The Road to Chintheche

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Making a difference in Malawi starts with getting there.

By Dana Ovadia | For a girl who is terrified of insects, frightened of the dark, and harbors a healthy distrust of crocodiles and venomous snakes, going to Malawi is akin to exposure therapy, extreme enough to make even the most sadistic psychotherapist cringe. Fortunately, not all bugs send me into full-blown panic. Just spiders, cockroaches, grasshoppers, locusts, large ants, and anything that flies with erratic and unpredictable motions. So, emboldened by six cans of bug spray and a bottle of malaria tablets, I felt armed and ready when my plane made its first touch down in Ethiopia. 

That was until I remembered that I was landing in a place where I didn’t know a soul, didn’t speak the language, and had been foolishly tricked by AT&T’s promises of international phone reception. 

Five years had passed since the last time I had climbed out of a plane onto a hot African tarmac. In 2007, bored with my job in medical transportation, and eager to prove that my undergraduate anthropology degree was in fact a valuable investment and not an indulgent waste of $120,000, I spent several months in Tanzania, volunteering with HIV/AIDS orphans and families. It was this experience that encouraged me to apply to nursing school, with the promise of returning to East Africa better educated and better prepared. Now I was actually on my way. 

But first I had to get there.

After flying onward to Lilongwe, Malawi’s capital city, my first night passed uneventfully, in that I was lucky enough to be picked up by the head of the nursing school. She collected me in an ambulance, which had disposed of its (hopefully not-so-sick) patients in honor of my arrival. The plan was to spend one night with a volunteer physician and his wife, embarking the next morning on an eight-hour bus ride to a northern village unmarked on most maps. 

Because buses here are overcrowded and adhere to no discernible schedule, and since I would be hauling 150 pounds of luggage crammed with medical supplies, wilderness survival tools, and a veritable pharmacy’s worth of pills, I arrived at the central bus station at half past six in the morning. This was a miscalculation. I would sit in the slowly baking vehicle for two and a half hours before it was deemed sufficiently crowded to depart. 

One might have regarded this delay as a benign bonus. Say, one who is plagued by severe motion sickness. Nothing prevents motion sickness like not moving. But with no organized waste-management system to buffer the station’s gastronomical riches, I was surrounded by rotting produce, chicken and fish bones, and flies tracing erratic flight paths between those things and me. As the stench seeped in, I wondered how much time would have to pass before I became the first person ever to develop motion sickness in a completely stationary vehicle.

But I slipped on my seasickness wristbands and slapped on a Scopolamine patch, for it is better to reflect on one’s clever triumphs of preparedness. In preparation for this trip, a couple of my fearless fellow nurses had offered me a parting gift of foley catheter insertion, for my bus-going comfort. This was kind, but I figured that a plastic bag of urine affixed to my leg would only add to the already cumbersome weight I would have to tote. So, based on further suggestions, I was now bravely equipped with a GoGirl “female urination device.” Crafted from medical-grade silicone dyed a fetching shade of lavender, its packaging boasted of convenience during camping trips, while canoeing, and at concerts. “Because,” as the company’s slogan states, “life’s greatest adventure shouldn’t be finding a bathroom.” 

I could not agree more. Life’s greatest adventure should really begin when a woman with a screaming toddler strapped to her back chooses the seat next to you, valiantly but vainly tries to appease her with suckle from her breast, and then lays the little angel across both of your laps while feeding her the juiciest mango on Earth. 

As the child’s sticky fingers found amusement with my hair and clothes, I eagerly awaited discovery of her mother’s cleaning method, since I would need to study it carefully and apply it to myself. But in the end there was no need. Her mother took care of us both, ingeniously spilling Coca Cola across my shirt and pants in an attempt to mop up the mango juice. By all rights this made us the heroes of the bus, since the flies now abandoned every other row to attend the sugar party in ours. 

As I gazed out the window for distraction, I noted that vendors selling samosas and eggs had been replaced by lush green foliage dotted with bursts of color, as women dressed in blues, yellows, and purples walked along the side of the tarmac with jugs of water balanced on their heads, and sleeping babies on their backs. Now if only my lap child would do the same …

But the sputtering engine interrupted my daydreams. As we pulled off the road it succumbed to heat and exhaustion, and refused to restart. Lap-child problem solved! Four hours into the journey, all one hundred passengers are forced to collect their belongings and disembark in the midday sun. 
Where now we wait. 

And wait. 

Repair efforts dissolve into workers napping in the shade of the engine block. The promised 20 minutes turns into two hours, and as sweat pours off of me, I begin to reconsider my four-sips-an-hour rule, deciding that passing out from heat stroke is an even more mortifying prospect than actually having to use the GoGirl. Besides, I’m not sure if either scenario could really make me look any more ridiculous than I already do, sitting on my pile of suitcases with my Fendi sunglasses and wide-brimmed floppy hat, discovering belated empathy for poor Shelley Long in Troop Beverly Hills

I glance over at the bus’s motto, proudly posted on its side: “Punctual, Reliable, Friendly.”

As promised, a replacement bus does arrive. However, it doesn’t have a single seat to spare. As people burdened with sacks of rice and squawking chickens nevertheless crowd into it, I soon find myself wedged so tightly into the aisle that I have neither the ability nor the need to stabilize myself with my hands. As the Nigerian author Chinua Achebe describes the crowded marketplaces of his 
native country, “If one were to throw a grain of rice in the air, it would never touch the ground.”

In the weeks ahead, I will face far greater challenges than this. I’ll make the rounds of a pediatric ward where mothers grouped three to a cot cradle malnourished two-year-olds who are struggling to achieve the physical and cognitive milestones of six-month-olds. I’ll pore over my tropical medicine textbook desperately trying to distinguish leishmaniasis lesions from Kaposi’s sarcoma. I’ll have to break the news to a 15-year-old who lives and breathes soccer, said to be the best goalkeeper in the area, that he may never play again due to a dislocated finger that went too long without rudimentary medical care. 

But that all lies ahead, and I know what I’ve signed up for. That is why, when we finally arrive at sundown, late, dust-covered, and hungry, I can’t help but grin. Because if you don’t laugh as you tumble through the smaller obstacles, how will you ever survive the bigger ones? After all, my journey is really just beginning.

One of the clinic employees has been patiently awaiting me at an appointed police roadblock since noon. Together, with my luggage, we trudge a mile and a half over rocks and sand to my final destination. Never have my arms been more numbly tired, never have I been more thoroughly exhausted, and never have I been happier to have a group of people call out my name, sequester my load, and hand me a lukewarm beer.

Dana Ovadia Nu’09 GNu’13 is an ER nurse at Pennsylvania Hospital and is currently pursuing a master’s of science degree in nursing.

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