Getting ready to go

The long wait is drawing to a close. The feeling is one of anticipation mixed with complete bewilderment at what lies ahead. My placement in Ntcheu, Malawi is very imminent now and currently it’s a frenzy of last minute planning and life sorting that I’m going through. The complexities of relocating for 2 years never really hit me until I’ve had to do it. The incredible organisation behind this big move deserves a few telling paragraphs, if only to put things in perspective. From cancelling or transferring utility contracts to arranging a smooth departure from all my contacts- a different kind of contract one could say, a social one- it’s just been absolutely bamboozling!! Add to that the forward planning of logistics of settling into a new place, a new country, a new culture, a new world and you can picture the fried spaghetti my brain has turned into!

The first aspect of that was the job side of things, which VSO has thankfully mostly handled on my behalf, but not without the incessant chasing of papers and references and personal statements, that formed the major part of my after-work duties for weeks.

The second aspect, also majorly handled by VSO, was the flight. Whether that helped alleviate or increase the stress level, I cannot decide yet- but relying on a third party to sort out travels for you can be daunting. Not only because I only found out about a month in advance when exactly I’d be leaving, but also because I would only have one month to try and sort out extra arrangements like excess luggage (believe you me, I’ll be needing that!). All that said, I do have to admit that having someone else sorting out immigration nightmare for you is a real blessing.

Thirdly, in a league of its own, came the medical preparation for the journey ahead- not just the medical of course, but the whole battery of vaccinations that my deltoid have fallen victim to (thank god the days of gluteal jabs are over!). Then also, I’ve had to think hard about how to build up my little arsenal of essential meds like antibiotics, antimalarials, antiemetics, antiseptics and, lord forbid, antidiarrhoeals. And how can I forget the dentist! That man, whom I wish I’d never seen, almost threw the biggest spanner in the works, but I decided to ignore him and get my crown sorted out when I come back here...

The fourth aspect, a big one for me, has been about how to keep myself sane while I’m out there. Making sure I’m able to pursue at least a few of the hobbies I’m addicted to has had huge implications on my packing. After making huge sacrifices on my climbing gear, it is very unlikely I’ll subject my cycling to a similar fate. I dearly hope I’ll be able to find stuff out there too. Intriguingly my hiking plans have led me to trawl yet another heavy array of gear with me, a lot of it being winter clothing. That was inspired by a fortunate trip I did in Malawi in 2008 when I experienced the full force of the Mulanje Massif’s microclimate while relying on a flimsy summer sleeping bag to keep me from turning hypothermic.

The fifth, and of course, principal aspect for me going to Malawi, is the job in hand. So, making sure I’m prepared to undertake this challenge has been a long and arduous process. The VSO training comprised two 4 day weekends of 8am-8pm brainstorming in the idyllic setting of Harborne Hall. To all VSO aspirants reading me now, let’s say that if only for Harborne Hall, your decision might be entirely justified! Besides that, there’s also been a great deal of skill and knowledge consolidation. This has taken from very familiar territory as Orthopaedic workshops to far flung corners of medicine as Obs& Gynae. On the whole, it has been hugely rewarding and the urge I now feel to put all this wealth of training to good use is gnawing at me. I made the deliberate choice to finish work quite late so as not to be away from medicine for too long and get rusty. Another big component of planning point five has been the early preparation of projects to embark upon while on base. These include the setting up of links with Orthopaedic colleagues whose knowledge and skills in the developing world I’m sure to tap into at some point. I am also setting up a collection scheme for redundant surgical equipment, which I hope to be able to ship across to my hospital. NHS buddies out there, spare a thought for this and expect me to poke you at some point for supplies if the project goes according to plan. It also goes without saying that my suitcases have had to be loaded with as much of a reading material as I will be allowed to carry- so much that I’ll probably expand the existing library created by my medical predecessor in the district hospital of Ntcheu to twice its present size.

The single most important challenge, my temporary (geographical) separation from Janet, can rightly be said to have been the most laden with emotions. As a true sign of its strength and of our mutual belief in the value of such a life decision we have decided to take, our relationship has not been strained by it. Our marriage of vows and souls in November certainly helped to strengthen it rather and, since then, it’s been going from strength to strength. An early, honest and joint approach to this decision was probably the key factor in enabling such a smooth transition. After all, the whole experience will be one embedded in partnership.

Well, obviously the reality of relocating for two years cannot be conveyed in six mere points. It is only through experiencing it that one can start to have a real feel for it. Before even starting my actual placement though, I would certainly recommend it to anyone after a good buzz in life. That says it all for me. After months of laboured activity and rigorous planning, I can now say I feel readier than ever before to leap into that new world now. The hardest step indeed, was the one I took ages ago when I decided for the first time to sign up with VSO. The change of mindset has already occurred now and it’s just a question of applying it to the world it has changed itself for. So here I go, all excited about that new adventure, all in tears from leaving my beautiful and inspiring wife, all upbeat about the myriad of fascinating medical and surgical experiences in store for me, finger-nail-less from the dread of having to do my first caesarean section, all impatient to get into my shorts and T-shirts finally and also all too aware how my mosquito defences will have to go up. Here I go to live it all for real.