Home Sweet Home

My God it’s cold.

In this infinite winter swathes of the public descend on emergency departments needing attention. Some can be seen and discharged, some need admission. Some are friendly and understanding despite the wait, others are less so. Undoubtedly though, all receive the same standard of care irrespective of how they treat the staff working in their best interests.

The beds are full. The hospital is full. The corridor is full. Staff are drawn but working and working and working. The scaffolding creaks and sways in the breeze. Still the team rallies, buoys each other, laughs. This remains my favourite thing about the emergency department; even when it seems that things cannot get any worse, someone will say something that brings a wry smile to even the most tired eyes. That fact, and the ultimate will of the team to win – to beat the pressures and still provide excellent care. Every joke cracked, every job well done is a massive finger up to someone, though it’s not always clear who.

I have applied to train in emergency medicine and join this battle weary team for the long haul. I’m happy with my decision and love working in the ED, but I’m still not sure if it’s a good career/life choice or simply some modern brand of self flagellation. No doubt it will be tough, but equally I know it will be great craic too. Time will tell what the ratio of these things will be.

As I wait to hear back from the interview and possible training that will begin in August, I wonder what to do between now and then. There must be some new exciting plan, some opportunity. As much as I am looking forward to starting in A+E full time once more, it’s time to make the most of the next few months of freedom, before I will have to accept I am actually an adult and embrace the associated responsibilities.

Ideas welcome.


Fly Away Home

Having flown regularly since my teens I have developed rather a laid back response to air travel. This has proven to be helpful and detrimental in equal measure, not least during this particular journey home.

An extended student existence has led me to subconsciously and unerringly hunt for the best deals, particularly on airfare. So, though protracted layovers are now a thing of the past (how I long to get those lost, insufferable hours back), I am not above impressive dog legging to save a few quid.

It was to take me four flights to travel between Livingstone and Northern Ireland. Following a hasty and much loved hold-bag-repack in the check in hall, the first phase or two passed without complaint. There was an amusing moment when it dawned on my neighbour that I actually didn’t speak French, despite us mumbling at intervals for the preceding few hours. Then the priceless enjoyment of a wet wipe and clothes change on a backdrop of inane airport loo conversation.

In Paris I was reminded of how fantastic the airport was. A plethora of seating opportunities, excellent wifi, Pret a Manger with a small queue and, fortuitously, a good friend waiting to be bumped into. Hilarity ensued. As luck would have it we were seated on the same row on our flight to London. ‘What are the chances?’ was repeated so many times we infuriated our neighbours. We were so carefree it started to infuriate me. Our flight delayed by fog (how I have missed this) not only meant that we had extra time to catch up, it led to my missing the final connection of the dog leg. The plot thickened, as on my own physical arrival at Heathrow it transpired my hold bag was now located somewhere other than luggage belt 3 in terminal 4.

My bag was to be delivered later that day. Only joking. They’d text me when it’s on its way. Only joking. You’ll collect it at Heathrow. Only joking. It’ll get to you at some point.

I really hope that last one isn’t a joke.

But after a delightful evening spent with friends and involving roast pork, a bed and a lift back to Heathrow it was difficult to be forlorn.

We made our way back along the M25 towards terminal 5. All was going well. I had plenty of time. Then the M25 did what it does best; traffic snarled around us. The clock raced as if it had taken some behemoth amphetamine cocktail. My flight time loomed. Dangerously. We crawled. I sat silently. We arrived and I ran, pelvic floor working hard not to leave bladder or bowel contents in my wake.

Our flight floated free of terra firma. Victory was close enough to taste.

Such naivety.

Fog now at the destination. We might be able to land. But maybe not. Don’t worry, if not we’ll land somewhere ‘close by’ and we can all relish the joys of a flight replacement bus. We flew over the dense blanket of fog. Underneath I knew Belfast Lough was hiding somewhere. I mimed to the trusty Disney playlist often utilised at times of existential crisis. A pocket of free air emerged and our pilot dive bombed (possible exaggeration). He landed beautifully.

Time crawled as we negotiated the back roads to avoid miles of traffic, not least because there was a full fridge waiting that contained a large quantity of off limits Christmas Day food. At least, I thought, there will be something in the cupboard to stop my stomach from eating itself, a cup of tea and access to my wardrobe. Because, though  I wasn’t that unfortunate emerging from the airport in December complete with flip flops and luminous sunburn, my supply of  sensible clothes was rapidly dwindling.

Time to put on my slipper socks, have a glass of wine and blissfully ignore the pile of unopened bills lying in wait.

Merry Christmas.

Thank You Safe Journey

Having finished our last clinic week it seems a good time to talk about how we have kept ourselves busy over the last few months. On Call Africa work in the southern region of Zambia and each week we base ourselves at one of three rural health posts, using them as a jumping off point to travel to the village of the day.

Our destinations range from thatched mud churches and concrete classrooms to open spaces and lean-to tarp structures. Before our arrival the message has gone around the surrounding area; some families have walked overnight and wait patiently for hours. There are areas where the only vehicle seen is our 4X4 rolling by on a monthly basis, and once the rains fully set in some villages will become completely inaccessible.

Much of the day is spent reviewing cases similar to those in a GP surgery; aches and pains, coughs and colds, lumps and bumps. We teach at local schools and act as mentors to community health workers the NGO has trained. There are wounds to dress, eyes to peer at, urine to sample, foetal heart beats to listen to. We distinguish infections needing reassurance from those requiring medication. There are patients with diarrhoea, bilharzia or worms from contaminated water, deformed limbs from healed fractures now suffering from debilitating arthritis, children losing weight, vitamin deficiencies, TB, malaria, tropical skin and eye infections. The list goes on. Many of our patients have been tested for HIV and we offer further testing if required. The level of infection is amazingly low, and from my experience here, those few who are HIV positive engage well with treatment. We encourage, give advice and many an explanation as to why medication isn’t always the answer.  Indeed, much like a GP surgery anywhere.

Service availability is the major adjustment. In the UK we are lucky as practitioners (and patients) to know that if we need further tests, a referral will be made to a nearby hospital. We are able to arrange transport to said hospital and have the tests free of charge. It’s not a question of ‘why?’, rather, ‘why would you not?’. Here, if I would like to refer a patient to hospital my first question is: ‘Can you and will you go?’ In cases of emergency we pause clinic, our land cruiser shape shifts into an ambulance and we transport the patient directly to the nearest appropriate facility. For non urgent cases our NGO stamp saves a significant amount on hospital fees. Unfortunately transport costs can still be prohibitive. All decisions are risk vs benefit. For our patients, it is the potential benefit of getting a test or treatment vs the risk of struggling to support their family. This is patient autonomy outside of a national health service. As much as I might want them to go to hospital, ultimately they must decide if it is feasible.

On occasion an emergency arrives while we are in a village. We assess the case, stabilise and transfer to the nearest available hospital with our blue light flashing. As we rock and roll our way towards an appropriate medical facility we try to not vomit, continue care and scribble medical notes in a vaguely legible fashion. On occasion we have limited room to manoeuvre with the team,    kit, patient and next of kin in the ambulance. In this way I have spent happy hours cross legged bouncing up and down with a colleague’s foot in uncomfortably close proximity to my back passage.

As the time nears to return home once again I become uncharacteristically wistful. I will miss many things – making the waiting queue giggle nervously at our screeching rendition of ‘Tomorrow’ while looking out at monsoon rains, terrifying small children with my white skin and smiling face, feeling like an overheating collie on the search for a puddle to rest my belly in, working with our team, educating community health workers, teaching in schools, the truly excellent curry house in Livingstone, laughing with our friends, the generosity of people and openness in communities. As ever when the time comes to leave, whatever challenges and trials have come before (and though I am hugely looking forward to seeing family and friends) I have a sense of wanting it all to continue. Not least to avoid the inclement weather and inevitable need to condense the last months into a Christmas catch up sound bite.

What if I slip on ice and fall on the station platform despite the nice lady’s warning? I suppose I’ll just make small talk about that instead.

Coup With a View

I love nothing more than waking up to the dulcet tones of a man in uniform. On television. Telling me that they’ve taken over the country, but it’s totally not a coup.

We had arrived in Zimbabwe several days before and were enjoying really rather a fantastic holiday. There was wildlife, Victoria Falls, excellent poached eggs, straight roads, amusing road blocks, towering granite balancing boulders, a fantastic natural history museum, ancient ruins and lots of cake. So, much to be happy about.

At most we had had one blotch in the copy book; a run in with our BnB host about room prices. I  calmly finished what I was doing before following the maid he had sent to summon me to his office.  The thing about engaging in power play with doctors is that we are a breed used to remaining calm in absurd situations, not cowing down to (in this case unreasonable) demands and, above all, maintaining a stellar poker face. All these came in handy, especially having spotted the framed poster of our host depicted as ‘the next president of Zimbabwe’ (insert quip here). No doubt he was surprised to find that the young white woman in front of him had absolutely no intention of kissing his feet. Not to be defeated, he proceeded to hold our bacon hostage when we emerged for breakfast the following day. 

Thank goodness he hadn’t held a grudge. 

We had moved gratefully on and now resided in a wonderful rental with lake views.  The sun set over the water and we congratulated ourselves on our good fortune. This is the life. We laughed as our friend got jumpy about insects in the house. She started counting; we started listening after 13. Especially when their wings started falling off . Suddenly there was some kind of wingless worm insect orgy happening on the kitchen floor. And the living room. And the balcony. This my friends, was a gaggle of sexing swarming termites.

The war began. Having holed up every crevice, we approached the arena. As time passed our coordination perfected…Soon we had the upper hand. Spray – swat – sweep – SHUT THE BIN. 

Always one to favour adrenaline highs, it was a relief to discover the excitement was only beginning.

I’ll admit I was confused at first as to why our previous host wasn’t on the television that morning. 

This. Is. Not. A. Coup.

‘If it looks like a duck, and quacks like a duck…it’s a duck’ takes the award for finest commentary over the next 24 hours.

Being well out of Harare everything seemed wonderfully tranquil. And while it was unclear what was going on, all news was reassuring. We four kept our veneer of calm wonderfully intact, though occasionally it thinned in places. If at any point it needed replenished though, all we needed was to take in the view from our windows. The only fly in our ‘let’s prep for lockdown’ ointment was our comparative lack of petrol. We ventured out – the pumps were empty. Without panic, we noted the  chicken and chips on sale next to the station forecourt. We bought that instead. 

Day 2 post (this is not a) coup we made our way back along the wonderfully straight road to the Zambian border. The road blocks had been taken over by the military – thankfully they were much more interested in looking for runaway government ministers than taking money from us. Relieved, we stalled on leaving the first checkpoint. Corporals flashed us the peace sign with the hand not holding an assault rifle. They spotted a woman behind the steering wheel with a man reclined in the backseat; hilarity ensued. It took us a day and a half to get back to the border, but by the afternoon of the first we were more than enjoying ourselves. The road trip playlist was up and running. We sang the classics with gusto. We had takeaway cake. Animals once again provided the most frequent obstacle. Standing in the middle of the highway, one cow turned to look at our waiting vehicle with abject disdain. Even getting completely rinsed at a petrol station didn’t dampen our spirits. We really wouldn’t have believed anything had happened if it hadn’t been for the odd machine gun and intermittent companies of men in camo methodically combing the bush.

We crossed the border. After everything we felt disappointed to be leaving this great country behind and ultimately mourned the end of our holiday. Why had we just made such a big fuss about nothing?

Luckily our cool, calm and collected response to the non crisis has provided me with much needed fodder for my recent job application. Yes I did shamelessly and directly mention our holiday in the context of my ‘ability to remain calm under pressure’. The fact that this actually relates to the termite killing fields type situation we  successfully managed is completely irrelevant. I only look forward to elaborating further at interview. 

Zimbabwe 2k17. If Carlsberg did holidays.


Help! I’m Scared of Africa

In order to try and deceive you into thinking we actually are doing some work while in Zambia, now seems a good time to talk about life camping on clinic. Every Sunday we pack up the land cruiser and head for the bush. The roads vary – beginning with tarmac before slowly progressing until the road disappears. The back of the car shapeshifts into a small boat on a big sea, the inside of a tic tac packet, Apollo 13 re entering the atmosphere and a zorb ball balanced atop a pneumatic drill. It’s fortuitous that the best way to get to know people is by banging heads and exchanging sweat, and I’m hopeful that when the rains come my skin will greatly improve with the mud baths.

We arrive and unpack kit for the night. Everyone chooses their point on the scale between ‘melting in a private green house’ to having ‘a see through net with theoretical chance of air movement but zero privacy’. Victor, our ops man in the field, drums up some food and laughs at muzungus’ utter inability to function in the heat. 

A few weeks ago I was a tad under the weather, leading me to crawl into the back of the 4×4 and remain. Luckily Victor was on hand to diagnose and treat. Is Sally sick? Don’t be ridiculous. Sally is scared of Africa. She’s so scared she is curled in the foetal position and won’t eat anything. These things are obvious.

Thank goodness this phobia seems to have abated.

The evening’s activities include reading, cards and Monopoly Deal. When feeling especially adventurous a new game is introduced; ‘Pasta or Disaster’ and ‘Cheese or Disease’ remain favourites. 

At bedtime a clamour emerges from the neighbouring tent reminiscent of a banshee being tickled. Heather’s tent fortress has been breached by a 5cm lizard. Everyone else quietly but hurriedly zips themselves in and low, slow, sleep-like breathing begins to rise from each. A suspicious person would smell a rat. After disposing of the terrifying creature a voice (now suddenly awake) quivers: ‘Sal…how sure are you that that lizard had legs?’

At what point does it become unethical to toy with someone’s emotions? One of life’s greatest decisions. 

Depending on how well you’ve timed your hydration a midnight wee is likely. Anyone that has ever been camping knows the pain of this realisation. Can I make it till morning? I really don’t want to get out. Will I be able to sleep? Certainly not on my front. Doing that might lead to the unintentional birthing of the bladder baby. Eventually the fulcrum is reached. No longer about pain threshold – it’s now all about the pelvic floor. The impossible happens as I manage to sweat more than I already am by simply concentrating.

One team member admits she strongly considered squatting in her tent and attempting to pee in a plastic glove. Unluckily for us she woke up enough to realise this was an amazingly idiotic idea. A trip to the nearby long drop. We each have careful notes on which one is the best option for day or night, not that we have favourites and discuss it daily or anything, but it’s useful to know where you are most likely to find a sleeping animal or  cockroaches that seem to have somehow mated with a scorpion. Because really, even though I like to think of myself as relatively experienced in these matters, no one is  above peeing all over themselves when something unexpected crosses your foot or flies into you from below. Finally an answer to that ‘let’s get to know each other’ question relating to a chosen superpower – able to aim, no matter the distraction.


The slow saunter of relief tends to gather pace as the wind rustles the bushes. We are suddenly aware how dark it is. Am I being followed? A hushed whisper from my neighbour becomes more persistent one night soon after her return: ‘Is anyone awake? Something fell against my tent…I think it’s a wild animal. Or my water bottle.’

I’m not sure who she wanted to clarify the situation. Obviously not me – I am scared of Africa. All bets are off. 


Budget Horror, Based on a True Story

Last weekend we made a trip to a nearby island nestled on the Zambezi. At first our destination was everything the website promised: ‘A magical experience of island heaven’ indeed. We were welcomed with open arms by our host, let’s call him Jim, a man of undetermined age who wouldn’t look out of place sleeping off a night of self indulgence in an inner city A&E. Appearances can be deceiving however, as Jim is also a man of great wisdom. Particularly interested in taxonomy, we learnt much about flora and fauna over the course of the afternoon. A cynic might say that as time passed the knowledge titbits became rather far fetched. Farcical even. But not us. How we thought, how does Jim know so much, about so much?

A man impossible to pigeon hole, Jim’s wisdom and interests extend far beyond the reaches of science alone; he is often delving into psychology and the study of human social interaction too. At the time of writing he appears to be conducting an observational study documenting guests’ response to the research question: ‘how would you like a threesome?’.

Could it be we thought, that this island isn’t actually what the doctor ordered? Maybe ‘resident sex pest’ was a hazard needing addition to the danger list of crocodiles, hippos and the sleepy python that ‘may or may not be dead’.

We ran away to our secluded fisherman’s huts. A storm was brewing and lightening flashed across the river igniting the sky and water. My enthusiasm for a solo cabin now a regret, I contented myself with repeated lock checking and considering if I should sleep with my multitool under the pillow. The wind rattled the shutters. It sounded very much like a persistent attempt at the door. Could it be that my earlier response to Jim’s request had been misunderstood? Suddenly this felt much like the true story on which a budget horror film would later be based. Having previously thought of myself as someone who might remain calm in this type of crisis, it was a disappointment to realise that this was not to be the case. If in doubt, I thought, take to the river. Armed with Jim’s golden nugget of ‘just bite one of their digits’, I knew the crocs would be no match for me.

The following day things returned to some semblance of normality as Jim appeared to have the worst kind of hangover. The moral kind. Left to our own devices we were able to lounge in hammocks and while away the day. Naively, much like children repeatedly tempted to touch an electric fence, we allowed the memories to melt away and lulled ourseleves into remaining for a second night. 

Reflecting on this life choice I look at myself hard in the mirror and slowly but deliberately palm myself in the face.

Not to be deterred for too long Jim re-emerged, this time accompanied by his girlfriend (we’ll call her ‘his accomplice’). The evening began in a relaxing enough manner. There was a canoe trip to see a fantastically underwhelming sunset, front row seats for semi tame wild animals eating food from guest’s plates (it was unclear whether they asked if the owner of said plate had finished eating) and a particularly agressive game of Trivial Pursuit led by Brian. It was only later Brian admitted he had been positively identified as “the target” (direct quote) by Jim and his accomplice through a combination of stage whisper and point. 

The evening continued. Music was played. Things were said. Requests were made. Insults were thrown.  Jim got randy. Popcorn was showered over us like confetti. Jim got mean. His accomplice actively and vocally disliked our music choice. Jim lifted his shirt and meaningfully rubbed his nipples. His accomplice climbed aboard the chest freezer and began a mating ritual of sorts.

It’s a shame that some things can’t be unseen.

‘A magical experience of island heaven’ indeed.

Boats, Hoes and Bilharzia

Following a lengthy African transport experience (detailed below) we arrived at Lake Malawi in high spirits. Cape Maclear boasts white sand, islands for exploration, sunset cruises and an array of eateries adorning the beach. It’s much like spending a holiday on the Med but with a few added bonuses. The water is fresh – so when snorkelling there is a distinct lack of stinging eyes or collection of salt at the back of your nose. On holiday completion there is no need to remortgage your house to cover that second bottle of wine (if only because there are more of bottles of Smirnoff Ice in the fridge than Chateauneuf-du-Pape in the cellar). After school the kids come hurtling to the lake side to loll in the shallows and race up and down the sand in the late afternoon sun. In the evening workers arrive to wash off the cares of the day. To spice things up at dusk you could head for an evening swim in nearby murky waters and find a croc or hippo to wrestle.

Maybe the most significant, and most dangerous animal in Lake Malawi is actually the lowly aquatic snail. Famous not for particularly for its rarity, beauty or big teeth but rather for its near permanent parasitic house guest, Bilharzia.

Bilharzia (Schistosoma haemotobium in posh circles) is crafty. The number of infected snails varies hugely throughout different areas of Lake Malawi, and indeed many collections of fresh water in Africa. It’s eggs infect aquatic snails where they incubate and hatch, developing into microscopic tadpole-like babies, plumes of which are released back into the water. Here they wait patiently for paddling ankles, collection in pots or for a friendly pipe to helpfully pump them into the nearest hotel shower. These Schisto tadpoles are expert diggers and are capable of burrowing through skin, where they continue on until they find a nice comfortable home to develop into healthy adults.

While some of you might have a shiver down the spine at this, never worry. While us big old humans can get sick during the initial infection (sometimes accompanied by the wonderfully named ‘swimmer’s itch’), the majority of us are relatively unaware of our new blossoming friendship. Unfortunately though, Bilhariza is much more frenemy than friend. Apart from the possibility of getting sick quickly there can be some serious side effects in long term infection or, like the kids frolicking in the shallows, you are exposed regularly over time. Some researchers got a bunch of kids in Kenya to run a bleep test (seems a little harsh) and it was compared to kids of the same age in Canada. While the Kenyan kids appeared for all intents and purposes healthy and happy, their exercise performance was significantly reduced in comparison to the youngsters from Canada. This is compounded by other research showing decreased levels of cognitive development (memory and attention), anaemia and growth stunting*. In an example more close to home, Chris Frome got rid of Bill and started making some serious money on the roads in France. If in doubt folks, let’s blame our lack of sporting excellence on a parasitic infection. Because let’s be honest, we all know it’s got nothing to do with talent, hard graft or sheer iron will.

To me, all this just adds a bit of flavour to a lovely holiday and yet another possible addition to my tropical disease menagerie. In truth I am much looking forward to the delightful chalky taste of Praziquantel tablets washed down by luke warm water, if only to alleviate the anxiety of my long suffering mother (and bring her voice back to a pitch that can be understood by species other than dolphin or dog). I suppose it does also have the added bonus of reducing the risk of serious health complications.

All travellers from honeymooners to hardcore adventurers to foot loose and fancy free hippy dippy types are equally at risk from this infection. Advice is to do a little research; steer clear of swimming in areas where infection rates are high (be aware of the showers or an inviting looking swimming pool too). And if in doubt, get the treatment. Because really, everybody loves a pill popper.

Happy travels happy campers.

*References available on request


David Livingstone Eat Your Heart Out

We decided to travel to Lake Malawi during a week long break from clinic. In our wisdom the overland bus seemed the most appropriate. We’re seasoned travellers we thought. Let’s get the 5am bus. Armed with pre prepared tomato and cheese rolls we departed. We were ready.

The first leg passed easily enough; it wasn’t until Lusaka that the fun really began.

Blinking, much like new born moles, we emerged into the midday sun and attempted to find the correct bus for the next leg. Much pushy helpfulness followed; before long we were led to the slaughter.

‘The bus is leaving, it costs this much, there is no other option, this is the last one, there are only a few seats left, time is running out.’

We get on the bus. I fear we may have been duped. If I saw those men again I’d like to think I’d wave my fist at them. Or at least write a strongly worded letter. On arrival at my seat I managed to insert my behind into a space where there really was only ‘room for a little one’. I resembled origami folded by a four year old; all corners and minimal forward planning. Exchanging sweat with the people either side of me I remained in the same position for approximately the next four hours. Ah yes I thought, I remember what this is like now. It’s a shame the glamour of this situation isn’t available for public consumption on social media. #wanderlust. I’d rather gouge out my own eyes with a spoon.

Unfortunately given we were now split at different ends of the bus the pre prepared snacks were some distance away. About hour 6 one of the cherished rolls (now resembling a soggy cheese toastie) made its way to me. My kindly neighbour bought a bunch of bananas for the helpless muzungu silently melting next to her. The in-bus entertainment system (besides my physiologically incompetent self) played a variety of different, and yet very similar, popular music videos featuring songs praising God. The key to a Zambian smash being that the lead singer remains in one place (a beach, for example) while a group of backing singers/dancers (all in matching outfits) stay somewhere else. It was like some kind of easy listening ground hog day. The real treat were the Zambian military choir who mixed the aforementioned recipe for music video success with khaki and occasional fitness tips.

The promised seven hours inevitably extended to over nine. 1000km down, we arrived at Chipata. The initial plan had been to get across the border into Malawi in one day. My 18 year old self would have strongly considered cracking on that night, risking the border being closed and jumping in a taxi to complete the next 100km at night. Because, you know, we’d planned to get to Lilongwe that day. But I’m not 18 anymore. Now I place higher importance on the little things. Like self preservation.

Luckily a man called Martin was on hand to take us to an establishment with a bed. The fact that the bottom of Martin’s car appeared to be dragging along the road under us was irrelevant. We pulled up at rather a posh hotel. At best they were a little perturbed at our arrival. At worst they were absolutely horrified. ‘How much is your cheapest room?’ Joe tried to help our situation. ‘I really don’t mind sleeping on the floor. I’ll sleep in the corridor, I just don’t care. Sometimes I sleep under my bed when I’m hungover because the sun comes in and it gets too bright.’ I suspect they dropped the price just to get us out of the lobby.

Having made the most of decent water pressure, air conditioning and complimentary buffet breakfast we packed all the miniature bottled goodies into our bags and made a beeline for the border. All this passed rather uneventfully. Was today to be a better day?

We were too aged to cope with the many buses and route changes required so engaged Gibson to drive us the next leg. Gibson had taken the same course as Martin entitled ‘How to Detach Your Chassis en Route’. He was also very attentive. Towards anything but the road. I was quite impressed as he crossed the central line, the opposite side of the road and nearly drove off the kerb all while still looking directly at the road in front of him. He wasn’t asleep or anything.

Soon though, we left the bright lights of Lilongwe and Gibson behind us. I’ll take your Gibson and raise you a Willy. Not even an innuendo. Willy had a nice car and was able to remain in one lane. Our chips were up. He proceeded to skim at least 30 minutes off the journey time, made possible by only touching the brows of hills (less friction when all four wheels are in the air). He was so ahead of time he was able to jump out and chase down a cyclist on foot. He then proceeded to use his foot to kick the cyclist on the bottom before marching back to our waiting vehicle. We decided against engaging Willy for the return journey.

As I had taken a bit of a lead in this decision making process, I couldn’t help but feel a little anxious at points as to how others were feeling about all this.

Get the bus to Malawi she said. It’ll be fun she said.

But like in all the best fairy tales, I was right. I believe my carefully constructed Instagram posts went far enough to show my family and friends that I was, indeed, living the dream while on holiday in Malawi. It really was worth every drop of sweat. Thank God for that.


On Call Africa

For the first time (in my case) we left the bright lights of Livingstone behind and ventured North East into the Zambian bush. I had more than my usual sense of relief at leaving technology behind…I’m not so sure the telephone banking lady enjoyed our phone call very much either. I can take solace in that at least.

After a few hours rolling around the back of the 4×4 on a mixture of gravel, track and sand we peeled ourselves from the seats and emerged. The queue began to build in earnest in the early hours of the morning and drugs, labs, weighing scales, lotions and potions were unpacked under its watchful case. A daily deconstruction of tetris from inside Mary Poppins’ carpet bag. Welcome to general practice, rural Zambian style.

The working days pass in a blur of common complaints mixed with tropical challenges. Lots of things we would see in a GP at home; aches and pains, headaches, coughs, colds, grumpy babies etc etc, but also some painful looking eyes, an array of unknown maladies and a decision on how to deal with an abscess in the bush (Dr Pimple Popper eat your heart out). Every day we move so each village has access to a clinic on a monthly basis. And every day the queue awaits our arrival as school desks, chairs and benches appear from I know not where. In between patients we comment on the weather, food, coffee, the fact we haven’t gone for a pee in a long time and the state of the loos. So really it’s much like any other day in healthcare, the only difference being that we pass judgement from school benches in village churches rather than in brightly lit sterile spaces.

In the evenings books are read and stars are gazed at. We break the silence by complaining about the heat, or until someone suggests a game or a group trip to the loo. Occasionally there is a clatter of cow bells. Sammy the snake pops his head around the corner and scares the life out of us all. A bat flies out of the long drop mid wee and all hell breaks loose. As time passes the games of monopoly deal become increasingly hard fought. Word games become hysterical. Our brains behave as if we have 6am delirium at the end of a night shift. Everything is funny. Eventually we head to bed, crawl into our mosquito free cocoons and pray we don’t need a wee until morning.