I woke ON my first morning in Mulanje to the blasting of country and gospel music. The flats where I am staying are for the single nursing and clinician residents — a bunch of 20 – somethings living in one place. Everyone knows what everyone is doing at all times, there is zero privacy (thank goodness I grew up in a big family and am used to this) and it’s just a big party. We all have our doors open in the evenings and greet each other as we pass by.
During my first two weeks here, I had no running water. I had to walk down the road to a manual water pump and stand in line with a group of Malawian women. When I tried to walk away with my water they all laughed at me because I couldn’t carry it on my head. I was so grateful when my water was finally fixed.
Now that I have travelled to different areas in Malawi, I can confidently say that Mulanje is the most beautiful. The mountain towers above the small village and the tea estates are full, green and rambling at its base. The roads are rich and red with clay and the people are so colourful and friendly. Did I mention the stars?! They are the most spectacular I have ever seen.
I have been running most days for exercise and as I run through the tea and look at the mountain it changes colour with the sun and cloud cover. I have a big running fan club of kids who cheer me on and run with me. They are laughing and cheering and all trying to touch me sneakily. Running with ripped clothes, bare feet and a mango in hand, these kids have the biggest smiles and joy about them. One day I had a small group of 16 – year – old women with babies on their backs running with me. It was strange to see them laughing and smiling, running in bare feet looking like they had no cares in the world and yet they were mothers already—giving their lives to another human being.
My work at the hospital has already evolved. The facility is a different world compared to Queens Hospital in Blantyre. There are separate rooms for the labouring women, usually adequate supplies and mostly enough staff working to appropriately care for the women and their babies.
I spent the first month trying to figure out my place and purpose working with this well – oiled machine. I am feeling so much more a part of the team now that I am a trusted midwife and friend in this group of hard – working women. I have taken an active role in the teaching of students as it gives me an opportunity to have a translator at all times! Most of the village women who use the hospital to have their babies only speak Chichewa and this is my biggest challenge. I have been trying very hard to get a grasp of the language and it’s slow going. My co – workers love teaching me and get a kick out of my pronunciation, but it’s all in good fun … I think. It’s challenging to be in a constant state of confusion. Sometimes I feel completely in the dark, struggling to take a deep enough breath; I really miss being able to express myself freely. One of my favourite co – workers had a long chat with me one afternoon and after she said, “Elleana, talking to you makes my head hurt!” It’s a slow – going process, (pangono, pangono) little by little. A turning point was after a delivery with a 15 – year – old first – time mom who had a big tear; the sister in charge told me I was doing the repair and then she pulled up a chair to watch me. I was under so much pressure but afterward she accepted me as one of them.
There is a sense of loss and grief that many of these women carry with them as part of their labour and birth experience. It’s not uncommon for a woman to have had four or five children with only two or three living. Most women have lost a child and that just becomes a part of life. There is a hilarious song that plays on the radio here called, It’s a Part of Life and the lyrics are ridiculous. A couple of the lines are, “your husband cheats on you, it’s a part of life; you get HIV, it’s a part of life.” These things don’t have to be a part of life! There are so many changes to be made.
We often have women come into the labour ward labelled BBA—born before arrival. Many women travel great distances by bike, taxi or foot and are forced to give birth alone somewhere on the side of the road. Sometimes they arrive in high – risk situations including a retained placenta, too much blood loss, or a preterm baby. These women have such amazing strength. They give birth on the side of the road and then walk the rest of the way to the hospital!
At a concert in Blantyre, I had my phone and camera stolen and it made me really sad. My midwife friend, Hannah was there with me and she said, “Elle, it’s just material. Remember that it’s just material.” She said the perfect thing to me, remembering that the real things of value in life don’t have a price tag.