Sleep tight: Don’t let the bedbugs bite!

Last weekend, Jon and I headed to Bua River Lodge for a much-needed break from Lilongwe.We’d been planning it for several weeks, but were almost prevented from traveling due to the usual: gas shortage. Somehow, we got the last drips of petrol half way to our destination, and we were able to recover from the stress of multiple dry pumps along the way.

We arrived in Nkotatkota Forest Reserve to find that our hiking trip had instantly been promoted to Romantic Getaway: we were the only guests for the night! We had the thatched roof chalets, the outdoor showers, the 3-story tree house, the chefs, the staff, the hikes all to ourselves! This news on top of the delicious coffee served in a charming coffee pot was almost too much to bear. Jon and I both giddily took photos to commemorate our luck. Ahhhhhhhhhhhh.

We spent the rest of the weekend reading, hiking around the reserve with our reformed-poacher-turned-guide, enjoying drinks by the raging river, and gorging on the delicious food – all in quasi isolation from the world. Safe haven. Relaxation.

It was such a nice weekend that the emergence of the bedbug bites the day after our return barely made a dent in our post-trip glow. Or, the bites left less of a glow and more of inflamed mess, but what can you expect? It was a jungle there (or at least in our bed)!

You look good....for 37

Today I turn 37. I cannot believe it. How did this happen????? I don't feel old. To Jon, I must not look too old. Last Friday, the only day that I work and Jon stays home, Jon baked me a delicious cake -- complete with chocolate icing, "3" & "7" candles, and a message written in chopped Swedish Fish candy: "You look good for 37"! Of course, I was just 36 at the time.

I was completely surprised when he brought out the cake! There had been no mess in the house, no chocolate smell, no idea that I would get cake early. We had some Peace Corps volunteers over for the night who also relished the delicious and decadent treat. Yum! The frosting took on a complete life of its own, acting as both topping and mortar, keeping the cake layers in place. I LOVE chocolate cake, but I only like frosting. Lucky for me, I got to pick out all the cake and leave some frosting on the plate. Jon, martyr that he is, ate the extra frosting to prevent waste...Happy 37th birthday to me!

One, two, three strikes…you’re out!

Out of condoms, out of HIV test kits, out of 2^nd line AIDS treatment…

At the moment, 6 shipping containers – literally millions of condoms – are sitting at the airport here in Lilongwe. They were donated by the Global Fund, as always around here, but they have not yet been distributed. They are just accruing airport charges that no one wants to pay. In fact, 1 of our two clinics was out all last week. Yes: no condoms in a clinic for HIV+ patients! The condoms are waiting for someone or some organization to come distribute them now that the Central Medical Stores (CMS) is temporarily shut down for a top-to-bottom reorganization and rebuilding process (read: corruption reduction). The decision to revamp CMS is great; the abyss left in its wake is terrible for the health system.

Compounding, or complementing, the dearth of condoms is a severe, nation-wide shortage of HIV test kits. See problem source, above. I guess if you can’t prevent infection, why test for it anyway? In an effort to help others laugh (uncomfortably) and not cry, I’ll tell a quick anecdote. Last week, a bigwig from the World Health Organization (WHO) came to visit the antenatal care center next door, Bwaila Maternity – the largest labor and delivery center in the country. We went with them to show the linkage to HIV care. The Bwaila team was showing the WHO delegation how they do HIV testing: a group education session, lining the women up conveyer-belt style for the HIV finger-prick test, and then individual post test counseling for results. The WHO folks were very impressed until they noticed that the women were holding cardboard strips rather than HIV tests. When asked why, the Bwaila team responded, “we wanted to show you what we do when we have test kits, but these days we have none.” So, they just line the women up for their tests, and then just put them back in line. Arghhhhh.

One last thing: there is also a severe shortage of 2^nd line HIV treatment drugs in the country – the drugs used to treat people who had severe side effects to the 1^st line drugs or who did not get better on those simpler treatments. Same ordering and distribution problems above. This leaves the sickest patients temporarily without drugs or temporarily (we hope very temporarily) back on the 1^st line drugs they failed previously. Because our clinic was one of the first clinics to have drugs back in 2002, we have a disproportionate number of patients on these later-stage medications. Our nurses and clinicians have to ask patients to come back next week (and the next) to get drugs. This week, a former head of the defunct logistics team (above) had the gall to make a personal plea to the director of my clinic to beg for 2^nd line drugs for a family member. Of course, there are no extra meds just sitting around and no personal favors. That’s karma for that guy, plain and simple.

To balance the news from the trenches, Jon and I have a big group of friends headed over tonight for a potluck. Do you know what turns a stressful week into a great weekend? MARGARITAS! Ole!

On finding our happy place(s)

Of the things we miss here in Malawi, relaxing coffee shops and inviting restaurants are on the list. Recently, we’ve come across two places to fill this gnawing gap. The first, Don Brioni, is an old Lilongwe institution right down the street that we somehow overlooked. Not only do they have great soup, delicious garlic bread, and tasty hummus, but the friendly owner and the quiet front porch make it a perfect date night. Who knew? Not us until now apparently....

The second, Ama Koffe, is a new coffee shop in the fancy garden/shopping complex, 4 Seasons. We were so excited by our Saturday morning find, that we actually had to take photos. Lovely tables with real flowers inset in glass; comfortable chairs, wi-fi, coffee served with homemade sugar cookies, a sweet stray dog to befriend, and flowers everywhere – it’s right next to the nursery. They serve fresh, hearty salads with more than iceberg lettuce, and a roasted vegetable sandwich that almost made me cry with glee. Plus, we ate the most delicious chocolate cake we have had in over a year! Honestly, it’s these moments that make us thankful to be here and thankful for places that make here feel more like home.