Wednesday, 7 September 2016

No Such Thing As Ordinary.

Morning came with a lovely sunrise and no electricity. Apparently the blackouts weren't just random but due to the caretaker at Canada House not paying for it even though he was given money to do that. Cathy was not happy and was going to have to look into that. In the meantime, we had reasonable options for breakfast and lunch without having to cook. Xander was right on time so we hit the road at 7:30am.
This is what our daily commute to Chipagla is like. First through the city of Blantyre on a major road with 4 lanes, divider lines and a median.
Then into the suburbs with 2 lanes no line but still separated sidewalks.
Then we turn off on to the newly paved side road to the village with no lines or sidwalks but gutter shoulders. Notice that there has not been a traffic, road or street sign any where.
About 3kms into the mountain, the village of Chipagala come into view.
You know that the village starts when the pavement ends. This is also a 2 lane road.
So is this
And then up the hill to the church that is hosting the clinic. When we arrive we can see that there are already people waiting for us. We are told that they started arriving at 6am. Bryan, Karen, Jessie and I hurry to get our areas set up while Sara and Cathy start registering people and handing out the card for those who waited from the day before.
We were really getting good at our flow and rountine and being able to assess and serve the patients in a timely manner. Things were going really well and I was looking forward to blogging about having such a wonderful ordinary day. The only thing was I needed a bathroom break and Cathy strongly advised me against it because there were only swatting toilettes in the village and ven she wouldn't use them. Meh, I have done enough travelling and camping to know I can survive rough bathroom facilities so I asked the paster where I could go. He said to follow him and took me to a house near by, which turned out to be his home and had flush toilettes! Once again, I had been honoured with VIP treatment and I couldn't wait to tell Cathy! 
Back to work, it was great to have some regular successes with our fits.
This is 57yr old Loney. We were able to fit him with this great pair of -3.00 glasses and he said that he has never see so far in his life. My thanks to Rachel Hill of Perfect Optical for donating this great pair of frames. And YES, It's about 26C and sunny in Malawi and he is wearing a turtleneck sweater!
This is 12 yr old Precious. She missed going to school today and waited 7 hours to get her eyes checked because she can't see the board and she wants to be an executive accountant. This -2.50 pair of glasses will change how she sees the world and make school so much easier.
She came with her Agogo(grandmother) Joyce. We checked her eyes too and she needed new readers to help Precious with her homework and to continue her work as a seamstress. Precious is the only child, over the age of 5, who had an adult come with them for their assessment. Thanks to Paul Fabish and Plastics Plus for making and donating these glasses.
I also got to assess the Deputy Mayor of Blantyre. He dropped by and worked his way in for a free assessment and a pair of readers. Bryan had a real problem with this as 1-He didn't wait in line like those who were there at 6am 2-Why were we giving him free glasses when he could probably afford to pay?
OK, I don't disagree with him on these points. And in a just and fair world, I would fight this too. But that is not where we are working today. Sometimes you have to work within the system, even when you don't agree with it, to get things done. We ALL know this. If giving the Deputy Mayor a free set of cheater readers makes the life of the community of Chipagala easier somewhere down the road, I've done the right thing. He will remember that he was treated well and with respect by the visiting professionals from Canada that were at the church. And if the church or community needs something or have a request, that memory might just open a door. I can do that. I hope that is what happens.
Not all problems can be solved with glasses. When I was in the Dominican Republic 2yrs ago, about 75% of adults have pterygium, a benign growth that is caused by UV exposure from not wearing sun glasses. Malawi isn't as close to the equator but it is still a problem. This is Louise, and hers is starting to block her vision. The only option is surgery which isn't affordable or available. I was able to fit her with +2.00 reader which she was very happy with.
This is 16 yr old Patrick. He came in because he is having trouble seeing the board at school. When I checked his eyes I saw that little black dot at the bottom with white around the edge. That is a foreign body imbedded in his eye. It has been there long enough that his cornea is starting to scar around it. I asked if his eye hurt and for how long. He said yes for about a month. I can't imagine the pain. Imagine a sliver of steel in your finger that your skin starts healing around because you didn't remove it. That is what is happening in Patrick's eye. I fit him with a pair of -3.50 glasses but told him he needed to see a doctor to ge that removed. He seems to be on his own, unable to pay and how to find a doctor. Our team has decided to take him to the hospital in Blantyre and pay for this. We can't solve all the problems but we can do this.
Cathy came and asked me about a special case. A women, Janet had brought information for a friend who couldn't come to the clinich but had been given a pair of +1.50 readers that were broken. Could we give her a new pair? I said we could but the problem is that we had a few people come with old glasses or RX and when we check them they really need something different. This friend was 66 yrs old and probably needed a stronger reader. What if we went to her home and checked her there. Cathy said that would be great if I was willing because she lived close to the church. I said sure, if someone could come to translate, I could walk over during lunch.
Our lunch break came and I grabbed a quick bite. The plan was to go to the lady's house then come back and get the glasses that I needed. The pastor and Janet would come with me. As I waited for them to be ready, I had a second thought and decided to just take a few readers in a couple of different sizes and powers to save a second trip and time. I grabbed the glasses and was ready to go. Xander, 2 pastors, Janet and I headed out to a lovely 25C sunny day. I asked what way we were going and Xander said to go to the van. I was puzzled, Aren't we going to walk? No said the pastor and we all got in. I thought, OK, I'm a women and getting the VIP treatment again and they don't want me walking. Xander turned the van and took off through the village. Then we were headed out of the village and turning on to a side road that wove further up the mountain. Then the pavement ended and we were on these goat trails of roads.
With grades of at least 9% that you as you crested over a hill you couldn't see the rest of the road over the front of the van. We were about 30mins into the drive and not at our destination yet. LOTS of thoughts are running through my head? Where the heck are we going? Bryan is going to kill me for leaving him with that huge line for this long. Did Cathy and Sara need Xander and the van for other errands and activities after lunch? I am SO glad I grabbed those glasses and don't have to do this twice. Cathy and I are going to have a serious discussion about the definition of "close to the church".
Finally we reached another village that, if possible, was poorer than Chipagala. Xander pulled the van over and we got out. But that wasn't our destination either. We still had to hike another 500M on "roads" that the van couldn't drive on( a goat could barely pass on".
Finally, we found Rose. She was sitting on a matt on her 3X10 porch unable to stand to greet us. I'm not sure what has impeded her mobility but it was clear there was no way she was going to get to the clinic. A quick assessment proved that she needed an upgrade to a +2.50 reader. The one I had wasn't the greatest fit but she was so happy to see again, she didn't seem to mind. 
Her daughter brought her her bible and she asked if she could read a blessing for me to Thank me for coming. I was honoured. It seems like a lot of effort to fit one set of readers. But this is all Rose has right now, the view from her porch and her bible to read. This significantly increased her quality of life. I usually agree with Spock from Star Trek, but this time, the needs of the one out weighed the needs of the many.
The pastors had a short care visit with Rose and then we headed back to the van. On the way, Janet parted ways with us. This is my house, she said. She hugged me and thanked me for coming from Canada to help her friends and family. As we walked on, I suddenly realised that I had been dreaded the rough ride back to the clinic but to Janet, the long bumpy ride had been a gift, as she had walked all that way this morning to get glasses for her and Rose. As we drove along, I wondered just how many people had done this route, or one like it, just to have a chance to get their eyes checked by us. This is why it is so hard to not keep working each day so that people don't get turned away.
On the way back, the pastors asked if I could do one more home visit and I said I would be glad to. We  got back to Chipagala and wove through the village. This time past the food vendor where all sorts of things were grilling in the open pits. I'm sure it's not a good idea to try any of it BUT I still want to try the local "thing"-rat on a stick. It was not to be found but Xander has promised me he will find me a good one!
The next visit was to a man who had been sick for a couple of weeks. He could barely sit up and it was difficult to do an assessment but the best I could figure out was +1.75 reader which seemed to help him. I was really wondering what I might be getting exposed to virally and bacteria wise and was praying that the shots and medication I had taken for this trip would be enough to protect me. Of course as soon as I got back to the church, I borrow the pastor's bathroom again to given my hands,arms and face a good wash.
It was back to work as my routine day had turned into anything but and now I had 2hrs less to work through those who were waiting.
As usual, as much success as you have, there is always heartbreak. Today this came from, 70 yr old Pnanzi. He was led in by a small boy, who was his grandson, and couldn't have been more than 4 or 5 years old. His eyes were completely white, corneas covered with thick scars that covered all his iris and pupil. I used my penlight to see if he could even track that. No. I asked how long he hadn't been able to see. He said that it had been many years, that he had been to doctors and that they couldn't do anything to help him. He just wanted glasses so that he could read his bible again. It took everything I had not to cry. I held it together and calmly apologised. I'm so sorry that the doctors couldn't help you. Unfortunately, there is nothing I can do either. There are no glasses that will help you read again. I am very sorry. Xander translated the best he could and said that Pnanzi didn't believe me. Xander suggested giving him a pair of readers to show him. I could do that. I got the strongest +5.50 glasses I had and put them on. Xander held the bible for him and I asked if he could see or read. He searched the page. The answer was nothing. It took a few more, "I'm sorry, there is nothing more I can do for you"'s before he allowed his grandson to lead him out. He had waited about 9 hours for a miracle that was never going to come.
At any other time, I would have called it a day at that point but there were still people waiting and they didn't all need miracles, they just needed help. A deep breath and I packed it away to process it later and help those who were still there.
I am grateful that things went smoothly from there. We worked a later to get the line finished so that no one got turned away. We almost ran out of daylight, which is our only light. Cathy needed to be back at Canada House by 6pm. Jessie and Xander quickly worked to pack up our room, Bryan called me to double check his last patient. He was getting -11.00 and -9.00 readings and wanted them verified. Yup, I was getting close to the same thing. He didn't have any glasses that high but I did, Jessie quickly unpacked to find them and we started trial lensing at -5.25 but could only get the very top line of the chart. I knew we could do better. I was once again grateful for my friend Deborah Perry, who just days before we left sent me dozens of beautiful glasses all -4.00 or higher with 1.67 or 1.74 lenses. 
 This is 54yr old Lovemore. He has never worn glasses. This beautiful pair of glasses donated by Deborah with 1.74 lenses and clip-on sunglasses -7.50 -1.50 X90 gave him 20/30 vision and he saw the world clearly for the first time. He was overwhelmed with joy! Thanks for giving us this success on what had been a really hard day.
We all had enough by that time. We got back to Canada house with still no electricity. Unable to get a hold of the caretaker there wasn't much we could do. We decided take out was fine for dinner so some went on a run for KFC...Yup that's available in Malawi. I hate eating western fast food in foreign countries but I just couldn't deal with a disagreement so I kept quiet. I stayed back with Cathy, Karen and Sara to hunt for flashlights and candles. We found both but nothing to light the candles with. All those episodes of Survivor have not helped me completely figure out how to get a flame from nothing. When you can't solve a problem, ask for help. We asked the guard at the gatehouse if he had anything and he gladly sent someone to get matches for us.
When the food crew got back, Xander did one thing better, he called the power company and bought electricity for us. His kindness was not unappreciated and we gladly gave him the money immediately, although I did ask if we could pay in chocolate or granola bars!
Cathy also had sad news for us, the Fat Monkey resort didn't have room for us for 2 nights and it was too far of a drive for just 1 night stay. The rest of the team can go next week but that will be after Bryan and I leave. Both Bryan and I are OK with this and Bryan thought that the time coudl now be used to squeeze in another clinic day since we have so many people. Cathy didn't think that could be done on such short notice. But then Karen and I agreed with Bryan and convinced Cathy to at least try to figure out a way to see if it could work. We're here and we have the time. Let's make use of it. She came around and is going to talk to the local leaders to see if this is reasonable. It's good when we can work things out.

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