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.

On the Road Again

I set up this blog 7 months ago in a feat of procrastination. Having travelled here and there for the last 12 months and not documented a jot online, now seems as good a time as any to actually start writing it out loud.

For those unaware I am now back on the move. After a brief stint in the UK to enjoy the utter lack of British summer time I’ve headed back to Africa, this time to Southern Zambia with On Call Africa. My own ego had led me to believe I was immune to culture shock, but this move has taken me a bit by surprise. Whatever the cause, the difference between Sierra Leone, home and now Livingstone has taken quite a shift in psyche.

Livingstone boasts close proximity to lots of animals with big teeth, Victoria Falls, rafting on the Zambezi and taxis with working seatbelts in the back seat. Elephants cross the road in front of your car and at immigration an advert for safari by segway beams down from a wall mounted flat screen. It’s a hop, skip and a jump to Botswana, Namibia and Zimbabwe, there are restaurants that serve western food that actually tastes like western food, hotels that take full advantage of sunsets over the Zambezi (complete with languishing hippos and the odd in house zebra) and bars that serve an array of single malts. On day one my eyes popped out of my head so many times I’m fairly certain a twitch developed. No doubt this led our operations manager to be more than a little worried for my sanity, though admittedly she had to get in line. As we ventured further the layout and cool temperature of the phone shop, the presence of a huge stationery shop, the presence of an overhead projector in said stationery shop (not my finest moment) and the size and scale of the supermarket all drew a wide eyed and breathless pause.

I admit I’m surprised by how thrown I was on arrival. I’ve visited places like Livingstone before, and it is in many ways a thriving and bustling town with plenty going for it. I suppose my definition of luxury while abroad has shifted somewhat.

Either way, Livingstone is only the half of it; I have no doubt that not a lot of time will pass in the bush before I’ll be dreaming of clean sheets and a cold beer once more.

Hiding in the hills

A snapshot of friends munching sweets on the way home from school in Gupsi Temporary Camp, Nepal Sept 2016.

Gupsi was built above Laprak village following the 2015 earthquake to house families who had fled their homes due to structural damage and the risk of landslide.

2 years have passed in Gupsi and life continues on. Laprak is steadily being rebuilt with cement and stone and sheer iron will – so much has already been achieved, and there is plenty yet to be come.

After the cold plunge

After weeks or months or years of contemplation, what is that finally makes us jump in? It seems the older we get the more reasons there are not to do something.

Last year I listened to an entrepreneur in sustainable business give a speech. Nearly 5 months on and his words have stuck:

‘Stop making excuses. Go out and fail and fail soon. Fail so completely the pain is unbearable.’

An uplifting start, but he went on:

‘When you have achieved those things – when you have failed – only then will you know that what you were attempting means something, is worth while and is worth trying again.

So dust yourself off, regroup, adapt and move forward’.

While this may not be the perfect mantra for all aspects of life, not least the exams I am currently studying for, his words have continued to spur me on to take the plunge. Or at least to stop the infinite delay until tomorrow.

To that end – welcome to the global funemployment blog.  Though it may begin as an observation of my experiences both at home and abroad, who knows where we will end up.