The last month before the apocalypse

This was written before the election.

It’s been so long since I’ve written that it’s hard to know where to start. Here’s what stands out in my mind over the last month:

• ·       Hospital stuff: the orthopedics department ran out of plaster for casts, so instead of casting they were splinting fractures for about a week. Also we had one day when there was no water in the whole hospital. Imagine running a hospital without water; I can’t, and it didn’t. Also during one night the OR team decided it was too late to operate and therefore three life-threatening cases didn’t go to the operating room until sometime the next day. I’m not sure what happened to the patients.  
• On a positive note, our shipment of donated surgical stuff got delivered and so we now have gauze and elastic wrap for the burn patients, and ostomy supplies for the general surgery team, which had just run out. Also, because it’s getting hotter, our census of burn patients is down to manageable levels, and the burns aren’t as severe. Not good for my study but I’m thankful not to be seeing so many burned kids. 
• ·       Weather: it finally rained! Two days in a row, last week, and then nothing so far. The first storm was meh, but the second one, holy smokes. We got hail, it lasted for over 2 hours, and was gloriously cooling. The kids were terrified at first, lightning flashed all over the place, white, purple and pink, and Stas cried that he was scared lightning was going to hit him. But then he recovered enough to decide that the next time it hailed he would eat it just to see what how it tastes. Alas, it hasn’t hailed since, so he’s still wondering.
• ·       Overall it’s been getting hotter steadily, and more humid. During the day the highs are in the low 90s, but the sun is intense and now rises around 5am, so by 9 it’s quite hot. Still not nearly as humid as North Carolina in the summer, and it does cool off at night, but the breeze at night is gone so it can be pretty stifling. To add to that the power usually cuts out at night so our fans don’t work. We’re managing to stay cool-ish by taking showers right before bedtime and going to bed wet, and so far, thank heavens, the water for us hasn’t been an issue except for one day. 
• I remain very thankful for steady water supply; dealing with power outages is one thing, but missing water quite another. Aggie, our housekeeper, loses water for a week straight. I don’t have scientific evidence for this but I suspect the pattern of shut-offs follows demographics here, with the heavily Malawian areas suffering the brunt of the drought and power disruptions. The only exception to this are the diplomatic areas, which do get their power and water shut off frequently as well, perhaps as retaliation for reining in the aid in the face of rampant corruption and government fraud. Fun times.
• ·       Fauna/flora: the local critters are sensing the shift in the weather and coming out in droves. Sometimes this is great; others, not so much (roaches! Christ almighty! Who knew they came in so many kinds and sizes and flying abilities!). The most impressive and memorable thing so far has been a massive emergence of some kind of insect, which looked like a combination of mayfly and mosquito, that came out by the thousands the day after it rained. These insects appeared to come out of the ground, along with hundreds of larvae, straight out of the cracks in our driveway. They filled the air at dusk and sure enough, bats came over swooping inches from our faces. As if that wasn’t cool enough, we saw strange lumps right by where the insects were emerging, and upon closer inspection, found the oddest looking frogs I’ve ever seen. They’re a rain frog, and look like a blob on four super short legs; it would’ve been hard to see where their mouths were except they were swallowing the flies as they emerged from the ground, and then the whole frog would accordion back and forth digesting the fly, and then the whole thing would repeat again. Equal parts grotesque and fascinating.
• ·       Work stuff: quite a productive month. We at Malawi Surgical Initiative have 3 oral presentations and 1 poster accepted at COSECSA, which is the Congress of Surgeons of East, Central and Southern Africa. I’m going to Mombasa, Kenya, at the beginning of December! Will be doing a podium presentation of our study on pediatric nutrition and burn injury outcomes, as well as a poster of the reduction in trauma mortality following the introduction of a general surgery program. Exciting! I’m nervous about leaving Micah alone with the kids but hopefully we’ve built up enough of a support system here that it will be OK.  Am finishing up 3 papers for submission for publication and working on 2 more. I’ve also become obsessed with the long term outcomes of upper extremity burns in pediatric patients here, who suffer from contractures and who rarely have access to specialist treatment, so I’m trying to figure out how to do a small pilot study of that. Stay tuned J
• ·       Extracurriculars: we go swimming most afternoons to battle the heat, and the kids have become quite the little fishes. Stas jumps in wherever he feels like it, and has just learned how to dive. He’s completely fearless and master of a style of swimming that makes him look like he’s drowning all the time, but he holds his own quite well. Agnieszka can swim the length of an Olympic pool doggie paddle style, which I’m not sure I’d be able to do, and has begun learning how to do the breast stroke and stick her head under water without holding her nose.
• The Japanese embassy put on a Japanese drum show last weekend which was spectacular; unfortunately so delayed that by the time the drummers came on, Stas had fallen asleep so hard that he almost fell off his chair. Janek also fell asleep, deafening noise notwithstanding. Agnieszka stayed awake and enjoyed it, as did we.
• Halloween came and went and we missed the Halloween trunk’n’treat because of the epic storm, although others went and had fun. The kids refused to get in the car and by the time they recovered it was too late. Probably just as well, since my homemade renditions of a cheetah (Agnieszka) and puma (Stas) consisted of hand-sewn tails and face makeup, so not my proudest effort. I’ve always loved late October, the cool days, the leaves and the flavors, but it’s not the same when it’s 90+ degrees and no one eats pumpkin pie. It’s surreal to see the month of November on the calendar and try to reconcile it with how it feels outside.
• Agnieszka’s birthday was a great success—“the best birthday of my life!” she opined—we had a bouncy castle and lots of food, and Micah had the brilliant idea to let the kids draw on the walls in the hallway, which are covered in old wallpaper that will be removed. This occupied the kids for the better part of the hour, although their parents weren’t super thrilled about reinforcing bad habits. Our hallway looks so cool now that I’ll miss the artwork when it’s gone.