police station yesterday having been accused by the security guards of stealing a bag of second hand clothing whilst the Norwegians were sorting it all out. ( A huge amount of sheets, material and clothing came over in the Norwegian container.) I was surprised and horrified that he should be locked up in jail without any official charge against him. They also told me he had been beaten up. The charge had to be made by the DHO or myself. I couldn’t do it. I couldn’t bear to think of this young lad in the cell now for nearly 24hours and I couldn’t bring a charge for ‘possibly’ taking a bag of second hand clothes. I think I did the right thing? My instincts told me that I couldn’t leave the country knowing he was still locked up. So I went and got him out. I tried to do it the right way. I went to the security firm, I phoned the DHO to get his support and the guy from the security firm came with me. So I got him released. It wasn’t too difficult. I was so naive that I didn’t realize until I was told afterwards that the police officers were probably waiting for me to give them money, so they didn’t get any! Well, Andrew is out of jail. I spoke to him briefly. He is just so young and was very quiet with me. He thanked me but he could hardly look me in the eye. I felt very sad as I have no idea if he is guilty or innocent. Of course he shouldn’t steal, but it was a bag of second hand clothes! He probably has nothing and the temptation was too great. God knows what I would do if I had so little. Would I steal too? Would you? The foreman says they have always trusted him and will probably put him on another site to work. I hope so. I said he shouldn’t come back to Bwaila. So why do I need to write this down? Why do I feel so unsure? It felt so right at the time.’’
Andrew has been to visit me twice since my return. Both his parents are dead, he lives with his only living brother here in Lilongwe. He is now unemployed as the contractor fired him due to the allegations made against him. He calls me ‘mama’ and seems to be waiting for me to sort things out for him. At present I am not sure what I should do. He thanks God daily for the love I have shown him. How will I continue to show him that love?
You can tell that I haven’t written for two months..... I have so much to tell.
An important part of my work is with the nurses/ midwives and now especially with the matrons. Recognizing the huge differences that will be encountered by all the staff when we finally transfer to the new unit I consider that some training and especially team building is vital. Along with the matrons, who are now taking a very active role in facilitating the groups, I am dedicating our weekly ‘in service’ training sessions to this end. On returning from Europe and taking up the sessions again (which by the way continued extremely successfully during my absence) I became overwhelmed by the task of successfully ensuring team leadership. This is going to be vital in the new unit as we start off with an almost totally new team. Before leaving for Europe I had already discussed the situation with a Malawian led NGO who specialize in Quality Improvement and leadership training. The head of this initiative is a very inspiring Malawian guy whom I felt really understood the unique situation at Bwaila. I contacted him soon after returning and was thrilled and extremely relieved to hear that he had already found funding for us and was prepared to become wholly involved in our leadership training. These sessions have now started and the staff are making weekly visits to the unit with their leaders, sorting out work plans, equipment needs, patient flow, as well as practical details of ordering and storage of materials etc. We will be visiting the public hospital in Blantyre next week to discuss and learn from them. As you can see it all sounds very busy......well it is! It is still a race against time to get the unit up and running before the end of the month but I am determined to do all I can to achieve this. The DHO, who has been away for the past five weeks, is now back and becoming involved. He is/will be ultimately responsible for the new unit. We have a good relationship and I am convinced that he will do all he can to make a success of it. (Taking into account the very limited resources and budget he has to work with.)
On a different note I experienced a rather violent attack on my person a few weeks ago. Being in the wrong place at the wrong time my car window was smashed with a machete knife and my hand bag stolen. Fortunately I only received scratches from broken glass and bruising to my arm. It has not had a lasting effect on me. I don’t feel as if I am in any more danger than I did before and continue to ask myself whether this type of violence is due to extreme poverty or greed? On a more positive note we have some great friends over here who can be relied on for love and support as well as practical help. Lucas is back at school and after a difficult first week as he adapted back to the constraints of being in school is also finding his way and happy to be here. The contact I have with my older children, though never enough, makes me very happy. They are all doing fine, finding their way in life with all its ups and downs, growing and learning, continuing to develop into wonderful young people and I am so proud of them. Both for you and for them I encourage you to find your dream and have the courage to follow where it leads.