Back after a long absence. This has paradoxically been the most exciting period of clinical activity in Malawi. Moving from low rumbling Ntcheu to the epicentre of trauma in Blantyre, while joining the on-call registrar rota, has come with a predictable surge in medical/surgical drama. Not a single week goes by in Queen’s when I don’t think, “well I could make a ‘case report’ out of that”! The somewhat perverse sense of medical excitement(perverse because it directly means that someone’s tragedy contributes to the doctor’s direct pleasure- although I have got over that one, through my “survival in a fast and stressful environment” doctrine) is satisfyingly tempered by the widely diverse range of my duties here: weekly teaching of 3rd year medical students and trainee ortho clinical officers, examining, course facilitation, clinics, drafting of a reference manual, outreach clinics to Ntcheu and Thyolo and other more epidemiological interests in these 2 locations. To say that I’ve got my work cut out for a year is quite an understatement!
The two ER-style dramas that have formed the highlight so far of my 2months in Queen’s have both been a direct consequence of the surprisingly intense second wave of the rainy season, while I’ve been on call. The soubriquet of trauma-magnet has indeed followed me to this corner of the world! The proof is that my 3rd on call was the quietest I’ve ever had. Hold on, that can’t be! That on call happened to be one I had effectively swapped and the “swappee” turned out to be a scene from a horror movie scene- assaults, lacerations and open fractures needing theatre attention for all night.
Land-slide wall
So here I am, slightly nervous that this is going to be my first proper call in more than a year and having not yet worked the system out fully. I pre-empt disaster by doing a systematic round of all relevant clinical areas to pick up the cases that might be referred to me during the night. Satisfied to have cleared all that up before 11pm, I yawn a final goodbye to my orthopaedic ward sister, who tells me “Hang on. Don’t go far!”. As anyone who has ever done a medical call knows, that statement is usually paraphrased as “Don’t even think of going anywhere cosy tonight!”. Just outside town, a multiple casualty has occurred, where a number of people who were standing by a wall suddenly had its whole weight collapsing on them! 2 ladies were severely injured, one of them pregnant. I find the non-pregnant one collapsed on the surgical ward without a pulse, being attended to by the intern on call. No bleeding visible anywhere, but a ghostly appearance. Pallor is a clinical sign that is certainly easily detectable on black skin, despite certain doubts I’ve heard to that effect. One feel of her pelvis and you got the diagnosis: Fractured Pelvis. But before that, the bit which is the real challenge here, is the ATLS resuscitation protocol- your ABCDEs. A challenge since ATLS was written with your western high adrenaline tertiary trauma unit in mind, not an under-resourced African hospital, where more than half of your assistants have never even heard of ATLS! As it was, my patient’s blood pressure was in her boots, with no accessible peripheral veins in her arms. Thus, aptly I decide to go for the area around her boots indeed and do my first unsupervised saphenous cut down. As much as is feasibly possible, I secure it and manage to administer just the amount of fluid and blood required to revive her. But as soon as she gets back to the ward (she was taken to theatre recovery for that), some “clever-clogs” decides to hang her fluid bag from the same drip stand as is normally used for the arm line. To no-one’s surprise, the line is too short and ends up simply yanking my cannula out!!! By that time, she has a recordable blood pressure though and gets an arm line inserted. The rest is standard open book pelvic fracture management- sling around the waist and legs, maintain BP (stable, therefore no need for ExFix in the middle of the night [which would incidentally have been my first one too!]) and wait for the morning to plan her definite fixation.
The pregnant lady, given the mechanism, also ended up with a pelvic fracture. However her clinical picture was entirely different, with pain being her main complaint. Everything else was stable and the reason for this stunning difference lay in the Xray pictures- whereas the first one was probably facing the wall as it fell on her and had her pelvis effectively opened up from the symphysis, the second one must have either been hit by the side or had the weight of the wall somewhat dampened by something else, sustaining a bilateral pubic ramus fracture instead without any posterior element, hence maintaining the integrity of that polo mint structure overall. That budding fetus in there must be relieved things didn’t happen the other way round!
About mini-buses
Remember that flash storm I once experienced at the start of my placement? Well I do remember thinking to myself that day “I’m glad this isn’t in the middle of the night and that the road is clear”. Such was not the luck of the casualties I admitted on that second ever call in Queen’s, when I was advised not to go far! A minibus effectively got sandwiched between a hauler truck behind and a car in front in what I remember to be the biggest downpour of the season. Impossible to attribute the blame to any party in particular here, but in spite of the commonness of reckless driving in this place, I think even the most meticulous driver could have found this unavoidable that night. The only safe option would have been not to go out. Those who made it alive (not sure how many but there were deaths on the scene), were barely hanging on. With full ATLS awareness in mind, the team on call (2 registrars, 2 interns and 2 nurses), used a multiple casualty approach, treating the most severe injury first, then the others. We split in 2 teams and managed to stabilise the 2 most unstable patients, both with clinically unstable pelvis fractures. Before I could even measure the vitals on my patient, the other team’s patient was already being wheeled to theatre, where I eventually joined them. I was effectively the senior orthopod for that night, since my consultant’s phone went unanswered on at least 10 occasions. The patient ended up needing multiple debridements, elevation of a depressed skull fracture (by the general surgeons thankfully) and an arm amputation. She then went to ICU intubated. It would have been a miracle if she survived and she didn’t. The second one also had multiple serious wounds that needed debriding, including open fractures of her forearm. Her outcome was more positive. As I got to the 3rd patient, whose main injury was a closed tibial fracture, the latter had evolved into a nice ballooning compartment syndrome. Now the dilemma arose about how I was going to do this case for the first time ever unsupervised. I’ve read a lot about it but this is a condition I’ve always tried to get involved in but never saw one while being on duty. So, assisted by the general surgical consultant, himself somewhat rusty on his orthopaedics, upper GI being his thing, I went on to translate book to limb for the first time. In that medically perverse fashion, I will admit to you that the opening up of a fascia which is in compartment syndrome must be one of the most satisfying feelings in surgery that I know of! It just bulges out and you can see the pressure offloading at once. And it’s a limb saved, potentially a life! Next big question then arose: do I fix him in the middle of the night, as indicated by the grade of his injury (Gustilo I) or do I plaster his leg with these massive open wounds? So I decide to go for the ExFix option and taught myself how to use this new kit that I’ve never used in the process. As it all held together straight when I tightened the final screw, I heaved one sigh of relief only surgeons can understand the meaning of! The last patient wasn’t mine and had mostly maxillofacial injuries, with a minor head injury. An on-call spent almost entirely in theatre and indeed a highly rewarding one. The way I downed that Coke I managed to lay my hands on at the end of that shift would be a serious contender for the next Coke advert without a doubt!
The rest
I wish I had enough space and time to document the rest in its full scope here. But since I have to actually DO the rest, I won’t spend much time DESCRIBING it. In brief it’s a mixture of trauma and elective work that I’ve not encountered much before. The trauma work is incredibly fascinating, with a lot of them presenting late and being non- or mal-unions. The tools we’re using are ones that are not so common in the UK anymore, e.g. K-nails and even then, improvisation is the key. Like just last week, we needed a 10x38mm nail and had nothing near it. So we combined two 8x42mm and then spent half an hour trimming it to 38mm! The elective work, for its part, is simply out of this world. Spinal surgery with the Prof- TB decompressions, laminectomies, fusions, pedicle screw stabilisations. A whole repertoire of terms that were hitherto very unfamiliar to my work vocabulary, let alone the spectrum of diagnoses involved- neurofibroma of the cord, syringomyelia, monofocal fibrodysplasia and even the first case of post op malignant hyperthermia I’ve ever seen.
This is the cutting edge of orthopaedics in the third world I think and I’m really thrilled to be involved in it. The learning curve is phenomenal but the sense of fulfilment even more so...
18 April 2011
11 April 2011
Bird’s Eye View
At least 2 weeks' worth. Longer but shorter blogs seem to be the norm with this city life!
With Saj visiting, I got to see Malawi from a new perspective altogether. This was in no small measure helped by the (temporarily) upgraded mode of transport, in the form of a rattly converted army Land Rover “Defender”. Luxury nonetheless for me! Our itinerary comprised a mix of unchartered territory as well as familiar stomping grounds of mine. Having a visitor around really gives me an excuse to go and explore the place I’m in better, while allowing me to see familiar things differently from the way I normally would.
The first few days were really a warm up to get into shape for the meaty stuff ahead. On day 1, we went up Soche, the mountain literally in my backyard, for a bit of joint lubrication and muscle awakening. We decided to enlist the help of a local who might be able to guide us up. As it was, we met a group of boys near the base and one of them volunteered to accompany us. Another candidate (who seemed more familiar with the surroundings) had to be turned down because we had absolutely no way of communicating to him! We shot up a fairly well defined path until we reached this overgrown grassy maze, where one could only guess the next bit from lines of flattened (slippery) grass. Only at this point did our “guide” actually reveal to us that this was the first time he himself was going up! From there, effectively there were 3 guides (Saj, me and this guy) while Janet opted for the safer option of sitting down for a nice view! We think we made it to the top, but there’s no way to verify!
Next, we enjoyed a couple of days at work in Queen’s before our next bit of exercise. This was a basic but informative insight into the health system here for Saj. It was also a time to tease out any car rental difficulties- which were aplenty! On Wednesday, we did our second mountain ascent inamidst the lush tea plantations of Satemwa estate in Thyolo, interspersed with banana and maize fields. We acquired a bike from colleagues out there to make the number up to 2. These were gonna be put to the test the very next day in Majete game reserve. Unfortunately it came to our attention that one of the bikes (mine) did not take too well to being squashed in the back with 2 suitcases and camping material, not to mention a hell of a bumpy ride. Thus once set to go, first the gears went dead, which took us the best part of an hour to “fix”. Then hardly 2 miles along the dirt road, I found myself attempting to define a new cycling stunt without much success- the single pedal ride, the other one having come loose and joined the gravel! After being rescued from heat exhaustion by Saj who cycled back to the Defender to come and fetch me, we headed straight into our first game drive. The catch was pretty good: eland, sable antelope, impalas, nyalas, water buffalos, water bucks, baboons etc. A cool starlit night set us up for a different circuit in the morning to see if we could abolish the elephant jinx. And how we did! 2 separate herds, one just off the track and a second literally within arse-slapping distance by a waterhole (full of hippos itself)! Zebras and an impressive bull nyala crowned this last drive and we were headed back to Blantyre ahead of the biggie. Carb-loading was in order that night, ahead of tomorrow’s plan.
Mulanje! The legendary massif believed to have inspired Tolkien in the Lord of the Rings was to host us for 3days and 2nights. An average of 6-7 hours’ walking per day, taking in 2 paths (Skyline and Otto’s), 2 huts (Chisepo and Thuchila) and 1 peak (Nandalanda) left us deliriously content in the end. The weather dealt us some pretty authentic plateau variations between intense rain, sun and fog. Our peak ambition in fact got thwarted on the 2nd day due to the rain, only to be revived on our final day before a timely descent ahead of the rain and dense fog which would have made the enterprise impossible again. Nandalanda was an epic though. Not to be climbed wet, unless you like water slides very much and your life a little less. The scrambling turned out to a pure rock climb in the end, where I even had to ditch the boots to enhance my grip! To complement the physical exertion of the expedition in style, Mulanje was the seat of a formidable biodiversity, which our expert guide (Comestar be his name) helped decipher for us. We kindled a certain fascination for bird spotting and came to recognise some incredible beauties like the Livingstone’s Turaco (Lourie), various Sunbirds, Shrikes, Bulbuls, Bishops and a even majestic Lanner Falcon at the base. Short of seeing mammals, we saw loads of leopard and hyrax pooh. Interestingly the latter’s fur was the distinguishing feature of the former’s pooh!
A long dirt road cross country drive brought us to Zomba town, where we did little but recharge our batteries. The next day (Tuesday) we took the world’s bumpiest dirt road to a less visited gem of biodiversity which is Lake Chilwa. The lake is actually shallow enough to be puntable for most of it. We dragged a couple of bikes on our boat to take onto the small island of Chisi. On sea as on land, we saw ever more birds, with a newly discovered thirst- Egrets and Herons of all sorts, Burchell’s Coucal, mjore Bishops etc. The island had only one dirt path, which we followed almost till its end (about 5Km). Yet on the way back, I (leading) came across a bifurcation and took the wrong lane. Thinking there could only be 1 road, I carried on, assuming I would join the main track. 45 min later, I found myself stranded on this other port from the one we alighted on. Our punter was back at the original one as agreed! Saj, who had been followed all along by a swarm of excited kids, got pointed in the right direction by them at the fateful junction. Hence we made separate ways to main land, but all the same in a more memorable way... an hour apart. In that time, Saj befriended with an English-speaking local, whom, together with my herculean return-punter, we took for lunch. Back in Zomba, we stocked up around its bustling market renowned for the best fruit in Malawi. We then went on to meet Caleb in Domasi for the night, where we were welcomed by a typically timed power cut. Still it made the peace of the place even more astounding.
Liwonde national park was our next stop and our most thorough delectation of bird life up to now. A legendary boat safari gave us no less than 25 new birds to remember, which I won’t even list this time! Or maybe I should try- Masked and brown throated weavers, Diccops, Fish eagles, Kingfishers (Malachite, Pied, Striped, Woodland), Spur-winged geese, Open billed Storks, White breasted Cormorants, a Martial Eagle, Boehm’s Bee eater, Lilac breasted rollers, Wire-tailed swallows, Striped Wagtails, African Jacanas, White-faced Ducks to name a few... Crocs were also a common sighting there and we got very close to some indeed. We had lunch at this cultural village (Njobvu) on the outskirts of the Shire river, which Saj will remember as his best of the whole trip.
Not ready to stop yet for the day, we set sail for Mangochi, along the shores of Lake Malawi. The road trip was now retuned to a drone of pure indulgent relaxation. By the way, we saw another fascinating rare bird then- the Southern Ground Hornbill (or Tukey Buzzard). After a pretty social night (another word for long awaited session!), we woke up reenergised for a bit of lake based activity. Thus Saj decided to recreate a past adventure of ours, which I was glad to have come out alive of! With a displaced sense of confidence, he lures me aboard this enormous kayak, without any safety jackets and glides effortlessly with the wind. Only when we have to turn around do we realise that this was not gonna be the same as the ride out. Knowing all too well how easy it is to capsize these shells, I finally put the oars down after our 5th or so failed attempt at overcoming the wind. Of course, I’m on another beach altogether now, separated from the starting point by a good mile of rock crossing. Quite a rewarding rock climb that proved to be, if I can see one positive side to this rather treacherous crossing. The owner of the place didn’t seem the least bothered when I told her what had happened and simply sent two of her Malawian employees to the rescue. The speed with which they rode the boat back against the wind was a real blow to our physical pride! Thereafter it was back to relaxation as previously agreed with a nice swim and a bike ride into a Baobab laden countryside, where we also recognised some of those recent avian discoveries of ours.
The Lake dream then followed a natural ascent into pure escape mood as we drove off to Cape Maclear. Admittedly more cliché than anywhere else in Malawi, once you’re there, you simply don’t care anymore and just enjoy it. This spot is also the ideal platform for snorkelling with Cichlid fish around the rocks of a nearby island. We made the most of this opportunity, encountering another typical cliché in the process- that of being duped by beach boys! Despite not having our formerly agreed sunset trip included in the ride, the very fact of coming into close contact with this wonderworld of Darwinian evolution was enough to keep up elated till the next morning. Interestingly, fish was on the menu that night! Not the Cichlid type though...
The remaining days were now strictly reserved for recuperation, given my failure to actually just lounge at the lake doing nothing as planned but opting for more physical exertion instead. We took a couple of backpackers with us out of Cape Maclear and ended up getting stuck in a sand bank before a small stream crossing. Such events really lack the drama and despair one might feel if it happened in Europe. Because here, within seconds, people just appear out of nowhere to assist (with the expectation of a good tip). When you have twenty strong pairs of biceps it usually doesn’t take more than 2 minutes to move even a 3 ton Defender! Thence we went very much uphill to Dedza (incidentally bagging a Sooty Falcon in our bird tally), where we checked into a very Malawian haunt for a very nice flavour of Malawian life for Saj. Top on the scoreboard for that night was the food. The downers were too funny to be troubled by for any length of time. Firstly we tried to get someone to tune the TV in our room to some news. We ended up being the ones teaching him how to do it. Once we did that, we realised the whole place had only one dish, such that what we would be watching would also be on other people’s screens. Not surprisingly, I had the world news on. At 1.30am, I realised at least someone had been more engrossed in world events than me that night as my next door neighbour (who crashed in around 11pm with a whole group of people) started to pray out loud for peace in the world and an end to all natural calamities. Hmmmmmm!!!! The one night I find a nice hotel without a bottlestore nearby with loud music to ruin the peace, I have a middle of the night sermon instead! Nothing against the actual prayer, but why out loud at this time of night? There’s something about the Malawian way of preaching one can only understand by being here.
Since we were in Dedza, we felt obliged to go and explore the UNESCO world heritage site of ancient rock art in the nearby hills the next day. Only mildly enthused by what we saw on artistic merit, what entertained us more was the new wave of charcoal drawings by kids on some of the rocks, as well as painted church messages. Meanwhile there was not a single hint of anyone doing anything to protect this site of global significance. Minimally perturbed, we embarked on the final leg, which was the Lilongwe trip to the airport. What a finale it turned out that was! An apocalyptic downpour caught us while we were in the market and cast such fascinating atmosphere to it all. The climax had to be the wooden strut bridge crossing in the end over gushing waters to get to the fruit and veg side of the market. We spent our last night with a friend of mine in his amazing guesthouse. Just what our lazy bones needed before a mega-holiday’s conclusion.
Saj’s last trip was to the airport, while I remained with a final leg to Blantyre. How our ancient Defender lasted all these days, without the slightest problem was on my mind, when the vehicle suddenly began trembling. As the amplitude kept increasing I pulled over and guess what? I had my first flat tyre. Hardly 3 hours after dropping Saj off. What timing! True to Malawi, a previous film repeats itself for me as, out of nowhere, self-proclaimed mechanics rush to the rescue...
Blantyre from Soche
Off to Majete. Man & Defender!
Nandalanda my beauty...
From Mulanje
The Chilwa island vibe
Hello~!
Ground Hornbill
Cichlids
Rock Art?
Final Crossing
With Saj visiting, I got to see Malawi from a new perspective altogether. This was in no small measure helped by the (temporarily) upgraded mode of transport, in the form of a rattly converted army Land Rover “Defender”. Luxury nonetheless for me! Our itinerary comprised a mix of unchartered territory as well as familiar stomping grounds of mine. Having a visitor around really gives me an excuse to go and explore the place I’m in better, while allowing me to see familiar things differently from the way I normally would.
The first few days were really a warm up to get into shape for the meaty stuff ahead. On day 1, we went up Soche, the mountain literally in my backyard, for a bit of joint lubrication and muscle awakening. We decided to enlist the help of a local who might be able to guide us up. As it was, we met a group of boys near the base and one of them volunteered to accompany us. Another candidate (who seemed more familiar with the surroundings) had to be turned down because we had absolutely no way of communicating to him! We shot up a fairly well defined path until we reached this overgrown grassy maze, where one could only guess the next bit from lines of flattened (slippery) grass. Only at this point did our “guide” actually reveal to us that this was the first time he himself was going up! From there, effectively there were 3 guides (Saj, me and this guy) while Janet opted for the safer option of sitting down for a nice view! We think we made it to the top, but there’s no way to verify!
Next, we enjoyed a couple of days at work in Queen’s before our next bit of exercise. This was a basic but informative insight into the health system here for Saj. It was also a time to tease out any car rental difficulties- which were aplenty! On Wednesday, we did our second mountain ascent inamidst the lush tea plantations of Satemwa estate in Thyolo, interspersed with banana and maize fields. We acquired a bike from colleagues out there to make the number up to 2. These were gonna be put to the test the very next day in Majete game reserve. Unfortunately it came to our attention that one of the bikes (mine) did not take too well to being squashed in the back with 2 suitcases and camping material, not to mention a hell of a bumpy ride. Thus once set to go, first the gears went dead, which took us the best part of an hour to “fix”. Then hardly 2 miles along the dirt road, I found myself attempting to define a new cycling stunt without much success- the single pedal ride, the other one having come loose and joined the gravel! After being rescued from heat exhaustion by Saj who cycled back to the Defender to come and fetch me, we headed straight into our first game drive. The catch was pretty good: eland, sable antelope, impalas, nyalas, water buffalos, water bucks, baboons etc. A cool starlit night set us up for a different circuit in the morning to see if we could abolish the elephant jinx. And how we did! 2 separate herds, one just off the track and a second literally within arse-slapping distance by a waterhole (full of hippos itself)! Zebras and an impressive bull nyala crowned this last drive and we were headed back to Blantyre ahead of the biggie. Carb-loading was in order that night, ahead of tomorrow’s plan.
Mulanje! The legendary massif believed to have inspired Tolkien in the Lord of the Rings was to host us for 3days and 2nights. An average of 6-7 hours’ walking per day, taking in 2 paths (Skyline and Otto’s), 2 huts (Chisepo and Thuchila) and 1 peak (Nandalanda) left us deliriously content in the end. The weather dealt us some pretty authentic plateau variations between intense rain, sun and fog. Our peak ambition in fact got thwarted on the 2nd day due to the rain, only to be revived on our final day before a timely descent ahead of the rain and dense fog which would have made the enterprise impossible again. Nandalanda was an epic though. Not to be climbed wet, unless you like water slides very much and your life a little less. The scrambling turned out to a pure rock climb in the end, where I even had to ditch the boots to enhance my grip! To complement the physical exertion of the expedition in style, Mulanje was the seat of a formidable biodiversity, which our expert guide (Comestar be his name) helped decipher for us. We kindled a certain fascination for bird spotting and came to recognise some incredible beauties like the Livingstone’s Turaco (Lourie), various Sunbirds, Shrikes, Bulbuls, Bishops and a even majestic Lanner Falcon at the base. Short of seeing mammals, we saw loads of leopard and hyrax pooh. Interestingly the latter’s fur was the distinguishing feature of the former’s pooh!
A long dirt road cross country drive brought us to Zomba town, where we did little but recharge our batteries. The next day (Tuesday) we took the world’s bumpiest dirt road to a less visited gem of biodiversity which is Lake Chilwa. The lake is actually shallow enough to be puntable for most of it. We dragged a couple of bikes on our boat to take onto the small island of Chisi. On sea as on land, we saw ever more birds, with a newly discovered thirst- Egrets and Herons of all sorts, Burchell’s Coucal, mjore Bishops etc. The island had only one dirt path, which we followed almost till its end (about 5Km). Yet on the way back, I (leading) came across a bifurcation and took the wrong lane. Thinking there could only be 1 road, I carried on, assuming I would join the main track. 45 min later, I found myself stranded on this other port from the one we alighted on. Our punter was back at the original one as agreed! Saj, who had been followed all along by a swarm of excited kids, got pointed in the right direction by them at the fateful junction. Hence we made separate ways to main land, but all the same in a more memorable way... an hour apart. In that time, Saj befriended with an English-speaking local, whom, together with my herculean return-punter, we took for lunch. Back in Zomba, we stocked up around its bustling market renowned for the best fruit in Malawi. We then went on to meet Caleb in Domasi for the night, where we were welcomed by a typically timed power cut. Still it made the peace of the place even more astounding.
Liwonde national park was our next stop and our most thorough delectation of bird life up to now. A legendary boat safari gave us no less than 25 new birds to remember, which I won’t even list this time! Or maybe I should try- Masked and brown throated weavers, Diccops, Fish eagles, Kingfishers (Malachite, Pied, Striped, Woodland), Spur-winged geese, Open billed Storks, White breasted Cormorants, a Martial Eagle, Boehm’s Bee eater, Lilac breasted rollers, Wire-tailed swallows, Striped Wagtails, African Jacanas, White-faced Ducks to name a few... Crocs were also a common sighting there and we got very close to some indeed. We had lunch at this cultural village (Njobvu) on the outskirts of the Shire river, which Saj will remember as his best of the whole trip.
Not ready to stop yet for the day, we set sail for Mangochi, along the shores of Lake Malawi. The road trip was now retuned to a drone of pure indulgent relaxation. By the way, we saw another fascinating rare bird then- the Southern Ground Hornbill (or Tukey Buzzard). After a pretty social night (another word for long awaited session!), we woke up reenergised for a bit of lake based activity. Thus Saj decided to recreate a past adventure of ours, which I was glad to have come out alive of! With a displaced sense of confidence, he lures me aboard this enormous kayak, without any safety jackets and glides effortlessly with the wind. Only when we have to turn around do we realise that this was not gonna be the same as the ride out. Knowing all too well how easy it is to capsize these shells, I finally put the oars down after our 5th or so failed attempt at overcoming the wind. Of course, I’m on another beach altogether now, separated from the starting point by a good mile of rock crossing. Quite a rewarding rock climb that proved to be, if I can see one positive side to this rather treacherous crossing. The owner of the place didn’t seem the least bothered when I told her what had happened and simply sent two of her Malawian employees to the rescue. The speed with which they rode the boat back against the wind was a real blow to our physical pride! Thereafter it was back to relaxation as previously agreed with a nice swim and a bike ride into a Baobab laden countryside, where we also recognised some of those recent avian discoveries of ours.
The Lake dream then followed a natural ascent into pure escape mood as we drove off to Cape Maclear. Admittedly more cliché than anywhere else in Malawi, once you’re there, you simply don’t care anymore and just enjoy it. This spot is also the ideal platform for snorkelling with Cichlid fish around the rocks of a nearby island. We made the most of this opportunity, encountering another typical cliché in the process- that of being duped by beach boys! Despite not having our formerly agreed sunset trip included in the ride, the very fact of coming into close contact with this wonderworld of Darwinian evolution was enough to keep up elated till the next morning. Interestingly, fish was on the menu that night! Not the Cichlid type though...
The remaining days were now strictly reserved for recuperation, given my failure to actually just lounge at the lake doing nothing as planned but opting for more physical exertion instead. We took a couple of backpackers with us out of Cape Maclear and ended up getting stuck in a sand bank before a small stream crossing. Such events really lack the drama and despair one might feel if it happened in Europe. Because here, within seconds, people just appear out of nowhere to assist (with the expectation of a good tip). When you have twenty strong pairs of biceps it usually doesn’t take more than 2 minutes to move even a 3 ton Defender! Thence we went very much uphill to Dedza (incidentally bagging a Sooty Falcon in our bird tally), where we checked into a very Malawian haunt for a very nice flavour of Malawian life for Saj. Top on the scoreboard for that night was the food. The downers were too funny to be troubled by for any length of time. Firstly we tried to get someone to tune the TV in our room to some news. We ended up being the ones teaching him how to do it. Once we did that, we realised the whole place had only one dish, such that what we would be watching would also be on other people’s screens. Not surprisingly, I had the world news on. At 1.30am, I realised at least someone had been more engrossed in world events than me that night as my next door neighbour (who crashed in around 11pm with a whole group of people) started to pray out loud for peace in the world and an end to all natural calamities. Hmmmmmm!!!! The one night I find a nice hotel without a bottlestore nearby with loud music to ruin the peace, I have a middle of the night sermon instead! Nothing against the actual prayer, but why out loud at this time of night? There’s something about the Malawian way of preaching one can only understand by being here.
Since we were in Dedza, we felt obliged to go and explore the UNESCO world heritage site of ancient rock art in the nearby hills the next day. Only mildly enthused by what we saw on artistic merit, what entertained us more was the new wave of charcoal drawings by kids on some of the rocks, as well as painted church messages. Meanwhile there was not a single hint of anyone doing anything to protect this site of global significance. Minimally perturbed, we embarked on the final leg, which was the Lilongwe trip to the airport. What a finale it turned out that was! An apocalyptic downpour caught us while we were in the market and cast such fascinating atmosphere to it all. The climax had to be the wooden strut bridge crossing in the end over gushing waters to get to the fruit and veg side of the market. We spent our last night with a friend of mine in his amazing guesthouse. Just what our lazy bones needed before a mega-holiday’s conclusion.
Saj’s last trip was to the airport, while I remained with a final leg to Blantyre. How our ancient Defender lasted all these days, without the slightest problem was on my mind, when the vehicle suddenly began trembling. As the amplitude kept increasing I pulled over and guess what? I had my first flat tyre. Hardly 3 hours after dropping Saj off. What timing! True to Malawi, a previous film repeats itself for me as, out of nowhere, self-proclaimed mechanics rush to the rescue...
Blantyre from Soche
Off to Majete. Man & Defender!
Nandalanda my beauty...
From Mulanje
The Chilwa island vibe
Hello~!
Ground Hornbill
Cichlids
Rock Art?
Final Crossing
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