Medical Zambia

First day at the Clinic

Kakumbi Rural Health Centre

Baboons. Need I say more? At least a hundred of the little blighters, making mischief. But animals have priority on the roads, so I waited until they had crossed.

The road was badly cut up by trucks driving through the muddy sand. There were lots of pools on the track, but the deepest had been partially filled in with old bricks to provide a better grip for the tyres. The big dirt road had several streams running across it, creating gorges which needed careful negotiation. As I reached the tarmac road, a lorry came into view. The passengers in the back were waving frantically at me. I didn’t realise I was so popular, I thought, until I turned the corner and saw a large bull elephant ripping tasty branches from a roadside tree. So they were trying to warn me.

Good morning and welcome to South Luangwa!

Normally when you see one elephant, you can be sure that there are others nearby. But lone bulls do venture off on their own, so I wasn’t too alarmed. I drove slowly towards him but couldn’t resist a few photographs. Just to prove the veracity of the story, of course.

Further along the road, I saw bushbuck and puku antelopes, as well as another mob of baboons. The village hasn’t changed much. A few new shops here and there, more potholes in the road to the bridge and a new restaurant, which I will have to visit soon.

More churches have been built beside the back road to the clinic. The Obama Bar has closed during the day and its courtyard is a haven for grazing goats. But at night it remains highly active. The clinic road is worse and I passed the rear of a sign saying, “Road Closed Turn Right.” The clinic has a new HIV/AIDS block in shimmering white, built by US aid (PEPFAR). The clinic now deals with 875 patients living with HIV without the fortnightly visits from the district hospital.

New block built with US Aid money for HIV/AIDS support
Maternity Block, now usable as it has an electricity supply
First delivery of my tenure – I had nothing to do with this!
Incinerator and drug pit

The maternity block has finally got an electrical connection so it can function as intended. The consultation rooms look cleaner, water flows from the taps and there is soap. The only towel is the one I donated in 2014, which looked rather grubby. I wiped my hands on the seat of my trousers.

Erina starts the fire with plastic and wood to heat the steriliser

The staff who knew me were delighted to see me again. The new health workers welcomed me back and we chatted about the good old days. “But the drug situation is worse now. We have less medication now than we had when you were last here, doc.”

The clinic water supply tower
The patients’ toilets, with the incinerator in the background

People in the Ministry of Health must be worried about the increase in malaria cases in this district. We are adopting a proactive strategy of testing and treating anyone who lives near all new patients found to be suffering from malaria. Unfortunately, heavy rain has made it almost impossible to get to remote areas to carry this out. It will be an interesting experiment.

The clinic now runs two community clinics a week, in which I will participate, as well as a schools inspection and health education
programmes (sexual health is on the agenda again).

It feels great to be back.


In the park again

I had the afternoon free to visit South Luangwa National Park today. The Zambian Wildlife Authority guards on the gate were glad to see me again and we had a long chat about what has flown under the bridge since we last met. But the Luangwa River is extremely full flowing under the bridge into the park. It is almost overflowing. This has been the first “proper” rainy season for ten years, with precipitation every couple of days.

Almost at the brim: the Luangwa River in flood, with rain over Nsefu

The rain makes the grass and leaves grow, so it is more difficult to see game and birds. But it is so incredibly beautiful that it is known as the “emerald” season. The main laterite roads are passable, but dirt tracks are treacherous. I don’t want to get stuck in the mud in the first week I am here. There were ominous rain clouds in the distance and it seemed likely that there would be a shower before the end of the day.

The roads do provide a dry way for some animals. Zebras prefer not to risk walking through swampy grassland for fear of crocodiles, so they trot along the road. Mating lions like to avoid soggy bottoms, and don’t care if the tourists are gawping at them. Actually, there are very few tourists. I only saw three other vehicles seeing animals in the park.

Hippo grazing in daylight – the grass is too lush to miss

First stop was fifty metres from the bridge, where a pair of hippos were grazing just down the bank of the road at the edge of the bush. They are often shy, but these two were just stuffing themselves with lush grass. The flow is so rapid in the Luangwa river that the hippos and crocs prefer to stay in lagoons. A kilometre further along the main road, the lagoon at Mfuwe Lodge was a carpet of green water hyacinths. I could just see the nostrils and eyes of another hippo as I was watching a Jacana (lily trotter).

Male Waterbuck
African Grey Hornbill

I spotted an African Grey Hornbill in a tree at the side of the road. There were the usual zebras, elephants, baboons, warthogs, waterbucks, impala and puku, but no giraffes. I heard a male woodland kingfisher perched on a dead branch, singing gloriously with his mate perching just below him. He was probably boasting about his new match to another male across the forest who was returning his call.

Muddy zebra
Zebra with red-billed oxpecker
Woodland Kingfishers
Long-tailed starling
Female impala, not to be confused with…
Female Puku
Lilac breasted roller

Although long-tailed starlings are very common, they are exceptionally beautiful with their iridescent plumage. I saw my first lilac-breasted roller, no doubt the first of many and an open-billed stork. The yellow-billed storks are ubiquitous at present. The white feathers on their backs develop a rosy tinge at this time of year.

Impala and elephant
Thunder and lightning, with moderate rainfall over the Park

Because of poor roads, I could not reach the oxbow lake, Luangwa Wafwa, which is one of my favourite places. I turned around and headed for Wa Milombe via Zebra Drive. I saw a group of pied kingfishers diving repeatedly at a roadside pool, as well as lots of antelope. Wa Milombe savannah plane is now a lake surrounded by swamp. To drive back to the main road, I had to negotiate a river crossing. I could see a young crocodile waiting in anticipation but it was raining heavily by now and I didn’t want to get my camera wet taking a decent photograph. This one will have to do.

Thursday Doors

Thursday Doors Christmas

The streets of Leicester are eerily quiet on Christmas Day. There is no mad stampede of shoppers rush to grab bargains in the High Street sales. Everyone is indoors, hopefully enjoying the festival with their family and friends.
These photos were taken with my phone two days later in the early morning.

It looks as though Santa Claus just managed to get out of the window in time.

I am now volunteering as a doctor in a rural health centre in Mfuwe, Zambia, so no more doors for three months, sadly.


This is the best time to see birds in Zambia. I am lucky to have friends who are passionate about birds in the Valley. After recovering from the flight, I got up at 6am to go bird watching with F. Around her bungalow there is a plot of natural woodland which is perfect for a wide variety of birds. Six was too early for birds, especially with grey skies and mizzling rain. We had a cup of coffee and set off at 6:20, both of us wearing wellington boots because of the flooded paths and copious amounts of mud.

Little bee eater
Red-necked Falcon

First bird we came across was a little bee eater, in a typical pose, clinging to a stem. A red-necked falcon was perched on a branch, scanning the ground for breakfast. There were so many white-winged widow birds that they seemed to get in the way, distracting us from other more interesting birds. We saw a pair of black coucals, lots of spectacled weavers and red bishops, a male cardinal woodpecker, a snake buzzard, some common waxbills, a canary, a pin-tailed whydah and a tawny-flanked prinia.

Black Coucal
Common Waxbill
Tawny-flanked prinia
Pin-tailed whydah
Male Cardinal Woodpecker

After breakfast, I checked into my new home for the next three months. It is much more salubrious than Kapani Ruin where I stayed in 2016. The roof has been built around a tree and there is a shaded area where I can relax after work until I start getting eaten by mosquitoes. There are two bedrooms, both en suite, and a combined living/kitchen/study area. Some repairs are underway, sorting out the bat pee in the ceiling, ordering a dining table, fixing some broken windows, getting another door lock, sorting out some of the kitchen surfaces, repairing a towel rail and applying a lick of paint.

Thursday Doors

Thursday Doors Myanmar 3

The final posting of doors from Burma. One from Maha Bodhi Tahtaung:

This is the temple at the site of the tallest Buddha figure in Myanmar – Maha Bodhi Tahtaung. Ladies wait at the door to sell flowers and branches of bushes which can be offered to the Buddha inside the pagoda.

Thanboddhay Paya is a pagoda complex containing over half a million Buddha image. Here are eight images above these blue doors. I particularly like the flowering climber wrapping itself around the columns at the side of the doors.

Thanboddhay Paya again, but no Buddhas in this photo, just guardian tigers. Note the coloured panes of glass in the doors.
Yellow doors at the top of a flight of stairs, at Thanboddhay Paya, near Monywa again.
This is a cave temple, just outside Bagan, called Kyansittha Umin. The door is wood and iron, with plaited strips of metal. I particularly enjoyed the brand of lock used to secure the temple.
The Buddha image in Kyansittha Umin

This temple is way off the beaten track for tourists. As we were on a cycling holiday, this was an easy 16km from our hotel. A monk was reading verses using a PA system which amplified his voice and (for me) detracted from the serenity of the holy site.

The Public Address system was working rather too well.
Flying Kenya Zambia

The Pleasures of Airline Travel

I have a love/hate relationship with air travel. Despite being a seasoned traveller, I still feel uneasy and anxious. Despite using a checklist, I wonder what essential item I have failed to pack. I try to give myself enough time to get to the airport, but there’s always the possibility of a crash on the motorway or the vehicle breaking down. Then there’s the wait at check-in. Does my luggage weigh less than the permitted maximum? What heavy items can I take out at the last minute to stuff into my pockets (this makes going through security even more tiresome)?

I managed to leave my home in a reasonable state, refrigerator emptied, central heating set to deal with a cold spell, bed linen washed and dried, personal video recorder primed to record Les Mis for when I get home, all electrical appliances unplugged. The bus was on time, but most seats were occupied. We arrived at Heathrow on time and I breezed through check in. Security checked my hand baggage as I had left my Kindle in the rucksack, but the officers smiled benignly and waved me through. I had a sample of whisky in the duty free – White Walker (Johnnie, of course) – to reward myself, before going to the gate. Why does everyone rise up and queue as soon as the stewardess announces that boarding will start with passengers needing assistance or travelling with children?

The flight was full and there were no aisle or window seats available. A Kenyan lady was sitting in my place, oblivious to her allocated seat. She moved to another seat, and had to move again. I sent my final SMS messages and shut down my cell phone. Why do the touch panels on the back-of-the-seat entertainment system always fail to respond to your first deliberate touch? I selected a film which I hadn’t seen and must have nodded off for a few minutes because I cannot remember anything about it.

I don’t mind airline food. It is not cordon bleu but it fills the gap and gives you something to do (eat) during the flight. We touched down at Nairobi a few minutes early and I settled down in the transit lounge waiting for my connection to Lusaka while the sun rose. I took advantage of the free internet to send more messages before we were called.

On board, I couldn’t resist a secret smile when two traditionally-built African ladies tried to squash past each other in the aisle. Even they found it funny. En route, I could see the summit of Kilimanjaro poking above the clouds. We landed in Lusaka and I took my time as I had seven hours to kill before my flight to Mfuwe. I was last in the queue for immigration and noticed that the officer had a problem with his arm. I remarked on this and we had a mini-consultation while he wrote out the receipt for my 30 day business visa. My luggage was ready for me and I breezed through customs.

There is a new Chinese-built airport a few hundred metres away from Kenneth Kaunda International Airport, ready to open in late 2019. The old airport is rather cramped with few places to sit and wait. I managed to offload my bags at the Proflight office (the boss had pity on me). I wandered around, chatted with some South African businessmen, sympathised with an elderly lady whose visitor did not turn up, watched some planes taking off and landing, had some lunch, read some material I had downloaded onto my phone and sat staring into space, nodding off with fatigue.

Finally, our flight was called and I was relieved to find that my luggage weighed almost exactly 30kg, meaning I didn’t have to pay excess baggage. I accepted the offer of a window seat and someone impatiently pushed in front of me. After I went through security to the gate, I thought it was strange that I wasn’t given a boarding card. I went back to check in and the receptionist told me that she had given my boarding pass to another passenger, but it would be ok as she would fix it for me. And I believed her.

Meanwhile, there was a minor incident at security when a man tried to take a cow shin bone onto the plane in his hand luggage. The lady checking the x-rays of the luggage must have been rather shocked to see it on the screen. The bone was huge, plastic-wrapped and had a prominent label from a pet shop. He had brought it in his hold luggage from Namibia, but had transferred it to his carry-on luggage to avoid excess baggage charges on the local flight. Bad choice.

“What is this? Is it from a wild animal?” she asked.

“No, it’s just a bone for the dog, a gift for him as we have left him at home for two weeks while we were on holiday,” he replied.

This raised several cultural issues for the security officer. “You bought a gift for your dog?” she asked. “What will the dog do with this gift?”

“He’ll probably chew it for a few hours then bury it in the garden,” he said.

Her eyebrows arched even higher in disbelief. “It is not permitted to bring animal parts onto a flight,” she said. The passenger objected to the bone being confiscated and appealed to me to provide a rational explanation.

“It is securely wrapped and unlikely to be a health hazard,” I ventured.

“I will check precisely the wording of the law,” said the security officer. “This might involve a prison sentence.”

Immediately, the man apologised and abandoned the bone. “It only cost 70 rand, I don’t want to go to a cell for that!”

Meanwhile, the manager of a safari lodge managed to bring a box of machine tools on board, saying that there were no sharp bits inside. This made me wonder if the official might have thought the cow bone could have been used as an offensive weapon by a terrorist. But it wasn’t exactly the jaw bone of an ass.

New Chinese-built Lusaka Airport

The flight for Mfuwe was called and I approached the receptionist who had given my boarding pass to an African man. She saw my face and it dawned on her that he had already passed through. She called him back and switched the passes. He clearly hadn’t read the pass, and neither had she.

Luangwa River
Meandering course, very full
The escarpment. This is the southern end of the Rift Valley
Touchdown at Mfuwe International Airport

We touched down in Mfuwe an hour later. The warm, fetid air oozed onto the plane. The sun was setting behind the clouds and it looked like it might rain again soon. The grass beside the runway was dazzling, emerald green. I felt the joy of arriving at a place I loved. This was the pleasure of travel – arriving safely.

Thursday Doors

Thursday Doors – Myanmar 2

The Shwezigon Pagoda is situated in Nyaung U, close to Bagan. This 11th Century pagoda is totally gold plated. Except for the red door at the top of the red staircase. It was the centre of “Nat” worship in Bagan prior to the advent of Buddhism.  There are 37 major Nats or guardian spirits. Some represent the forest or mountains, but others are more specific, such as Min Kwawzwa who is a sort of “patron saint” for tramps and alcoholics. 

Check out the “Fake Booze” Johnny Walker Red Label by his foot
The Ananda Pagoda

This pagoda has been recently restored following earthquake damage. It is very beautiful, although its doors aren’t anything special.

In Britain, we have a tradition of the groom carrying the bride over the threshold through the door of the married couple’s home. So I think it is appropriate to add a wedding photograph.

This is the equivalent of a cloister which allows worshippers to walk in the cool to the inner holy area of the Ananda Pagoda. It’s a doorway without doors.

Inside the pagoda there are some huge, tall doors and some huge tall golden statues of the Buddha.

My paternal grandfather was a very practical man who died many years ago. I know what he would have to say about this magnificent monument, this glistening white pagoda: “How the hell did they hang them bloody doors?”

Thursday Doors

Thursday Doors in Myanmar

“It’s beginning to look a lot like Christmas
Everywhere you go
There’s a tree in the Grand Hotel “

Well, this is the Nyaungshwe City Hotel at the end of November. They are gearing up to Christmas, even though the vast majority of the population are Buddhist. The City Pub is decked with spray-on fake snow. Pretty boring set of doors, otherwise.

You’ll have to go on a diet after all that fattening Christmas feasting to get through this temple door at In Dein. This structure was built in the 13th century, but was abandoned and swallowed up by the jungle. It has been renovated over the past ten years, but some pagodas have been left in ruins with trees growing out of their brickwork.

This is the Hsinphyumae Pagoda in Mingun, on the banks of the Irrawaddy (Ayeyarwady is the new name) River. It is blindingly white. Up at the top of the pagoda, you can see this metal door. It is Myanmar’s version of the Taj Mahal – it was constructed in 1816 representing the mythical heavenly abode of the gods, Mount Meru, by the King and dedicated to his wife Hsinphyuma who died in childbirth. Her title was Lady of the White Elephant.

Back in Rangoon (Yangon is the modern name), the former capital of Burma, the colonial architecture is beginning to crumble. The building with wooden shutters/doors was a court, but is now used by the police.

Other doorways in Yangon are used by vendors of street food. Anyone fancy a dish of purple sago? I am not sure what the green bits are, perhaps lumps of jelly. Delicious.