New Rhodesians

We got back into town this morning in the mission vanette. It was possibly the most uncomfortable journey yet - I was sharing the passenger seat with Maggie, so I had to balance on my left buttock every time Mr Banda shifted the gearstick into second. Meanwhile, Chas was obliged to perch on top of a large pile of cassava on the back, wrapped in a government issue blanket. I think I got the best deal.

We spent the morning at the Kabulonga market - a monthly event where all the well-off residents of Lusaka assemble to eat cake and haggle over traditional African crafts. Nearly all of the people who go are Afrikaans or expats. It is nice, but slightly odd at the same time. It is by no means the worst excess of white Lusaka society - I have heard an eyewitness account of an impromptu Gilbert and Sullivan recital in one of the posher cafes - but at times you are left wondering if 1964 ever happened. However, despite vague worries about neo-colonialist behaviour, we went along, as there aren't many opportunities to purchase handmade farmhouse cheddar in this part of the world. Very good too.

Back to the diary:

17th May 2006

Violet is two years old and severely anaemic following a bout of malaria. She was transfused on admission, but the situation has not improved. We have been trying to get venous access to re-transfuse her, but we didn't manage yesterday. Today, to my irritation, her parents are agitating to take her home. Sister Valeria and I take them to the office for a chat.

I explain that if she gets another bout of malaria in the near future, it will probably kill her. The father tells me that they live in a village far from here (there are only two terms of geographical description in Mpanshya - a place is either "near" or "far"). During the week that they have been in hospital with Violet, they have missed the harvest and the monkeys have eaten all their maize. So, their choice is either to take their seriously ill child home and salvage what food they can, or to starve. I suddenly lose my appetite for strongarm tactics, and write a prescription for iron and vitamins.

24th May 2006

I am doing a round with Mrs Lipalile, one of the nurses, and she asks me to see some triplets who have been admitted to the nutrition centre. She tells me they are from a nearby village, Lukwipa, and their mother gave birth to them on her own at home. She didn't know it was a multiple pregnancy. They are now 17 months old, and are frequent attenders at the nutrition centre.

We arrive at the centre, and are greeted by the howls of three tiny toddlers. They are competing for a nipple. Taonga and Mary win the fight and snuggle into their mother contentedly; Natasha cries even more loudly. The older brother, who looks about five, picks her up and tries unsuccessfully to console her. I think I only spend 10 minutes examining this family but it seems like a long, long time.

As we leave, Mrs Lipalile asks me if I have children of my own. When I tell her no, she says "You must have one here! We will deliver you, we are very good midwives." I thank her for the kind offer, and tell her I will let her know. Hmm.

26th May 2006

Joost has been the first of us to get malaria. He was feeling ill earlier this week and went to the lab to get tested. He seems remarkably cheerful despite his affliction. I start to feel slightly dodgy a couple of days later. Nothing specific, just a woolly head and a short fuse. Arguably not a huge variation from my normal state. I put off going to the lab, hoping it might get better, but it doesn't. Eventually I go along to see Mrs Mwale, the technician, and sheepishly offer up my digit for a blood slide. I am passed the result a couple of hours later in a sealed envelope marked "Dr June". One trophozooite. It's malaria but only just. I nick the only remaining course of combination antimalarials in the hospital, and take the afternoon off.