“The most we can do is to write — intelligently, creatively, critically, evocatively — about what it is like living in the world at this time.” Oliver Sacks. “To take a photograph is to align the head, the eye and the heart,” Henri Cartier-Bresson
Durham is famous for its magnificent Norman cathedral, sited on a forested loop of the River Wear, next to the castle.
Palace Green, between the castle and cathedral, has lots of wonderful doors. The most famous door on the cathedral has a sanctuary knocker. Unfortunately it was being renovated when I visited, but here is the “dog tooth” zigzag moulding in the door arch. And a poster describing the flaming head knocker. People seeking sanctuary had 37 days to sort out their problems before they faced justice or were banished from the kingdom for ever – transported to the port of Hartlepool to sail to the continent.
Doors on the green:
Around the cloisters, there are more doors of interest. The monks used to do their laundry here and would hang their cassocks on the stone windows. The cloisters were utilised as a location in the Harry Potter films – the quadrangle where Harry magically releases Hedwig the owl from his hands in “Harry Potter and the Philosopher’s Stone”, and again in the “Chamber of Secrets” where Harry, Ron and Hermione learn how to turn animals into water goblets.
Inside the cathedral, there is a door built into the huge clock.
Yes, this is the answer to my question, “Who was the famous daughter of the commander of the Zeppelin which bombed Hartlepool?” Max Dietrich was killed when his Zeppelin crashed in flames into the North Sea less than a mile from Hartlepool.
Pieces of debris were washed ashore and can be seen in the Hartlepool Museum.
Outside the barracks, by the corner light I’ll always stand and wait for you at night We will create a world for two I’ll wait for you the whole night through For you, Lili Marlene For you, Lili Marlene
Bugler tonight don’t play the call to arms I want another evening with her charms Then we will say goodbye and part I’ll always keep you in my heart With me, Lili Marlene With me, Lili Marlene
Give me a rose to show how much you care Tie to the stem a lock of golden hair Surely tomorrow, you’ll feel blue But then will come a love that’s new For you, Lili Marlene For you, Lili Marlene
When we are marching in the mud and cold And when my pack seems more than I can hold My love for you renews my might I’m warm again, my pack is light It’s you, Lili Marlene It’s you, Lili Marlene
My love for you renews my might I’m warm again, my pack is light It’s you, Lili Marlene It’s you, Lili Marlene
Hartlepools – Old Hartlepool and West Hartlepool (no longer referred to as “British West Hartlepool”) again. Pretty bright colours. There are two museums, one for the tow one for the Navy. I like the door advertising money for old rope.
Easter weekend was sunny and warm. I drove up to see my aged parents and enjoyed the sea air.Hartlepool used to be a grim town, chemical plants, gasworks, steel industry nearby. But it has been spruced up recently.These doors are all from the old town at the edge of the harbour. Some houses have been gentrified, others are in need of tlc.Hartlepool was bombed by a zeppelin raid during the first World War in 1916. It was shot down and all the crew died. My grandmother lived ten miles up the coast and can remember seeing the zeppelin crash in flames into the sea. The airship captain had a famous daughter. Anyone hazard a guess? Clue Lili. Answer next week.Also, this part of Hartlepool was bombarded by German battleships in December 1914 during WW1 killing 130 civilians and a serviceman, the first to die in action on British soil during the conflict.But during the Napoleonic war, a monkey was washed ashore clinging to driftwood. The monkey was obviously not British and couldn’t speak English, so the locals assumed it was a French spy and hanged it.If you ever want to sample NHS care at the local Accident and Emergency department, go into a pub or bar on a Saturday night and shout out, “Who hung the monkey, then?”
My replacement arrived. We had the obligatory sundowners on Kapani Pan (where there had been lions just a few days before). I said my goodbyes to the expats and local staff at the health centre. No tears, just hugs. After my final early Monday morning meeting, I left behind some medical kit for the clinical staff, an electronic thermometer, a thousand candle power head torch to illuminate nooks and crannies, an otoscope which you can’t turn off without dissembling and a few tongue depressors.
It took about an hour to pack. One bag contained 540 origami cranes to be hung at my daughter’s wedding; it weighed less than 2kg. The other bag had my medical kit, some clothes which survived the “Boom” and handwashing of Theresa and a few presents. I travel light apart from technical stuff and electronics.
I had my laptop, mouse, two cameras, lenses, Kindle, music player, binoculars, battery chargers and iPad. This always causes problems at airports because I have to carry them as hand luggage to avoid theft from checked bags. At Nairobi Airport transit, my carry on bags looked so suspicious that I had to unpack completely. The security officer swabbed everything to detect any residue of explosives. I noticed that the screen of my laptop was dusty and asked the officer if he could clean it while he was checking. “Ah, sir, sorry. We don’t offer that service,” he apologised.
At Mfuwe International Airport, the checks were less stringent. I sat in the departure lounge after checking in, chatting to a Naturetrek birding tour party. An airport official interrupted me, “The District Commissioner wants to see you!”
For a brief moment, I thought I was going to be detained. Or perhaps they finally had my plastic Temporary Employment Permit card. But DC Caroline just wanted to bid me farewell and express her gratitude for my work in the Valley. I said goodbye to her and to F who had also come to see me off.
The my flight from Lusaka arrived so I went through security again, telling the staff the same joke about my trousers being about to fall down because I had had to remove my belt. “Those with boarding cards for the Proflight to Lusaka, please come to the gate.” Oops, while I was chatting outside with the DC, they had issued boarding cards and I didn’t have one. (Regular readers may recall that on the flight out to Mfuwe, the airline staff gave my boarding card to someone else.) No problem, they just printed off another card and I joined the queue of Chinese tourists taking selfies on the runway by the aircraft steps.
I feel sad at leaving. It is almost my second home now, my sixth visit to Zambia. But it is time to go, to move on. I have lots to look forward to in 2019. Including my appraisal and revalidation.
Well, only one wheel and it didn’t go bouncing down the road
in front of me; it just bent outwards.
I first noticed that the steering was sluggish in Chipata.
The car was not as lively when I accelerated. I thought that the power steering
had stopped working. Perhaps there was a hydraulic system which needed topping
up. However, being 150km from Mfuwe, I decided I should drive carefully home
rather than going to a garage in Chipata or calling for help from the lodge
which services the vehicle.
The journey back was enjoyable and I didn’t notice a problem
with the steering when manoeuvring the car over the high speed bumps on the
road. The rolling hills were verdant and fecund. I chased a thunderstorm as it
passed through, getting deluged with heavy rain and emerging into bright, clear
The following day, the fault seemed to have corrected
itself, but I made a mental note to contact the maintenance men to check it
over in the afternoon on my way to do a home visit. We did a community clinic
in the morning then after lunch I was driving on a bit of road that was part
tarmac, part dirt. Driving at no more than 30kph, I suddenly felt the front
passenger side of the car dip down and the vehicle pulled to the left. I braked
but was unable to control the car’s swerve to the verge of the road. The car
stopped before it careered down the embankment. I thanked my lucky stars and
got out of the vehicle.
The front passenger wheel was at an impossible angle and the
ball joints which attach it to the axle had failed. I am a complete novice when
it comes to making mechanical diagnoses, but the clue was the ball (from the
ball joint) sitting in the dirt. There was some liquid dripping from the axle.
I tried to call the maintenance men, but the mobile network was down. I decided
to use the car’s radio instead for the very first time and I was told help was
on the way.
It is considered good manners to stop when you pass a vehicle
which has broken down to see if there is anything you can do to help. Half a
dozen vehicles stopped for me and one chap told me that he had a spare
whatchamacallit in his garage if I needed it. Another person offered the
opinion that the car had already done 240,000 km and with the state of the
roads it was driving on, she was surprised that the ball joints hadn’t gone
already. The same problem had occurred with a local chief, but his vehicle
careered off into the bush with him frantically turning the steering wheel to
I was rescued and taken home within the hour. If anyone
needed medical attention, they would have to send a car to pick me up until
another vehicle could be pressed into service. The next day I grabbed a lift to
the village and R took me to the scout training camp deep inside the national
park to do a first aid workshop. Gunshot wounds, fractured limbs, vehicle
accidents, animal attacks, snake bites? All of the above, but mainly basic
hygiene, using medication properly, keeping wounds clean and avoiding infection
On the day I left Mfuwe, the ball joints and other parts had
arrived from Lusaka, but the car had not been fixed. I hope I have not
developed a reputation as a car wrecker!
A week before my departure from Zambia I drove to the immigration office at Chipata. I responded to their rather threatening email by asking for the location of their office and whether I needed to bring any supporting papers, but i didn’t receive a reply. I used Google maps to get a general idea of the town layout but the red marker pin for the office seemed to be close to the downs, a shambolic local market. I decided to aim for the Boma or administration centre.
I reached Chipata Boma just before 10am and found the office in the next street. At the front door a guard from the private security firm Octopus asked me to fill in the visitors’ book. While I was completing the details (identity document number, car registration, address, etc) I asked the guard if he had eight arms so he could capture any wrong doers. He looked blank. “The Octopus has eight tentacles,” I explained. His facial expression didn’t change, “What, bwana? Testicley?”
I should have known by now that many Zambians don’t get my weak attempts at humour. The security guard was not familiar with octopus anatomy. He directed me down the corridor. Immigration Officer Priscilla was staring at a computer screen while finishing her breakfast at her desk.
“You should have come here immediately after we sent the email,” she chided me. “But I asked for my authorisation to be sent to Mfuwe Airport Immigration Office when I applied online,” I replied.
“The plastic cards are not yet in stock, so you have to come here, to the provincial centre,” she said. “What have you been doing in Mfuwe?”
“I’m a volunteer doctor at Kakumbi Rural Health Centre,” I replied.
“What kind of doctor? I am getting these headaches…”
I explained that I didn’t have my medical equipment bag with me and my practice was restricted to the Mfuwe area. She pressed me further, so I asked for more history concerning her mutu.
“Are you very stressed?” I asked. “That can cause mutu like you describe.”
She agreed and went back to picking at the keyboard, filling in data fields. There was a scuffle in the corridor and two officers entered the room with a man wearing handcuffs. He sat on the floor leaning against the wall and smiled at me.” Illegal immigrant. Second time he’s come here from Malawi,” explained one of the officers.
“Next time, turn right instead of left and go to Mozambique instead,” I told him. I will never learn; Malawians don’t get my facetious humour either.
Officer Priscilla left her ornate, highly-polished Chinese desk with my passport and papers. I chatted with the dusty Malawian until he was taken to be charged. Priscilla returned and made a great show of stamping a page in my passport. I am never sure if the violence used to do the stamping is to emboss the paper or if the ink pad is dried up and worn out.
“This will take you to 15th of May, then you return here and I will give you another three months and another. We want people like you here, doc.”
“Thank you so much, but I am leaving next week.”
“No, but when are you coming back from leave?”
“I’m not leaving to go on leave. I will be departing, going back to my family.”
She understood the importance of family ties and I told her about my daughter’s impending wedding.
“But you must come back. We need you here. There are no doctors in Mfuwe. You have been helping us. God bless you.”
I took my passport, signed the security guard’s ledger and left. Legal again. I took the opportunity to visit the town’s two supermarkets, Spar and Shoprite.
Whenever I have been working in rural Africa and I return to the UK I marvel at the variety and opulence of the food on display at supermarkets, even Aldi and Lidl. How can anyone need so many types of breakfast cereal? I used to buy coffee in bulk because of my subliminal thinking that “it might not be available next week”.
So visiting Spar, even with its depleted shelves, was part of the process of readjusting to life at home. There was even a small coffee shop to remind me of Waitrose. Only patrons could sit here and use the toilet facilities. On the wall above the key for the toilet was a sign “New. We now offer iced coffee!” It was hot and humid so I ordered an iced coffee and went to the toilet.
When I came back, there was a mug of lukewarm grey liquid on my table. “But I ordered iced coffee,” I protested. The people at the next table volunteered the information that they saw the waitress adding the ice to my (hot) coffee at the table. Coffee with ice, rather than iced coffee.
I looked at my email. Priscilla had sent me a message – a notice to appear before an Immigration Officer (Section 14 of the Immigration and Deportation Act 2010). “To Ian Cross of Mfuwe Middlesbrough United Kingdom”. I was required to return to Chipata at 10am on May 8th to receive the temporary employment permit in plastic card format. “Failure to comply constitutes an offence punishable with a fine not exceeding 200,000 penalty units (?) or imprisonment for a period not exceeding two years, or both“. But I will be in Nepal then…
There’s a set of traffic lights in Chipata just outside Spar. They are so slow to change that impatient drivers cut through the fuel station and supermarket car park to avoid waiting. I noticed that the car’s steering felt stiff and sluggish as I pulled away from the lights. “Perhaps it’s because I’m driving on tarmac not dirt tracks,” I thought. Big mistake.
Il buono, il brutto, il cattivo – starring Clint Eastwood, Lee Van Cleef, and Eli Wallach
Working today at Kakumbi Rural Health Centre wasn’t really like being in a Spaghetti Western. The variety of clinical conditions cause me to feel joy, sadness, anger and despair, but this would not have been such a good title.
The Good. I have written about this little girl with sickle cell disease in the past. She had a nasty ulcer on her thigh which stubbornly refused to heal until we started daily wound toilet and dressing. Slowly, it began to heal. She stopped screaming when she saw a nurse or doctor because she could see how the ulcer was responding and she became my friend. I hadn’t seen her for a month or so, but she turned up today to get her monthly supply of folic acid (to help produce replacement red blood cells), penicillin tablets (to stave off infection) and anti-malarial prophylaxis (patients with sickle cell disease are prone to more severe attacks of malaria). Sadly, we have run out of folic acid (even for the first trimester in pregnant women), stocks of penicillin have been exhausted and we have never stocked Maloprim. She ate her breakfast while waiting for the pharmacist to tell her we had no drugs to give her and smiled at the camera. Isn’t she beautiful?
The Bad. This man was bitten by a hippopotamus three weeks ago. Bad because he was acting badly when he was attacked by the hippo. He is a very lucky man; most hippo bites are fatal. The wound was debrided and allowed to heal from underneath (by “secondary intention”). This needs a bit more tidying up and he will have an impressive scar, but he has lived to tell the tale.
The Ugly. Late yesterday afternoon, a man was fishing in Kapani Lagoon. He had probably bought “muti” from a sangoma – a magic potion which allegedly prevents crocodile attacks. It didn’t work in his case. He was bitten on the left leg and came to the health centre after normal working hours. Unfortunately, the nurse on duty sutured the main gashes and prescribed antibiotics which were not available.
Twelve hours later, he could not walk and had to be carried into the health centre. My colleague, the clinical officer who doesn’t like pus, asked me to sort him out. His leg was swollen and the skin was shiny and tight. The sutures needed to be removed. We have no scissors, so I had to do this with a pair of forceps and a scalpel blade. As soon as I snipped the first stitch, there was a mosi oa tunya (Victoria Falls) of putrid, orange-brown pus which burst from the wound. It stank so much I gagged. It reeked of rotting fish. Crocodile oral secretions are renowned for harbouring multiple pathogenic bacteria. I have never smelled a croc’s breath, but the pus probably smelled like crocodile halitosis.
The second wound I opened up had a different odour, sweet, sickly and fetid. The pus was watery and had bubbles in it. Looking deep into the wound, I could see the muscle had turned brown and black in parts. This is wet/gas gangrene, clostridial myonecrosis (dead muscle). This patient needed urgent surgical debridement, cutting away all the dead, infected tissue. Without a general anaesthetic, this is beyond my skill level. I knew that funds were really tight in the district and there was very little diesel left in store. We begged for an ambulance and were rewarded. I hope that I see him again before I leave and that his leg has been saved.
Because I am morbidly curious, I asked him how big the crocodile was. Like any fisherman, he extended his arms about a metre apart. “That small croc did a lot of damage,” I said. He replied, “No doc, that was the size of its head!”