Whatever you do, work at it with all your heart….

Well, after the longest trip ever coming home…I am back. I am not quite in the right time zone yet (even after a week), but I am back and hit the ground running. One objective I had while in Malawi was to plan the Study Away trip for Health Care Professionals and others for August 2015. (http://www.uab.edu/students/academics/study-away). If you read my first blog, this is what has been in my heart from the beginning. I am extremely excited about the people that I met this trip and opportunities that are before me for this group. I am still working out the details, but here is a glimpse at the possibilities:

1. Stay at an orphanage and provide simple health activities.
2. Visit and assist in the local clinic and Blessings Hospital that is located near the orphanage.
3. Work with Kamuzu College of Nursing (KCN) faculty and students at the hospital and district clinics.
4. Work in a nurse developed and run clinic in one of the areas that was affected by the recent flooding.
5. Work with a group that serves food to more than 600 vulnerable children and women.
6. Explore two amazing cities in Malawi – Lilongwe and Blantyre.

And that is just the beginning…I can’t wait to lead the team, Malawi is truly my heart. I hope YOU will join me! Contact me for more details – dkwalker@uab.edu

During my trip I also worked with KCN during their OSCE (or validation) for their undergraduate students. I was a runner for supplies because my Chichewa is not even close to being good enough to evaluate a student fairly. But it was a great experience to watch how the faculty worked together and how the students took care of their “patients” with what they were provided, which sometimes was not a lot of supplies.

Room set up with exam rooms and hand washing station at the end of the tables.

Faculty preparing for OSCE

On another note, I thought I would provide you with a glimpse at the rains that I experienced every day…the clouds would roll in and dump a ton of water in a matter of minutes. These pictures were taken within minutes of each other. You can see how flooding can be an issue.

 

A few more pictures around town and across the country…so you can see what you can experience during the Study Away Program in August 2015!

The “Quick Pass Driving School” was not so quick….long line of traffic and even a pedestrian was walking faster.

Jeans for sale at a local market

Tea plantation

The rain clouds for the day

A glimpse of beautiful Lake Malawi

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Why Malawi? (Part 2) – The path…

If you read my first story you learned the beginning of how Malawi came to be for me. Was it a path that I chose or one that I was led to? I obviously had a choice, but I feel like it was more the “leading me” that got me to where I am today.

Zomba

The path has not been the straight and narrow, nor has it always been easy. It has been full of twists, turns, curves (often hairpin), mountains and molehills. But with each experience, my eyes have been opened, often to a whole new perspective.

Zomba Plateau

One reason I do it and keep doing it…it’s the people – the beautiful people.

Do you ever wonder why you meet a particular person? Why on earth did your path cross with theirs? Is it to gain a new insight? Give them a new one? Bring someone happiness? A smile? Challenge our way of thinking? Establish a relationship that connects you with others – which you may have not met otherwise.

I believe my path crosses with others for a reason. I may not know the reason at the time, but maybe I am not meant to know. Along this lifelong path that I am on I have met some beautiful, amazing people –especially in Malawi or connected to Malawi. Each has contributed to me trying to understand this complex world that we live in – full of diversity, emotion…. I am finally starting to see the pieces fitting together, which is rewarding. So as I continue to try and understand the challenges of the healthcare here in Malawi, I must first understand the people and their challenges –be it physical, emotional, spiritual –the everyday stuff.

Chip, owner of Satermwa Tea and Coffee Estate – http://www.satemwa.com/story

So this trip seems different for me –the people, the place…I am making more connections and trying to understand where do I go from here and what on earth am I supposed to do next.

Men passing the time with friends

I am meeting with people from other schools of nursing to see how I can help them develop oncology content; meeting with people at the College of Medicine to discuss interdisciplinary activities; and met an amazing nurse opening up a clinic in a neighboring village (I think I might bring the students here)…so making progress and heading in the right direction. It is all very exciting!

Chrissie – Amazing nurse who is opening a clinic

The people of Malawi

 

The people of Malawi

A taste of reality…

I arrived in Malawi on January 31 after two days of travel…it wasn’t all that bad. I have actually learned to how to sleep on a plane quite well, especially when given 15 hours to do so. I got caught up on movies (four to be exact) and met my seat mate, Sarah, who is coming to Malawi for the first time to help teach people at the hospital how to test for hearing aids. We also had some excitement on the plane when they announced they needed a doctor on board to come to door three, luckily that individual was okay, because I am not sure there is much you can do when you are half way between the US and Africa. So air travel is always an adventure.

Taking a break–Rachel, Chef Steven, and Me…enjoying dessert…watching the animals

Anyway, I am staying with a friend here, which is different than in times past. I am also in a different city. So I am not in a guest team house, have transport readily available, and so on. I am staying in a house seeing everyday life and challenges. The first three days we didn’t have water – we went from neighbor to neighbor each evening in search of water for a shower. Luckily it is back on! 🙂 Electric comes and goes. I am finding out that it is near impossible to do anything on line – everything must be done in person – and it usually takes two or three trips to get anything done. So with that it takes ALL day to do one task. I know it is not the village, but if we have these challenges – I can’t imagine what challenges they have in the villages, especially after all the devastating flooding that has happened here in the past month.

Jack Bower – sweet pup where I am staying

 

Why Malawi?

I often get asked “Why Malawi?” My short answer is “Why not Malawi?” But that usually doesn’t satisfy the inquiring minds. Trying to explain something that has been in my heart for as long as I can remember is not an easy task, especially when some of it you don’t understand yourself. So as I have been challenged to do over the past year– to reflect on milestones in my life, I thought I would share my thoughts on “Why Malawi?”– The long answer.

My first experience with anything international was when I received my first pen pal in elementary school– I think it was first or second grade. One of my teachers went to Australia and came back with stuffed Koala Bears, kiwis and PEN PALS. How exciting was that? I snail mailed (yes, that is all we had) my pen pal, Victoria in Sydney, Australia, for more than 20 years. I almost met her on my trip to Australia in 2000, but that is a whole different story.

Africa 2008

So my pen pal experience sparked my interest in the world. I started my international traveling experiences in high school and as soon as I got out of college (the first time), I worked 12-hour shifts so that I could travel the world… which I did. I have to say in my younger days it didn’t matter where I went, just as long as I was seeing something different and experiencing something new. Of all the places that I traveled, I never had the opportunity to go to Africa…but it seemed to constantly be on my mind…for some reason. And then….

Fast forward to 2008– talk about milestones—

Malawi 2013

I had gotten married two years prior and funny thing; my mother-in-law had a similar heart for Africa. She was planning her first trip to Africa with two individuals– a friend and a physician. Their mission– visit an orphanage in Malawi to see how to help. As the trip was being planned, the doctor had to back out. That is where I come in. I was asked to go and spend close to three weeks exploring opportunities for medical teams, fund raising, etc. It was perfect. This was my opportunity to try to understand why I felt the way I did about Africa.

Leading up to the trip…five weeks prior to leaving, my father had a massive stroke at the age of 64 and was found to have melanoma that had metastasized to his brain (causing the stroke). Being an oncology nurse practitioner, I knew that this meant my time with him was limited, no matter how you look at it. I traveled back and forth from Alabama to Florida and had to make decisions that one hopes never to have to make during their lifetime. It was during a difficult conversation that I had with my father that he told me to go ahead and go to Africa because it is something that I have always wanted to do. He assured me that he would be fine and that I could “do more in Africa than here.” I went to Africa as planned…and three days later I got one of the most difficult phone calls my husband probably will ever have to make.

When I found out that my father had passed away I was in a common area at the orphanage playing with the children. I remember it well. I took the phone call, left, walked for what seemed like miles (not really) and went back to the guest house to be alone. It was during this time that I felt such a connection with Africa that I will never forget. I felt a peace over me. I knew I was where I needed to be.

Malawi 2013

What kept going through my mind was that I knew my dad and enjoyed (although he might tell you different during my rebellious teenage years) 35 years with him; whereas, the children that I am surrounded by at this moment may have never known their parents, or at the most only for a very short time. For the next hours and the following three days, as I waited to get a flight out of Malawi, I found comfort in a place that I have now grown to love. So many things happened during that time that confirmed why I was there at such a time as this.

Fast forward…my desire to go back to Africa and “finish what I started” never left me. I did go back– to Cape Town, South Africa, in 2011; Zambia in 2012; and then finally back to the ”heart of Africa,” Malawi in 2013. How things have played out as I have reflected back on them does not give me a sense of surprise, but one of AMAZEMENT. If we follow our heart, be patient and do what we are supposed to do, amazing things will happen.

Malawi 2013

And amazing this happened in 2012. Four years after my first trip to Malawi, I was invited to a discussion at UAB with an international leader that just so happened to be from Malawi’s Kamuzu College of Nursing AND she also just so happened to be visiting with the individuals (100X Development) that help run the orphanage that I stayed at in 2008. What are the chances, right? In 2013, I had the chance to go back to Malawi yet again and explore how I could use my gifts and talents there. In 2014, I received my Fulbright Senior Specialist Award allowing me to spend six weeks in Malawi helping to build oncology nursing curriculum; now in January 2015, I am returning to continue this work. In August 2015 I am taking my first team to Malawi. Seven years after my first trip, I am able to see it through. I know my dad would be pleased.

Follow Dr. Debbie Walker as she returns to Malawi

Over the next three weeks The Trailblazer will follow UAB School of Nursing Assistant Professor Deborah Kirk Walker, DNP, as she works with the faculty at the University of Malawi Kamuzu College of Nursing to continue her work integrating oncology into their curriculum and providing support for oncology nursing education in Malawi.

Her work is part of an ongoing collaboration between the nursing schools at KCN and UAB.

We hope you will join Dr. Walker as she works with our colleagues in Malawi to strengthen nursing education and patient care for the people of Malawi.

Time has flown by…

By Dr. Lynda Wilson

 

Getting water at the well

It is hard to believe that my three weeks in Malawi is almost over! It has been such a privilege to be here and to teach in the new PhD program, and also make many new friends and renew old friendships. Another week has flown by.  My last blog was written on August 15, before we headed for an amazing weekend to visit the Bushman’s Baobob camp near the Liwonde National Park, about a 3 hour drive north of Blantyre. The day started with a trip to the Blantyre market to stock p with vegetables and other food for the trip.   On the drive we passed many villages and small towns, and saw lots for sale in the markets, including barbecued mice on skewers, which seemed very popular in one particular village.

The Bushman’s Baobob camp is beautifully situated in an area with more Baobob trees than I have ever seen in one place…the legend of the Baobob tree is that God became angry with the Baobob for being too proud of its beauty, so turned it upside down…the trees indeed look as though their roots are where their branches are. Debbie and I shared a chalet with a curtain for a door and I must admit I was a bit anxious the first night that the monkeys or elephants would smell the trail mix that I had left in my back pack and want to come for a visit – but alas, no such problems!! The stars at night were amazing, and we had a lovely early morning drive and then walking safari in the park where we saw lovely birds as well as elephants, impala, wart hogs, and water buffalo.

The kangaroo care unit at Queen Elizabeth hospital in Blantyre

A highlight of the week was a visit to the neonatal intensive care unit and neighboring Kangaroo Care ward…this is an 18 bed unit (soon to be expanded to 40 beds), where mothers stay for up to 3 weeks and care for their preterm infants providing 24 hour skin-to-skin care to keep the babies warm (since there are not enough incubators to meet the needs)…in the small and crowded neonatal intensive care unit they have no ventilators, and only four CPAP (continuous positive airway pressure) machines which they use to deliver oxygen to the smallest preterm babies. The head nurse explained that they usually do not treat infants who weigh less than 1000 grams (they have to make difficult decisions and set priorities to decide who can get the CPAP since the resources are so limited). Malawi is a leader in the global Kangaroo Care initiative, and many hospitals have these Kangaroo Care units, which have the potential to save the lives of preterm babies in such low resource settings.

I taught my last research class with the PhD students on Wednesday, and they surprised me with a lovely farewell luncheon and presented me with three lovely chitenge (the beautiful African fabric). Two of them had designs that were advocating for Kangaroo Care and for support of premature babies (“Every Premature Baby Deserves to Live”)…This was so touching as the students know how passionate I am about newborn health!

Kamuzu College of Nursing

On Wednesday after class I travelled from Blantyre to Lilongwe, a four hour beautiful drive through the mountains…we were treated to a lovely African sunset over the mountains just as we came into Lilongwe, about 6 pm…I spent the past two days on the KCN campus in Lilongwe meeting with Dean Address Malata, an amazing nursing leader. Address was recently elected as Vice President of the International Council of Midwives. An unexpected treat was the opportunity to have dinner and then meet today with Tore Laerdal, the son of the man who founded the Laerdal Company in Norway…this is the company that produced the original CPR training manniken (Resuscianne), and has subsequently produced many different products to aid in simulation training in health care. They have launched a $2 million project in Malawi and Zambia to save the lives of 10,000 newborns by providing training to midwives about “Helping Babies Breathe” and Promoting Safer Births. Here is a link to the brief project video for the 10,000 Happy Birthdays video https://www.youtube.com/watch?v=9AQCqxuare0

Further information on our programs can be found on http://www.laerdalfoundation.org. During our meeting today with Tore and his team, one of the KCN faculty members shared results from her qualitative study for her MSN thesis in which she followed up 30 mothers who were discharged home from the Kangaroo Care unit…I had tears in my eyes as I heard some of the quotes from the mothers she interviewed in their homes. One mother dug a hole in the dirt floor of her hut and filled it with peanut shells and then placed the baby in that hole in order to keep the baby warm. I am continually sobered when I see the depth of the poverty here and amazed at the resilience of the human spirit…how people can cope with what I cannot imagine having to cope with.

I am eager to return to Malawi (hopefully in January) and to continue to work with the amazing students and faculty I have met here.

 

I refuse…

By Dr. Deborah Walker

Faculty from the Community Department –
Claire (from Australia), Idesi, Winnie, Jane and Debbie

Last week I was busy working with the community department helping them look through the whole curriculum and individual modules identifying areas for oncology content. I feel like we got a lot accomplished. Winnie, Jane, Claire and Idesi are fantastic! This week I spent time with the med-surg faculty at various times – Gladys, Rodwell and Annie. I have provided them with a tool kit on a disc to get started and I will continue to help them identify information for their modules. So much to do, so little time left.

I was able to meet with the US Embassy Officials and thank them for my Fulbright and will be meeting with the Ministry of Health Officials tomorrow. They have asked that I inform them of what I am doing here in Malawi in an effort to connect people and initiatives so that people are not always working in silos. Brilliant idea!

Hand Washing Station

I also had some time at the hospital and spent some time in the oncology area. I was able to talk with a nurse who administered chemotherapy and the Chief Nursing Officer about their needs for oncology education. I took two pages of notes, so I think I have my work cut out for me for the next trip. Words cannot describe what I saw. I didn’t take a picture. I didn’t need to. It will be forever in my mind.

After work this week I decided to be adventurous. I hopped on a bus and headed back to Blantyre to meet up with Lynda Wilson and a few other ladies that I have met here. We had a girl’s weekend at Bushman’s Baobab. What fun! It was like we were all old friends getting back together – oh the stories!

Debbie (Me-AL), MaryAnne (Peace Corps-Michagan), Katrin (Germany), Rachel (From Wisconsin, but after her Fulbright, moved to Malawi fulltime), Lynda (AL), Ros (UK)

 

Picture are from around the camp site. No electricity. The picture on the bottom of the collage is what I stayed in. Please note: No door, just a curtain! With elephants, wort hogs, etc. outside. If you are thinking -“how frightening.” Why yes, I was thinking the same. Not much sleep this weekend.

I don’t know why but I have such a facination for these trees – Baobab tree AKA Malambe tree.

I thought I would share a picture of the shower and the view from the shower in the morning. You have to be very efficient.

 As my time comes to a close,” I refuse” to think that I am done here in Malawi…I believe I have only just begun. During my 4.5 hour bus ride back to Blantyre, as I was listening to my music…this song came on and sums it up! I hope you read it and then download it and really listen to it.

“I Refuse” By Josh Wilson

Sometimes I, I just wanna close my eyes

And act like everyone’s alright

well no they’re not

This world needs God, but it’s easier to stand and watch

I could say a prayer and just move on

like nothin’s wrong

But I refuse

cause I don’t wanna live like I don’t care

I don’t wanna say another empty prayer

Oh I refuse, to sit around and wait for someone else

To do what God has called me to do myself

Oh I could choose not to move

but I refuse

I can hear the least of these

cryin’ out so desperately

and I know we are the hands and feet of You oh God

So if You say move

it’s time for me to follow through

and do what I was made to do

and show them who You are

Cause I don’t wanna live like I don’t care

I don’t wanna say another empty prayer

Oh I refuse to sit around

and wait for someone else

to do what God has called me to do myself

Oh I could choose

not to move

but I refuse

to stand and watch the weary and lost

cry out for help

I refuse

to turn my back

and try and act like all is well

I refuse

to stay and change

to wait another day

to die to myself

I refuse

to make one more excuse

cause I don’t wanna live like I don’t care

I don’t wanna say another empty prayer

Oh I refuse

to sit around and wait for someone else

to do what God has called me to do myself

oh I could choose

not to move

but I refuse

I refuse

I refuse

yeah

I will miss the “warm heart” of Africa.

Until next time Malawi!!