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Ward round (18.03.2009)

This is the ward round in the Nutritional Rehabilitation Centre in Zomba. Unlike to Kumi the patient numbers are always between 40 and 50 children in the moment and can rise sometimes up to 80. There is one Clinical Officer (something inbetween a medical doctor and a nurse) responsible for the ward and therefore doing ward rounds every day. But still with this high numbers of children it is difficult to keep an overview, especially, because they are discharged very early, often after only few days to enter the community based outpatient program for nutritional rehabilitation.

Telephone antenna (24.04.2009)

This pole is an antenna for mobile phones and it is placed near to our house. In the beginning it was quite helpful for me to find the house because roads hardly have names and there are so many small roads and bis houses everywhere that it is not so easy to find the right one. And it also has the advantage that we have a very good connection with the mobile phone.

Kangoroo Method (24.04.2009)

The hospital here in Zomba is actually well known for the kangoroo ward and the successfull implementation of this method. Mothers are admitted here when their babies have a very low birth weight but are stable otherwise. Then they are thaught how to tie their baby with direct skin contact to their chest. Through the body warmth of the mother the baby is also kept war - which is as good as or even better than the incubation beds. A really gread method and for the mothers here not so uncommon because they are used to tie their children with clothes on their back.

Driving School (24.04.2009)

There is one driving school in Zomba. Every morning on our way to the hospital we are meeting at least one of their cars - most of the time staying in the middle of the road blocking everything because the student has to learn how to turn the car or how to park it. This sign posts are in front of the driving school building and everytime I pass by I have to smile a bit. Driving a car in Africa is always a bit of an dangerous adventure and to put an advertisement for coffins directly under the sign post for a driving school could be interpreted in a rather nasty way...but I think most of teh Malawians don´t feel that way. It is both just a normal part of the daily life here.

Poinsettia (24.04.2009)

In Malawi it is now becoming winter and this is the time this plants to start flowering. In Germany they always come during christmas season in small pots for decorating the houses inside. But here there are huge trees everywhere along the roads. It is really getting colder here now. It feels a bit funny to wear pullover and socks all the time, but there are no heating systems and during the night it can become rather cold already. For the local people it is a very uncomfortable time because very few people have warm winter clothes and their houses are very poorly isolated.

Traffic lights (24.04.2009)

This is the traffic light in Zomba. It is "the" traffic light because it is the only one! It is placed in the middle of the inner city and most people are really stopping their car when the light shows red. It is also helpful to describe certain places in town: the traffic light is always a good starting point that everyone knows here in Zomba.

Old hospital files (24.04.2009)

Old hospital files in Africa - a challenge for any studie I believe. This is one of many interesting findings I made while going through the files: a dried up gecko baby that must have died after going into a pile of old files. Poor thing! Other findings were not so nice, e.g. rats had eaten part of the paper or other got wet and are now sticky and full of fungus.

Cultivating tobacco (24.04.2009)

Here in Malawi tobacco is one of the major exports. Also one of the local staff at home is having a big garden where she cultivates tobacco. Since I wanted to know more about the cultivation we visited her one afternoon and she showed and explained everything to us. Very interesting. On the picture you can see the tobacco plants. Most of the leaves are already harvested as you can see from the cuttings around the trunc.

Drying tobacco  (24.04.2009)

This are fresh harvested tobacco leaves. They are put together - always 4 leaves attached to each other with some kind of grass and then they are placed like this to dry in the shade. In some areas you can see huge shelters and houses filled with these tobacco leaves. But the local peasants who are doing the biggest part of the work are earning only very little money.

Nsima (24.04.2009)

The main staple food in Malawi is "Nsima". In UGanda the same food was called "Posho". It is just maize flour that is mixed into boiling water and then mingled to a sticky pap. The taste is of course better when the maize is ground fresh before preparing the Nsima and this is done here with this big mortars. When we visited the tabac garden we were also invited to eat nsima and beans with them and then allowed us to try to "grind" some maize in the local way. It is not so easy and takes really long!

Zomba Central Hospital (24.04.2009)

This is the main entrance of the hospital. It is called a central hospital which means, that it works as a tertiary referral institution for other smaller hospitals around. With 500 beds and an bed occupancy rate of sometime nearly 200% it is compared to Kumi really huge. The german development aid GTZ is running a program here. They sent 3 specialist doctors from Germany to work here and to train local doctors. Charlotte is one of them. Generally this is a great idea, but the problem is, that there are no local doctors in the hospital to be trained! The work is done exlusively by clinical officers who are working as doctors but have less training and far less salary. Training these people is still a good thing to do, but they are staying very often only for short period of time, because the working conditions are bad and the salaries poor. Very sad!

Gift Yusuf (24.04.2009)

This is on of the children in the NRU in the moment. The boy is 10 years old and (surprisingly) not HIV positive. He was tested may times, because he showed so many symptoms, but the result is clear and malnutrition can make similar symptoms like AIDS. After lots of investigations there was a problem found in his intestines: an obstruction which causes pain and makes him to vomit quite often. Now they want to operate him, but before that he needs to gain some kgs - otherwise he would not survive the operation. But he doesn´t like the therapeutic feeds so much and every day he was asking for chicken meat. One day we then bought a chicken and Christine, our housemaid prepared it for him. You should have seen this smiling eyes when he ate the chicken! On the picture he is sitting on Christines lap after eating the food.

View from the Zomba Plateau (09.03.2009)

Malawi - a small but beautiful country. Here you can see the view from the Zomba Plateau downhill on the city. It is end of the rainy season in the moment and therefore everything is green and flowering.

View from the Zomba Plateau 2 (09.03.2009)

Here a second view from the Plateau. This time in a different direction. The lake and the island in the background are part of the Nationalpark in which I had my first night in this country.

Nationalpark (09.03.2009)

Charlotte surprised me with booking a lodge in the nearby Nationalpark already for the first night after my arrival. It is only a small park near to Zomba. The landscape is really beautiful, but unfortunatly it is difficult to see animals in the rainy season, because the grass is quite bushy. But still these Baboons were running around everywhere.

Sundown (09.03.2009)

A beautiful sunrise at the Lake Malawi. Unfortunately this huge sea is infected with bilharzia. Not a very servere severe disease, but at least it keeps me away from swimming there.

Cutting wood (09.03.2009)

Like in Uganda the bicycle is the most important way of transport. But there at least in this area here there are no bicycle or motorbike taxis. Maybe it is because of all the mountains around the town, but I really miss it, because it was always such an easy and nice way of moving from one place to another.

Chiponde (18.03.2009)

In this small plastic containers the special therapeutic food for the malnourished children is provided once they enter the second phase of rehabilitation. In most books it is called "Plumpy-nut", but here it has the local name of "Chiponde". It often takes some days for them to get used to this sweet groundnut paste, but when they like it, it is a wonderful thing, because nothings needs to be added and it also requires no boiling and therefore reduces the risk of diarrhoea.

Back in Africa (09.03.2009)

It is now 1.5 years that I am back from Uganda in Germany. It is a long time and I got used already very well again to the comfortable life. But still: when I stepped out of the airplane on Saturday I felt like coming home. The smell, the red soil, lots of children, laughing and curious people everywhere and of course also things like power-cuts, endless long waiting times and bargaining on the market... Everything so different and so at the same time. But it is just great to be here again .

Pictures from Malawi