Lake of Stars

"Lake of Stars" is a nickname for Lake Malawi, possibly because of the way that the night lights of the fishermen look like stars on the dark lake in the evening. Lake of Stars is also the name of a huge music festival on the lake that draws tourists (mostly from Britain) to Malawi for 3 days of African and British pop. Local expats, like us, and wealthier Malawians also love the festival.

So, last weekend, Jon, Veronica, our friend Pally, and I rented a "family chalet" at a beautiful lakeside B&B about 25km from the festival to enjoy a little relaxation on the beach by day and some music at the festival by night. We took a gorgeous drive down the escarpment from Lilongwe and arrived at the beach ready to do....absolutely nothing. This we excelled at! We drank coffee, swung in the hammocks, napped, and enjoyed the monkeys playing in the trees above our bungalow. [The same monkeys were far less enjoyable at night as they dropped mango seeds on our tin roof, waking us all up (repeatedly) with a start.] Still, we did manage to get off our duffs for a few minutes each day to kayak down the cove, snorkel with the colorful cichlids, and take a (nausea-inducing) boat ride to watch the sunset over the Senga Bay Hills.

Aside from the beach, we also managed to enjoy some of the music (and some of us, Jon, enjoyed the music more than others). On Friday night, we caught both Oliver Mtukudzi (a music legend from Zimbabwe) and Tanashe (also from Zim). Amazing music, great vibe, the requisite fire dancers, and a really diverse group of people made the few obnoxious, uber-drunk people less annoying. It was also pretty interesting to see the conservative dress requirements of daily life in Malawi disappear -- replaced by the appearance of far more cleavage and thigh than you would ever (ever) see around town. Even our Malawians friends noted that the attire most frequently seen at the festival was usually reserved for prostitutes! So, either 1) it was a pretty open environment for people to be themselves; or 2) there was a whole lot of business going on later in the evening; or 3) a mix of the 1 & 2. I vote #3.

Saturday's music was slightly less inspiring: the gospel reggae and long delays dampened my enthusiasm . In my defense, I was awake at 5am (and would be the next morning too). Jon loved the Noisettes, and protested when the 3 of us made him leave just as the crowd was warming up at midnight. Next year, we'll camp at the site so that the pre-midnight and post-midnight crews can both have their way. That will be win-win-win!

UPDATE (By Jon): I just wanted to say one more thing about the Noisettes to those of you who will appreciate this reference (Sasha, basically). Although I only got to see a couple songs of their set, it was shaping up to be legitimate rock spectacle akin to seeing Janelle Monae do her best crazy James Brown impersonation at Bumbershoot. There were caped unitards, shiny suits, back-up singers wearing fringe with coordinated dance moves, and catchy pop hooks. I hated to leave.

Fall's replacement

I really do miss fall colors (not to mention cooling temperatures). However, in lieu of the reds, oranges, and eventual browns of October in the States, we have our own dry season colorfest. Behold the purple and yellow carpet that blankets our yard! Plus, the whole city (and likely whole country) is similarly covered with these Jacarada trees in various stages of bloom, making every drive and walk unusually fragrant and delightful. Not too shabby, Malawi!

Michael Jackson had one...

But we have none. That's right: no gloves!

This email message came to me at the end of the day yesterday:

"This is to inform you that the district [NOTE: not even just the clinic, but the DISTRICT!] has run out of latex gloves.The referral pharmarcy as well as Central Medical Stores doesn't have any in stock. The district medical officer has also been informed, they are trying to procure the gloves from private pharmacies, but they didn't commit as to when they are going to get a supply. This development has affected our operations."

Maybe they can just use condoms as gloves? We have thousands of those laying around the clinic. Great infection prevention. Maybe just a tad slippery...

Out with the old, in with the new!

This week, there were many dog comings and goings in the household. Tomato’s reproductive organs left first, and then she was adopted on Saturday. Congratulations, Tomato: you became a woman, lost your femininity, and gained a new family all in the same week! Her new family – a young couple from Denmark – is lovely, so I am certain that she will be happy. I, however, am a little sad to see her go.

Not so sadly, Zebra chased the housekeeper’s kids (imagine shrill screams of unimaginable volume at 6:15am every day) for the last time. Zebra thought it was a game; the kids believe wholeheartedly that they were being hunted for the kill. She was returned to the kennel. Foster mom fail! [Zebra shown here enjoying her preferred (and quite odd) sleeping position.]

And, to replace them both, welcome Peanut (fuzzy) and Daisy (sleek)! They are adorable, adapting to puppy paradise swiftly, and made good progress on paper training their first day. I must admit that there are few things that bring as much joy as puppies. Maybe playing with puppies while eating dark chocolate? I’ll try that now. Hope I can handle the elation!

On death and dying

This will not be a happy post. Maybe not the best one to read if you are having a good day…

I understood what I was getting into when I moved to Malawi to work in an HIV/AIDS clinic. With between 4-26% infected with HIV (12% overall), I did not expect to be laughing all the time at work. Most days, I am just fine: The clinic is full of people who are doing well on their antiretroviral drugs, people generally appear healthy, and the sickest patients go to the inpatient center, not to us. Plus, I look mostly at the clinic data and help the programs improve – an indirect link with patient care. This week, however, we ran out of some key medications leaving some people to exhaust their supply and spend a few days (or weeks…) without their drugs. People were audibly angry, as was the staff (not at the patients, but at the situation). The drugs are actually literally right across the street at the central medical stores, but the logistics folks can’t seem to get them here. Compounding this, we also had a woman who brought her very sick child to the clinic for HIV testing and treatment; the baby died within minutes of arrival. The wailing from the day care ward was indescribable, but haunting as you would imagine. Another death later this week, also in the day care ward, released another series of bone-chilling, eerie cries.

Our clinic also sits right next to the newest maternal health clinic in the country. The new clinic is clean and sparkly, in part because only half of it is open. There are not enough nurses or staff to actually run the new center. Malawi has one of the highest maternal mortality rates in the world: 1% of women who deliver in a facility die in childbirth (usually the rate is higher for women who deliver at home). Even more frightening: 1 out of every 18 women in Malawi will die due to pregnancy or delivery-related causes. Most of the time, I can ignore the dreadful conditions for new mothers and their infants, but not this week. First, an OB/GYN friend of mine told me that she lost 3 women in one morning, all due to preventable causes. In brief, she noted that one woman died because the assistant nurse didn’t want to bother her supervisor; one woman died because there was no blood available; and one woman died because the clinician failed to recognize the presence of a second fetus (just a week after training on twins). I walked back to the clinic after this shattering conversation to find out that the newborn baby of one of the staff nurses had just died of pneumonia. I met the child, all swaddled, just 3 days before.

Folks at the clinic talk about the period from 1995-2005 as the period where funerals were everyone’s main social activity and every day was filled with loss, mostly due to AIDS. But, it still feels like death and dying are too common, almost commonplace, to me. Our “social welfare” committee reports every day on wedding, deaths, births, etc. This week: one wedding and funerals for 2 staff parents, 6 cousins, and 1 husband. The thing is, this week was pretty typical. I cannot imagine what it was like before. I find it hard to stay tethered with the situation as it is now.

And, that’s a brief rational for why I am off for my second nap of this warm Saturday afternoon.