eastern

2007-04-27T07:00:00.000-07:00

This is one of the villages for which the the World Medical Fund runs a monthly outreach clinic.

gender equality promotion float

2007-04-07T10:17:00.000-07:00

in preparation - Nkhotakota Boma Hospital

ghost world

2007-03-26T15:01:00.000-07:00

2007-03-10T22:27:00.000-08:00

the night creeps past
we sit in wait for the dawn

trying to think of something to rhyme with either of those non-scanning lines

i'll type real fast
and moles will dig up the lawn

night shifts suck, even though, blessedly, the bleeper bleeps less than during the day. with any luck i'll just sit here for another two hours and then do the ward round, followed up by a brain-bucking espresso and pain-au-chocolat (surely they'd sell better if called pleasure-au-chocolat? H-hang onto the bedsted, Mrs Pooter!), 15 minutes of not daring to fall asleep on the train, by pretending to read the Guardian (doesn't help) then slipping into my enourmous, extremely comfortable bed to sleep, sleep, sleep and oh sleep some more.

2007-03-05T14:17:00.000-08:00

March! Progress! Career (as in runaway wagon)!

Sat at desk once again - trying to re-assimilate the various quirks necessary to pass muster (normally referred to as 'exams') as a professional medical doctor. Leaden are my ventricles (all six of them) I can tell you that much.

Now have been at the new hospital for one month. It is quite nice. In the morning I walk across a park, over a small river populated by plastic bottles and real ducks to the nice sigmoid new building complete with tower that changes colour. Work is enjoyable, being both varied and, most importantly, not too hard. I can relax a little. In order to let my shirts live up to their promised 'low maintenance' I wear a jumper all the working day. I have also eschewed the neck-tie.

Baobab

2007-01-16T05:11:00.000-08:00

'b) Bark: The bark fibres are commonly completely stripped from the lower trunk yet the tree is able to survive and regenerate new bark. The fibre from the inner bark is particularly strong and durable and is widely used throughout the distribution range of the tree for rope, cordage, harness straps, strings for musical instruments, baskets, nets, snares, fishing lines, fibre, cloth, etc. (Griasard, 1891; Williamson, 1955; Sabri, 1968; Woodruff, 1969; Drar, 1970). In both Senegal and Ethiopia the fibres are woven into waterproof hats that may also serve as drinking vessels (De Wildeman, 1903; Grisard, 1891).'

Turns out the baobab is a useful tree indeed, as I discovered witht eh help of this paper here. Have a look here also.

Kidnapped!

2007-01-13T04:27:00.000-08:00

The World Service is on repeat, so I have had to resort to the English language service of MBC Radio 2, which delightfully is doing a special on George Michael! I’m not sure why – no explanations are forthcoming. Either G.M is terribly popular in Malawi (doubtful), or Radio 2 has a very select listenership, or the DJ is a massive fan, and has perhaps launched into an off-the-cuff biography just to share his love with lucky us. If so, the detail of his knowledge is impressive, if a little unnecessary.

The other day we went to assess a potential new clinic site, out in the middle of nowhere. We set out early, stopping in the market to buy provisions: soft drinks (two each), bananas, salted roast peanuts, ‘milk scones’ (huge, delicious white buns known locally as ‘Bin Ladens’ because after you eat only one ‘you are destroyed’, as Nurse Gloria put it). We drove south past the lagoon that is the breeding ground for chambo (a big-boned, big-toothed, tasty cichlid fish that is widely eaten), turned west and drove about an hour down weaving dirt roads, through the fields of sprouting maize and scattered mudbrick houses, over gorges and down escarpments, until we came upon a beautiful school compound, recently built by the Norwegians. Under the ancient mango tree in the dust courtyard, against which leaned a tangle of uniform black bicycles, sat about forty men in suits, who all stood up in unison to reveal the half-bricks they’d been perching on as we clattered up in the jeep. They were the chiefs of the surrounding villages, who had come to help make the case to WMF for the area having a clinic. We were greeted by a smartly dressed man with a gold tie-pin, and taken into his tidy office, with a high shiny tin roof and walls crammed with posters covered in useful information about the schools, objectives, statistics, maps etc. Courtesies were exchanged, and a long discussion ensued in Chichewa. After that we were taken to a classroom, and placed on a bench in front of our audience (the chiefs) who were sitting patiently at the desks. In turn, we all stood up and introduced ourselves (the forty chiefs included) each person receiving a burst of applause. Then there was a short silence. No-one seemed to want to be the first to speak. One older man cleared his throat and stood up. He spoke for about ten minutes, receiving the odd laugh or applause. This seemed to encourage the others, and as soon as he sat another was on his feet. He gestured confidently, and joked successfully, earning more laughter and applause. When he was done two people stood up, and there was a tense moment of eyeing each other before the younger one conceded the floor with a gracious smile. He took his turn next. All these speeches were addressed to us, and I had to look as though I was paying close attention, nodding appreciatively even though I didn’t understand a word. During the fifth or sixth speech – I was beginning to wonder whether the speechifying would be as exhaustive as the introductions – Mr Dezi whispered as discreetly as possible (neither of us taking our eyes off the speaker, who was only five yards away) that they were making their case. It sounded strong. He thought we would start a clinic here soon. Now he could stop the speeches. When the speaker sat down, Mr Dezi stood up, tall in his bright orange trousers and white labcoat. As he spoke I could finally let my attention wander. There was an enormous jet-black hornet, the type with a tiny waist, purple-black slivers of wing and long droopy legs, on the ceiling above me. It was having a rest from searching for food I think. Its spread feet hugged the surface of the wooden beam gently. It was nibbling something, stubby antennae waving about distractedly as its head bobbed purposefully over the chewed object. A beautiful creature, I thought.

A faint wailing sound drifted into my awareness. I remembered our young captive, still in the jeep. On the way to the meeting, as we passed through a small village, there had been a sudden loud bang and something ricocheted off the windscreen. The jeep screeched to a halt, and instantly Mr Dezi and the driver Mr Mussa were out of the cab, sprinting over the field, hurdling bushes as they chased down a terrified boy. The impromptu hunt disappeared from view behind a hut, and a moment later they reappeared, holding between them a raggedy, grubby boy of about twelve, who was wriggling, rolling his eyes, and protesting at the top of his voice. He was placed rather unceremoniously in the back of the jeep, which did nothing to calm him down, and off we drove. I was a bit mystified as to what we were to do with him. Mr Dezi showed me the reason for the commotion: a large catapult made out of a tree branch and strips of rubber inner-tube – a pretty fearsome weapon. The boy meanwhile continued to holler at the top of his voice as we sped further and further into the countryside. At one point he started beating his hands on the back of the seat next to me, until it suddenly collapsed forwards. He was so surprised he stopped wailing. I was a little concerned about the legality of our actions: technically, had we kidnapped him? But Mr Dezi explained everything was fine; we would return him to his home as soon as we finished the community visit.

The general meeting with the chiefs was closed, and we adjourned to the smart office, where three five warm bottles of Sprite were lined up on the desk (next to a miniature flagpole sporting the Norwegian flag), one for each dignitary (which including me and the driver Mr Mussa). There was more discussion, thankfully this time in English. Mr Dezi told them the prospects for a clinic were good. We aimed to start soon. The area had a population of 45,000 and only one health centre, which might mean one doctor, two clinical officers and about three nurses, if that. Certainly not enough medicines. There was more talk in Chichewa (about where a shelter for WMF to use would be built, and when).We said our thankyous and got up to leave, just as the loud raspberry exhaust of a motorbike came into earshot. The Head Chief had at last arrived, a pleasant man, well presented in a crisp white shirt with gold cufflinks, black trousers spattered with flecks of red mud. He apologized, saying he had mistakenly come the day before. He was very pleased about the clinic, and assured us that a venue would be constructed forthwith. We all stepped outside into the bright sunshine, for a group photograph with all the chiefs. We waved goodbye, and were off. Our prisoner sat quietly in the back, his bottom lip sticking out.

After quizzing the boy for directions we returned him to his home, only to be told by a neighbour that his dad had gone to the police station, claiming his son had been abducted by Satanists. I know the World Medical Fund is a secular organization but I thought this was pushing it. Tucking our tails into our trousers, we went and sat with the boy, his father (also shoeless, in worn-out shorts and shirt), the local bobby and his wife, amongst the plants potted in beheaded plastic bottles, on the narrow verandah of his small brick house. Mr Dezi relaxed back in his rickety three-leg bamboo chair, and negotiated quietly in Chichewa (this is very unusual in Malawi), gesturing occasionally towards the jeep. The policeman spoke to the boy, and the father, who seemed relieved that the crack in the jeep windscreen pre-dated his son’s mischief. The catapult was handed back to the dad, which I was a bit sorry about as it would have been fun to play with, and we went home.

A Great Worm

2007-01-11T12:19:00.000-08:00

Dracunculiasis medinensis, or Guinea worm: the epitome of the unpleasant parasite. This is the worm that wriggles in your very flesh, with no diminutive size to excuse it from your revulsion and horror! Contemplate this serpent of the subcutaneous tissues, and tremble you mushy-entrailed, temperate climate-dwelling saps! Tremble! Now!

This worm is endemic in a large part of Africa, the broad band of sub-Saharan semi-desert regions that includes such vast countries as Chad, Mauritania, Mali, Ethiopia, coastal west African countries, and ‘the’ Sudan. It is caught by drinking water contaminated with the vector copepod crustacean. Worm larvae burrow their way from the stomach into various body cavities where they mature and mate. Once fertilized, the female will burrow onward, outward, into the fatty tissue just below the skin, usually near the extremities, usually on a leg. She is the length of your arm. Worms may be seen or felt as they migrate under the skin. They may get lost on the way to the leg and end up in the joints, brain or even the eyes, resulting in arthritis, brain abscess, blindness. The foreign tissue stimulates the immune system, and the patient will often have itchy rashes, hives, fever and vomiting. Once settled the adult female will work her uterus to the surface of the skin, where it will protrude slightly, waiting to release thousands of eggs on contact with water.

Unpleasantly, a painful, very itchy blister will form around the worm tip, which will burst and become an ulcer infected with various bacteria. Interestingly, the tremendous itching of the ulcer is relieved by immersing the limb in water.

And the treatment? Antibiotics help loosen its grip on the flesh. Then, you make an incision in the skin over the worm’s midriff, and catch a loop out, passing a short rod underneath so it won’t slip back, or tempt out the tip by immersing the leg in water and lassoing it with a piece of cotton thread. Then, gradually, delicately (so as not to break it) the worm is ‘turned’ – one twist of the rod each day until its hold is sufficiently diminished for the remainder to be eased out in one long pull.

There is a nice picture here and info in English here

For adventures with ticks, snakes, disease and tropical nastiness generally, without having to leave the safety of anything at all (except sleep) may I recommend you read 'Congo Journey' by Redmond O'Hanlon, or indeed 'In Trouble Again'. Africa and S America, respectively.

2007-01-06T23:12:00.000-08:00

Blantyre

2006-12-30T10:30:00.000-08:00

Nigh is 2007.

Sweaty day today, cycling the 16km to the Pottery (and back again), where after brief instruction I managed to 'throw' some bowls. I tried to make some fancy shapes but they just turned into either a) splatters on the walls or b) bowls, all different sizes but the very same shape. Tomorrow I shall heave my lardy frame and unwieldy bicycle back there to paint these creations, with naif representations of crocodiles/fishes etc. Someone back home will be the lucky recipient of a beautiful piece, attractively moronic, and yet deep enough to stop milk falling out onto the table.

Christmas came, and it went. I dstracted mself from the lak of turkey to gobble by squeezing myself into a tiny minibus (despite it already being full) and sat in it for four hours, reading my book and pretending that my buttocks did not ache, until it delivered us all (chicken included) to Blantyre, the town of my childhood. It didn't look anything like my memories, and what was there seemed to have moved around in a very disjointed fashion. The 'Hong Kong' restaurant, for years one of the few places that served edible food, and whose napkins were always damp and very worn, was still there, as was St Paul's Cathedral (a bit smaller than the London one. I still knew the way back to our old house (left 14 years ago)or at east tought I did - the 'shortct' I arrogantly decided to take leading me totallly astray. Nowhere could I find the broad street, lined with tall airy jacaranda trees,that we used to live on, until suddenly I realised the narrow, pockmarked road I was bouncing alng was it (Mahatma Ghandi Drive), and the tiny dirt road by that shabby drain was my old turning... and there it was. Our old home, the place where I played as a child, the garden in which I had many adventures - each tree was still there, my parents rockeries and raised flower beds, built so carefully out of brick were still flourishing. The house looked a bit faded but really just the same. The oddest thing was seeingthings I had no clear memory of, that were strangeyet familiar, nd that evoked so many memories, tiny things like seeing flying termites for the first time, making a tiny bow and arrow out of bamboo skewers to shot giant moths (don't worry I never hit any), burning my radio controlled car (the love of my life, aged 12) aroud and around for hours - nothing terribly exciting i guess, but it was there, soid and real, and no longer a past so distant that it felt imagined. It was quite overwhelming. Then I pedalled off to see the old primary school... won't bore you any further but it did make me cry, not least because I realised what a happy childhood I had had, and how good that place was, full of creativity and fun. It still smells of pig, the responsible beast wallowing in mud in the school farm - I think it probably a different one now, but seems to use the same eau de toilette as his predecessors.

Malawi time nearly done now... two weeks to go. Pedalling back through the muggy dusk air, the sun throwing my cycling shadow wide across the road, as I received countless greetings from folk going about their business as I passed by, I felt that I should try to soak up the experience in my memory (to be used later in defence against the cold or the drudgery of commuting when ack in London) - the low light and the pinking high clouds, the dark green of the trees, the way the reddish bowrn earth of the fields, lyng between livid green shoots of maize, seemed to extend sideways, upward, to form the brown houses topped wit ragged thatch, where children sit on the porch, singing songs. The road would endlessly divide this world in front of me, and trucks piled high with goods and people would roar by, cycle-taxis, carrying women riding side-saddle clutching goods and/or babies would drift past me (slightly embrrassing seeing as i was propelling only my own weight), and the people on their way home or to the local market to hang out or have a beer always by the roadside, ready to turn hteir heads and stare a me and maybe offer a greeting (with varying degrees of sincerity). By the time I was back in Nkhotakota the sheet of cloud above was lit red and orange, and Iwas ready for a cold shower and a colder beer.

all i want for christmas is...

2006-12-16T02:17:00.000-08:00

Lilongwe:Capital City

2006-12-14T07:00:00.000-08:00

Last Thursday we piled into the Landrover just after dawn, and headed south to Lilongwe. We had a meeting later that day with UNICEF, to discuss a future programme for the prevention of transmission of HIV from mothers to children. We had all been looking forward to the trip, as a visit to the capital city means being able to get certain things done – renew visas, do photocopying, buy things you can’t get in Nkhotakota (oats and lentils, a whisk) and, for me at least, a break from the routine of clinics, and the end of the rather intensive work shaping the programme proposal. Plus I wanted to get the satellite box in the guesthouse working, so as to resume my television habit.

It was strange to head back down the road that brought me to Nkhotakota a month ago, when I could barely keep my eyes open. The bumpy the road to Salima brought gradual changes in the landscape as we headed south along the lakeshore: it became hillier, and baobab trees started to appear. They are wonderful to look at; massive, tall, sparse, with smooth grey bark like an elephant’s skin, and usually standing on their own. They are often scarred at the six feet nearest the ground – none of my companions knew why, but it looked as though squares had been periodically removed, perhaps to repair canoes with. The scars were all well healed, so whatever it was, people seem to have stopped doing it. The air grew cooler as we climbed away from the lake towards Lilongwe, passing over-laden flatbed articulated lorries belching out black exhaust as they crept up the long curves. Having climbed we came out onto an escarpment, looking over a large plateau dotted with jagged mountains, and what must be the largest building in Malawi – a set of huge silos that looked very incongruous against the leafy green of the plain, which marked the business and industrial zones of the capital, invisible amongst the trees. Lilongwe is an odd city, because at first you don’t really see much evidence of urban development: it feels like a park. Only after driving down endless avenues, with the odd gated low-rise compound set back from the road, will you encounter a sudden roundabout and a modern building of black glass selling Toyota Landcruisers, while each of the turnings will take you down yet another leafy avenue, indistinguishable from the last. The disorientating effect of this was added to by the throngs of other white Landrovers filling the roads, combining house of mirrors with maze. Mr Dezi pointed out one large empty plot, and told me that in 1995 there was a war there. Not knowing of any conflict in Malawi, I asked him what had happened. Apparently, after Life President Banda’s term was brought to an end, members of his ‘Young Pioneer’ organization had armed and barricaded themselves in the Party headquarters. The siege had not lasted long, being ended quickly by the army, but many lives were lost. I was shocked by this, because I had not heard of such things in Malawi. Though quietly oppressed, Malawi did in a way benefit from its dictatorship and lack of mineral wealth by not spending the second half of the 20th century being torn apart in the interests of ideology or money, as in the case of its neighbour Mozambique (it still goes on: Rwanda, the DRC, the CAR, Chad, Sudan…). It also made me realize something else – how unknowingly I had grown up in a dictatorship, where expressing political opinion could readily see a person disappeared, tortured, killed. It even had an armed fanatical youth wing, the innocent-sounding ‘Young Pioneers’ who in reality were often not young, and were a quasi-military organization with powers greater than those of the police. Apparently Kamuzu Banda had set up the organization as a training initiative to boost Malawi’s agricultural productivity. As his style of rule became more autocratic, and his Life term instigated, the YP became the eyes and ears of the only legal party – his Malawi Congress Party – and ultimately its political Inquisition. Malawi is such a beautiful and peaceful place, and my memories of childhood being one of freedom to roam and play, it seemed so odd that a Waco-style showdown marked the end of the Banda era. I said as much to Mr Dezi, who said that it was true, that many people didn’t even realize they were under dictatorship back then. Perhaps the control of the media and education was so easily achieved in such a small, poor and uneducated country that few realized what was happening. Even though it is twelve years since democracy came to Malawi, people will often point out the freedoms they now have that were denied to them then. People seem to relish talking about politics, and the newspapers reveal a media obsessed with the ins and outs of government, from the interpretation of the Constitution to individual politician’s actions (or lack thereof). The other day, when heading back from clinic, the team started discussing something enthusiastically. I asked why everyone had started shouting loudly all at once. Mr Chawinga explained they were debating the controversial Section 65, which threatened to remove some MPs from parliament, as after the last general election, they had left the parties they’d been elected to, and took their seats across the floor to form a new party, thus taking power! The high court had ruled to enforce Section 65 which outlaws such electoral fraud, and much uproar swept across the land (some of it at sixty miles an hour, in our Landrover). With a wide smile Mr Dezi pointed out that in Banda’s time you could be denounced and thrown to the crocodiles for such liberal talk.

Eventually we arrived amongst the city streets, with shops, banks and other city-like things. Relieved to air my damp trouser-seat and stretch my cramped legs, I was set down, and walked into Shoprite, the rich people’s supermarket. Delight of delights, they have a bakery, which does not only sell white bread, but brown bread, and cakes, and chocolate brownies, and flapjacks. I put lots of things in my basket, then, realizing it would be impossible to eat all these treats before they went stale, dolefully put them back on the shelves again. An hour later, heavily laden with yellow plastic bags of dry goods, I was stood outside in the car park reading ‘The Nation’ as waited to meet the others. A man sidled up to me and muttered “Hallo sah, ‘ave you got it? ‘ave you got it? Banana?” I looked at him, uncomprehending. “What?” I demanded loudly. He leaned in close “ ‘Ave you got it? Banana? Pineapple? Fresh!” he hissed. The penny dropped.“ Oh… Avocado!” I roared, delighted to finally understand that he was trying to sell me fruit. He shrank back looking furtively about, into the shadow of a mango tree, and beckoned me to follow. Not understanding the apparent need for secrecy, but otherwise tempted by bananas (an oddly rare thing in Nkhotakota), I stood my ground and enquired (at the top of my voice naturally) as to the price, at which point he broke cover and made a dash for the main exit. A man in uniform had wandered over, and politely told me that it was an imprisonable offence for vendors to operate in the car park. Slightly taken aback, I apologised and hid under my hat. A little later, I noticed a figure standing on the railings that run around the car park, waving and shouting in my direction. I waved back. He then held up an enourmous fan of green bananas. Glad still have the opportunity, I went over and bought them, legally, on the pavement of the main road. They were delicious.

A little while after that, having repeatedly made the error of smiling and waving enthusiastically at each white Landrover that pulled into the car park, in the mistaken belief it would contain my friends, only then to have to hide behind ‘The Nation’, I was startled by a loud honk on a car horn close by. I lowered my newspaper and scowled at the white Landrover pulling noisily up in front of me. “Dr Adams, get in, we are going to Multichoice” (the Home of satellite TV). The busy street disappeared behind us, and we were swallowed up again by the long intestines of Lilonwe’s avenues. Eventually, after asking every person we could, and driving around in circles for what seemed an age, we found the un-signposted Multichoice building, glinting quietly behind a high brick wall. Clutching my satellite box chip card, I pushed back the glass door and stepped into a realm of cool air and marble floors. Television screens flashed smiling advertisements in tempting bright colours, and attendants sat at desks busying away, while satisfied-looking customers strolled about. I presented myself to a desk, removing my sweat-ringed hat and holding out the card. As the attendant took the card and tapped at their computer keyboard, I was soothed by the air conditioning and seduced by the musack, almost hypnotised by the imminent prospect of having at my disposal a satellite extravanganza, a televisual smorgasbord, and the reasonable chance of watching a Bond film on Christmas day. The immediate pleasantness of my surroundings extended into this fantasy, so that not only would there be television, but also air conditioning, a big sofa, and quite possibly a cocktail with a miniature umbrella in it. The attendant asked me if I had the box. Mmh? I asked, smiling widely so as to prevent any break in my developing fantasy. The box? The card was already in the machine. No, not the box for the card, the machine. Why do you need the box for the machine I wondered out loud, smile beginning to freeze. He said, you need to bring in the machine. Otherwise you could be using a stolen one. You can’t open an account without it. I thought of the machine, three hours away in Nkhotakota. No 007 for Christmas then. Fortunately I still have a number of books to get through. Television is bad for you, anyway.

insectivore

2006-11-27T11:47:00.000-08:00

if only i were, then i would be in a gourmandary of delights. i write this in the glow only of the computer screen, as the power circuits will not support having the lights on inside at the same time as outside, or something. As a result i am sitting in an ever-thickening cloud of insects, despite cunningly distracting a good lot of them by pointing a torch at the oppsote wall.a large shiny one keeps getting in the way of the cursor here, a bit like a cat sitting on a newspapaer just when you are trying to read it.

sad news for the World Medical Fund - one of our two clinical officers is to leave us at the end of the week to work in the capital city, Lilongwe. This means more work for the remaining incumbent and that I am actually needed for my remaining few weeks here.

Tomorrow we go back to the government hospital, which i have come to dread, as - to use a well worn phrase describing such things -the conditions are appalling. it is not very clean, very overcrowded, very understaffed and hoplessly under-equippped (someone nicked the ultrasound scanner recently), the patients are really unwell with conditions that are never seen in England, as well as conditions well known to me but have developed so badly that they have become difficult to discern.

Dwangwa

2006-11-21T06:28:00.000-08:00

Pecuniary concerns drove me north on Saturday, to a village called Dwangwa, which Mr Dezi had informed me had a bank that changed money and an ATM, but that I must get there by 10am before it closed. Dwangwa lies a mere 56km north of Nkhotakota, which I guessed would take about 30 minutes by car. Uncertain of the public transport however, I got up early and headed down to the middle of town. Sure enough, a bus sat by the side of the road, completely empty, while a fellow washed its headlights with a bucket and rag. A bit of wood with ‘Dwangwa Mzuzu’ scratched on it sat on the dashboard. I asked him what time the bus was due to go. Seven he said. Then he asked me the time. Seven thirty I said. He assured me we would go soon. I got on the bus, while he wandered over to the marketplace and disappeared. A fellow with shifty eyes followed me on and tried to convince me to go on the pickup parked just in front ‘because it won’t break down like bus’, and wouldn’t accept when I tried to inform him that the pickup was going to Thyolo and Mulanje (I had espied a bit of wood on its dashboard telling as such), and after standing in silence next to me for a while he also wandered off. I sat there for a bit longer. I wondered whether the pickup was really going to Thyolo. There being no sign of the first fellow (and therefore no imminent threat of the bus actually leaving) I got out and asked where the pickup was going. Dwangwa, a third fellow said, and only two hundred kwacha. I pointed to the sign saying Thyolo and it was removed hastily by the driver to hoots of laughter from the various people gathered about. How long would it take? About half an hour. I got in (the front seat, and aware of the privilege), and took in the appalling state of my transport. There were holes everywhere, the door wouldn’t shut and anyway there was no handle inside to open it with. I could barely see through the windscreen riven with cracks and clouded by a sticky-looking smear of beige I could not identify. By the time (it was some time, and still no sign of bus driver or indeed any passengers) we were receiving our push start and the engine coughed into life, I was planning my method of escape should our carriage drift uncontrollably towards a gulley or suddenly burst into flames. However our driver seemed fully aware of the vehicle’s shortcomings and drove not much faster than a gentle trot, slowing to walk at the start of any slope. This will take a long time, I thought. It took even longer than that, and after 80 minutes of holding the door shut, when I was beginning to wonder whether Dwangwa was a concept rather than an actual place, we entered some forest. Brachystegia is woodland of open canopy which used to dominate much of Malawi but has since much diminished due to a process a match factory owner in Blantyre once (rather impoliticly) called ‘natural thinning’ (sadly for many Malawians firewood is the only affordable fuel), but here in the Nkhotakota Reserve is in full glory. The dry season has brought many shades of brown and red into the treetops, making for beautiful views of the forest as we rounded hills. I dreamed we might see an elephant, and saw three baboons. A little later we passed a sign saying DWANGWA, which didn’t seem to demarcate any change in the consistency of the forest. The engine stopped and we drifted to a halt. Dwangwa, my seat-buddy stated, as we retrieved our personages from the intimacy of the last two hours, and unbent ourselves out of the cabin. No buildings. I walked for a bit and passed a bus stop, then some houses. A shout of ‘asungu’ went up amongst the children playing, which I took as a poor indicator of finding my metropolis with bustling financial centre. I passed a tractor, and came to a junction at a break in the trees, with a sign saying Bank pointing down a road. I looked down that road, which undulated straight over a wide plain of green sugarcane, all the way to the horizon, with no hint of a bank-like silhouette to comfort me. I wiped my forehead. I looked at my watch: 930 - nearly out of time. I looked at the road, and wondered whether running would make any difference. A white truck appeared, and stopped beside me. With a gentle hiss the door opened and a mist of cool air spilled gently out into the road. ‘Get in’ a voice intoned. I did. A few minutes later I was outside a large sugar refinery and the bank, which was in fact not one bank but two banks. One was quite empty, with a large dot-matrix sign flashing the latest exchange rates down into my money-minded eyes, and the other was full of long queues. I chose the empty bank. The young lady behind the counter politely informed me that they didn’t change money, and that I should go next door. She explained, when I protested, that the exchange rates were displayed because the bank hoped to offer that service ‘in the near future’. I hung my head and went to queue. Some time later, when the clerk had spent some minutes jiggling a wire in the back of his computer in order to ‘get the rates’, I walked outside, waist thickened by a wadge of kwachas. A boy on a bicycle offered to take me back to Dwangwa. I perched on cushion attached for the purpose and we wobbled off across the plain, through the thick air sweetened by the smell of the sugar cane and my relief at having the job done. After about 10 minutes of having my kidneys rattled on the pillion, we crossed the river Dwangwa bridge, passed the sign saying 'Beware Crocodiles' and came to rest at the side of the road. Dwangwa it turns out, despite my skepticism, is indeed an actual place, with a bustling high street and busy shops and stalls. The ‘God Is Able Shop’ and the Primary School whose motto was ‘Ignorance with Education' stood out, alongside long rows of cabbage and the bucket-maker.

The pickup home was newer and faster but no more comfortable, even though I had somehow been granted a front seat to share again, this time with a young woman. She asked me if I spoke Chichewa, and I had to say I do not. She told me with a note of reproach in her voice that Malawians do not speak English, they speak Chichewa. She is a single mother to a ten year old boy, and was going to Lilongwe (some 200km away from Dwangwa) to sell fish. She asked me jokingly if I wanted to adopt her son. I asked her how long she was going to be in Lilongwe. Back this evening she said, by six. I did wonder how realistic that assertion was, but did not express my doubts. Making a rather feeble attempt to carry the conversation further, I asked where her fish were, peering quizzically at her small blue handbag, and then reaching out to pat it as she gazed evenly back at me. In the back, she said.

Monday 20th November

2006-11-21T06:14:00.000-08:00

I am back in the blogosphere, thanks to Mr Nkhoma generously lending me his laptop - although that was not the reason. Rather, I am supposed to be writing a plan for a study we will shortly be undertaking here at the World Medical Fund, on worm infections, with a view to possibly starting a treatment programme. I will do just that, once I have a bit of diarising off my chest.

Work today was quite tough, starting at 730 and not getting back from clinic until 230, without break. The clinic took some time to reach, being out in the marshland that fills the various depressions near the lake shore (this was once lake but has silted up over the millennia to form wet plains between rocky rises), and only accessible via dirt road. This is fine (if a bit bumpy) for the moment, but I am told access can be cut off during the rains, even for our powerful Landrovers. There was a high proportion of sick children today, mostly malaria, and the usual infections, rashes, poor nutrition. We worked sat on tiny school chairs at school desks, brushing the flies away from our noses, while the mothers patiently waited in the adjoining classroom, in the cacophony of screams and wails from their children. I saw my first case of suspected TB, in a seven year old who had been coughing for over six months, and had become very thin. Another little boy who’d been burned terribly in June came in wearing a headscarf. His mother peeled it off to reveal a black plate of dried stuff (ash?) covering almost the entire top of his head, through cracks in which green pus oozed and a sickly odour emanated. She was convinced the child was a victim of witchcraft, and had been applying traditional medicine, feeling too that hospital medicine had failed her child when he’d been in hospital. This was disheartening in more than one respect: that treatment had been incomplete (the chance of the child receiving the plastic surgery needed for his arms being small), that his mother might well be making things worse by applying poultices (of whose properties I can safely guess only one thing: not sterile), and that the very simplest treatment this child needed i.e. regular cleaning, dry sterile dressing and follow-up, was not available. We took three children back to the Boma hospital, a rather pathetic cluster of low buildings surrounded by pitted bare earth, two broken Toyota pickups, some trees sporting bright orange blossom and the odd goat. Various figures stood on the bare verandahs, or lolled on the floor, either patients or their relatives sheltering from the sun. Tomorrow I will find out more – I am to accompany Mr Chawinga (one of the WMF’s clinical officers) to observe a ward round.

In the afternoon I went to Farmer’s World and bought a bicycle. It is called ‘The Hunter’, the label stating reassuringly that it is ‘all steel’. It is a noble beast, having more moving parts than I could conceive – all rods and bearings – and special bent handlebars that mean you can’t pedal as you go around corners. It came with a pump, spanners, lock and a large mirror on a bendy thing that appears to have no actual means of attaching to the frame. Unfortunately the manufacturing process doesn’t involve tightening any nuts so it was unridable. On the advice of the proprietor I wheeled it around the back to a small bamboo shelter where two men took it from me and took it almost completely to bits and put it back together again in order to tighten it up. I confess I found the scene before me a delight, as with home-made tools, among a sea of broken and rusting bicycle bones, my wheels were dissected, spun and balanced, brakes adjusted, and seat squared. I was off, hefting my wobblesome steed up the road to have a look out over the evening plain. About a mile out of town a young man drew up beside me and told me he’d seen me at the repair shack and witnessed the hasty revision of the price from the initial MK350 to MK850, and that he was very sorry to see a stranger in his country treated that way. He is 17, and wants to be a doctor, and not in Malawi, because Malawians are greedy, although this was probably because they are very poor. We talked a bit about why many children get sick here, and how he might get into medical school. He asked me if I could be his mentor in that regard, and I said ok, though in my mind I doubt that drifting from school to university as I did will provide many gems of wisdom for him, who will have much tougher competition for a place.

Back at the base, my new acquisition received admiring coos and expert whacks on the tyres. Later, talking to Mr Chawinga about what I should do with the bicycle when I leave, he revealed that it cost about three times the security guards’ salary. Saving up for a bicycle on that would take almost as long as would me to save for a car in the UK. I began to feel a little embarrassed by my extravagance, which though useful, is not a necessity.

Please note that any patients mentioned will have had various details changed for confidentiality’s sake.

Nkhotakota

2006-11-13T10:11:00.000-08:00

Day three in Africa. The first day I spent in a jeep with my new colleagues, watching the red and brown hills roll past and cyclists wobble gently from the middle of the road. I kept banging my head on the window every time i nodded off, to wake with a jolt, so tired I kept thinking the Chichewa my companions were speaking to each other was English. Then I went to bed, capable of little else. Yesterday was a more fulfilling, cooking my first meal, and having my first spider terror in the apartment. A particularly large and fast critter with huge claws and menacingly pale limbs skittered around my bedroom and yes, hid under the towel on the back of my door. Only once armed with a mop, bucket and copy of 'Quantum Physics for the Curious' ( I assume the very curious, because it is quite a substantial work), plus a large can of DOOM crammed into the back pocket did i have the courage to face the beastie. The battle was brief and I am sad to say a little one sided. It fough valiantly, claiming my left arm, which remained tightly in its grasp even as it died. It shall be stuffed and placed on the wall, where no doubt catching the corner of people's eye it will make them jump out of their skin. The arm might be a bit creepy too.

Charles, one of the security guards, kindly took me out on a walking tour of the town late in the afternoon. We trailed along dusty paths between numerous squat white churches with unfamiliar names ('The Brethren of Bible Breathers' stood out), trees with bright blossom, and wonky thatched houses. Mangoes are in season, preoccupying the children with either knocking the heavy fruits out of the tree with a well aimed stone or stick, or clambering about the branches, rattling them heavily to shake them loose. They would stop to yell 'Howah you?' and wave at us. There was a football match on in the shadow of the local station radio mast - we could hear the shouts of excotement some way off - where the pitch was marked out only by the line of spectators sitting obediantly on the ground. As we approached, the ball flew high into the sky, the crowd cheered and broke ranks, spilling onto the hallowed dust, only to be kept in line by a figure dressed in black with his matching sunhat pulled down so far on his head he had to crane backwards to se where he was going as he strutted the perimeter waving a cane menacingly.

Today we drove out into the (for want of a better word) interior, where I had my first clinic, in a tiny brick building with a tin roof. This was loaned to us by the local chief, who came to greet us warmly. A crowd of mothers squatted outside with their mostly very young children, partly shaded by an acacia tree, and waited patiently to be seen. Mr Dezi, the chef clinica officer kindly interpreted for me whilst seeing his own patients at the same time. The children were indeed ill, iller than would be the normal fare at a London A&E, and with more dangerous conditions, all of which i am not familiar with treating. Malaria seemed to nthe main culprit, exacerbated by poor nutrition. We treat any illness we see on the spot, though the diagnosis is largely presumptive. Only the sickest children will we take back with us to one of the local hospitals, where the mother has a choice between paying for decent care at the local mission hospital, or having next-to-nothing for free at the state institution. Feedback and followup for those remaining in the village is done by local volunteers who organise the day, and represent each village in the clinic catchment. While the volunteers do not make formal reprts (some are illiterate) they do know each mother well, and keep close track of the children's progress.
In a way what the WMF does is limited - we do not do blood tests beyond basic Haemoglobin levels, nor scan or xray our patients, and have only a partly-closed feedback loop, but simple interventions and health advice delivered on a regular basis, with thte possibility of inpatient care in dire need, can only improve the prospects for these children and ultimately their communities.

Tomorrow I will do the same at a different village, and then attend the antiretroviral clinic for children with HIV.

the adventures of Xeman

2006-11-08T11:36:00.000-08:00

Please use magnifying glass.

time to go

2006-11-08T10:56:00.000-08:00

a confusing evening yesterday at the Bethnal Green Working Men's Club Art Quiz. the camelhair trenchcoated quizmaster(against the backdrop of a giant broken 'heart' of pink lightbulbs) drilled us with questions such as 'what artist am i thinking of?', 'name three of the seven easy pieces', and 'the films of ingmar bergman: mostly a) horse b) bird or c) muffin?' (it is, incidentally, bird), plus a few easy ones such as what the range of HMS Belfast's guns is, and what they are pointed at (we didin't know the answer, obviously, because unlike the other questions it had nothing to do with Art).

Roman Imperialist Country Club: rocked my flat on Sunday, competing with the storm of fireworks in the surrounding streets for attention from the neighbours, but benefitting from the dry ice-like haze lying all around for glamour. New track pretty much done - must find way to post the recording... i smell MySpace upwind. More later.

Malawi: I am going there on Friday, so help me, with the World Medical Fund. Should you, dear reader, wish to help support them please visit their website (once the server is up and running again!), where I believe you will find details about donation!
Go to!

The Roman Imperialist Country Club

2006-10-08T15:14:00.000-07:00

Well, maybe that's what we will be called. Today, Chris, Chris and I met up at Burbage House to play some music. The cellar was damp, the carpet on the wall green and musty, and the amps very loud. My guitar, dubbed 'the rig', starred: a few hacks with a hacksaw and the pickup fitted, it produced an awesome array of moans, jangles and crunching fuzz almost by itself. They each took a guitar, and ground out some licks while I pounded the skins, light of heart. We rocked for two solid hours, and I still can barely hear a thing. It was great.

party over

2006-09-25T07:09:00.000-07:00

The party was again a great success - lots of people along, (a number of guests by several degrees of separation), vast numbers of empty bottles and fagbutts the next day, and a good time had by all. In fact, there were no disasters. It seems there has always been an upset of sorts at each party so far: Mark passing out in the loo after slipping and banging his nose on the basin; Ulka vomiting on the Holy of Holies (my bed, leaving me feeling violated for some weeks); the phantom piss-bottler; Tom setting fire to himself by sitting too close to a candle (and me beating out the flames on his backside with a paper plate)... this time Pasco did crush all my tomato plants with a tumble, drenching himself in wine in the process, but this did not perturb me unduly.

So after getting to bed at about 4, feeling i'd got away with it this time, I slept well until, dreaming in the early hours, I thought that there was someone in my bed. I woke up and discovered that there was indeed a man - Richard fast asleep, squeezed into my single bed with a generous flap of duvet over him. He was snoring gently, but woke easily and crept back to his own bed with a sheepish grin.

joke

2006-09-22T12:09:00.000-07:00

excerpt

2006-09-15T08:14:00.000-07:00

And swooping down on a missal bound in violet velvet, with gilt clasps, from which, in her hast, she let escape a few of those pictures edged with a band of yellowing paper lace that mark the pages of the feast days, my aunt, while swallowing her drops, began reading the sacred texts as fast as she could, her comprehension of them slightly obscured by her uncertainty as to whether the pepsin, taken so long after the Vichy water, would still be able to catch up with it and make it go down. 'Three o'clock! It's unbelieavable how the time passes!'

A little tap against the wondow-pane, as though something had struck it, followed by a copious light spill, as of grains of sand dropping from a window above, then the spill extending, growing regular, finding a rhythm, turning fluid, resonant, musical, immeasurable, universal: it was the rain.

from 'Swann's Way' M Proust

sgjosjgn

2006-09-09T17:19:00.000-07:00

I had a thought. I hope DCW don't mind the bit of unsolicited promotion and reproduction of original yellow artwork on my blog (see earlier) which, given that it is not looked at by more than a handfull of irregulars, most of whom will know me with personal closeness and warmth (and know DCW with that and then some), is hardly going to help them break america. Still, should anyone notice, it is the action rather than the thinking that counts I hope so.

progress

2006-09-09T06:36:00.000-07:00

onwards and downwards

things

2006-09-05T09:05:00.000-07:00

Two days ago when running down by the canal, i was surprised by a wasp flying up my right nostril and stinging me there. I mention it because it still tingles.

Meanwhile, progress charted:

bandly needed

2006-09-03T17:09:00.000-07:00

DAVID CRONENBERG'S WIFE a great band learn more see them play

Vegetable, animal, mineral

2006-08-29T06:19:00.000-07:00

On behalf of JB...

Meanwhile, consider this aquatic marvel

and this expanding stone

trove

2006-08-25T18:49:00.000-07:00

A few weeks after a party we had a while ago, when I was trying to find my shoe polish in a cupboard under the sink, I noticed someone had stashed a bottle of Lucozade there. The seal was broken, but it was full to the brim. I unscrewed the cap only to be surprised by the powerful whiff of stale urine. Who did it, and why, I wondered. Was the queue for the loo too long? If not the loo, what other place did they find in our small and very much thronged flat to micturate in privacy? I was intrigued by the peculiarly respectful tidiness of this act (had their bladder really contained exactly 500ml of urine at that time? If there was an excess, where did it go?), and revolted by finding my cupboard polluted in this way... Did they do it in the kitchen, then stash it, or was it some uninvited (let's hope as much) guest who gets a kick from stowing ready-filled plastic bottles of urine in a stranger's cupboard?

revision

2006-08-21T16:55:00.000-07:00

Examinations loom. Books have acumulated to teetering point about me, threatening to blot out the sun, or at least any remaining tea mug space on the desk. Piles of files, and files of piles of bits of paper... scribbled notes on HLA typing for renal transplant, the differentials of hypoparathyroidism (pseudo and psuedopsuedo, if you were wondering), autoantibody associations of different unpleasant diseases etc etc etc etc etc. Comfort: tea; biscuits; running; guitar; TV (NOOO! turn it off!) and this picture of a once-beautiful woman

jon baines

2006-08-16T12:48:00.000-07:00

jesus waylays

2006-08-03T08:23:00.000-07:00

Last Sunday I was stopped on the street north of HydePark by an African lady, who asked me if i had a church pass. I said no, i didn't, and asked what she was alluding to. She pointed to a minivan behind me, with rainbow stripes and 'Army of Jesus' on the side. It made no sense at all.

rose tyler's mum

2006-07-19T03:05:00.000-07:00

rose tyler's mum, in clapham, with a selecta of other apparently blonde ladies who breakfast.

celebrity rash

2006-07-13T08:52:00.000-07:00

judi dench outside the national gallery, in a blue car

work, lovelife, and whatever tickles your fancy

2006-07-08T07:16:00.000-07:00

photoautomat

2006-07-06T16:00:00.000-07:00

black and white photos, a sequence like in Superman or RomCom love image medleys

electronic window gizmo

2006-07-06T15:54:00.000-07:00

Oliver in Berlin - Orianebergerstrasse i think.

celebrity spots

2006-06-25T12:34:00.000-07:00

The young blue-eyed Scottish woman who plays some sort of counsellor in Green Wing, with dog, outside an Organic food shop.

catherine ellis!

2006-06-25T05:01:00.000-07:00

Catherine Ellis.

celebrity spot

2006-06-13T15:57:00.000-07:00

so far...

the Preacher from Nathan Barley
the frizzy sometime presenter of Popworld
the blonde one in the Magdelen Sisters and Shameless
some geezer from a home/garden programme
a bearded fellow who i saw on a BBC4 documentary about the history of the war film in Britain and the USA, who smiled at me vaguely

(chorus)
that's five
five alive
imagine, the surprise
brought tears of excitement to my eyes
and cries
of joy to my larynx,
tongue, palate and lips

sweaty pit

2006-06-11T15:43:00.000-07:00

On my way home through the balmy evening, I popped in to see the Anti-Folk gig organised by Tom Maine, of David Cronenberg's Wife's renown (see link). Sadly I had missed DCW, but caught Paul Hawkins and the Awkward Silences, and liked them very much indeed. I won't explain why. Worth mentioning though was the great t-shirt, the electric saw, and the shirts-off climax in the final number, where the great t-shirt, flung in rock and roll abandon narrowly missed a jigging slender girl right at the front of the crowd of twenty-five people. It remained on the floor for the closing bars and applause, but was whisked up into the arms of another excited young lady seconds before i could reach it. I hope he got it back. I met George South again after many months and that was good. I met his wife Nadia (which i believe means 'healer' in another language) and that was good. I met Tom and though good it didn't work, because our conversation seemed to coincide unfortunately with only the very loudest parts of the songs being played (something about wrestling?), and he was in demand, so I became nervous and blurted out ill-planned questions, as you do with people in demand: 'So, do you come here often?', 'Do you know the people in the bands?', 'How old are you now?'. That sort of thing.

jesus changes

2006-05-29T08:35:00.000-07:00

On the tube there was a poster advertising a musical, named 'Christ, Jesus!' or something the like. It had a picture of a jesusy type (long hair, beard, blue eyes, moderately athletic chest, robes) running along in a state of elation, in a green spot. Across the picture it boldy stated 'It change my life' under which was in smaller text 'Name Witheld'.

controversy over ID cards

2006-04-29T17:52:00.000-07:00

Oh never mind.

Who am eye? Booo! to the ID card proposals...

2006-03-20T11:02:00.000-08:00

ID cards as proposed by the current govrnment are a bad idea for the following reasons (among others)

1. The government proposes ID cards should be mandatory for those applying for passports. This is sold to us as voluntary because passports are not compulsory. Driving licences are also not compulsory, but they are very necessary. So why not demand that we are ID'd when get a driving licence, instead? Because people wouldn't stomach a £80 windfall on your driving licence, and would start to question why the hell we need ID cards in the first place. Compulsion by stealth indeed...

2. Giving every British citizen an ID card cannot really be expected to reveal to us the number of illegal immigrants in the country. I have seen Venn diagrams. Clearly someone in goverment has not.

3. Including data on an ID card that cannot be read or accessed or challenged by the carrier, is an infringement of privacy and liberty. Will we be able to control who this information is shared with, or indeed challenge what kind of information is recorded?

4. One argument i have heard in favour of the proposed ID cards is that a huge amount of data about us is held by all sorts of organisations already (e.g. credit rating, marketing data), so what is the problem with a little more? Well, to me it seems that that data is already too much, and already affects the opportunities and choices we have - more in this case is not necessarily better (think of insurance companies wanting to get their hands on medical details).

5. The records kept by insurance and marketing companies does affect our economic opportunities and choice, but it does not as far as I know, affect our criminal status. At present the police have the right to collect and permanently keep DNA (which is human tissue) from any individual arrested, even if not charged, without appeal. This means that a national DNA database of the 'bad' is growing under our noses. What pretext is the minimum for arresting a person and taking their tissue for databasing? In what way can an arrest without charge be used as evidence in a later court case? Is the mere suggestion that you might have once made a separate transgression enough to stand as evidence in a court, or sufficient to bring a case to trial? Surely this would normally be inadmissable - so why collect the DNA? It smacks somewhat of the mediaeval French justice system (see Ch2, discipline and punish, by foucault), or the inmates of guantanamo bay. Maybe not directly connected to ID cards you might counter - but what is the relevance of that DNA if it is not ultimately for some sort of policing purpose?

6. Why on earth do they want to do this? It will be very expensive, quite possibly not as reliable as hoped and the benefits are unclear.

SO, to make ID cards acceptable.. what do we need? I think compulsory might be ok, PROVIDED:
-that all data carried be accessible and challengeable by the owner via an easily accessible and transparent appeal process
-that the ID cards and database are extrememly secure. I don't want every employer I work for to be informed of my syphilis, alcohol problem or political persuasions..!
-that they contain NO records of any past criminal/antisocial behaviour (that is a police, and separate matter from identity)
-they contain NO data about travel or employment/national insurance etc - again these are matters entirely separate from identity
-any medical details are put there at the owner's discretion

It seems that the goverment really wants the ID card so that they can in fact have all the above!
If it were simply a matte of identity I might not be so disconcerted...

If I have made any errors of fact, or grievous conundrums of argument, please do comment and let me know.

progress

2006-03-15T15:32:00.000-08:00

It has ben a while since blogging. Now the excitement (yes, excitement) of being a doctor is finally wearing off, and the weirdness of it all is fading into normalcy (yes, normalcy) I am instead being harangued by pre-Spring (and quite possibly pre-christian) urges, such as running away to somewhere hot, or jumping up and down for hours and hours, brain full of cocktails of disturbing substances that will make it all seem a bit further away at least. I got some shades, and a scarf. God bless 2006.

I suppose one should put up thoughts of note, or quotes, or instructions for dancing, or Tuvan throat singing ( i think I managed somehting of a poor semblance of the latter in the loo the other day. Quite hypnotic, until wrested from reverie by flatmate thumping on door asking if I was all right) or other diversions. Speaking of which my new acting training is going swimmingly. I can recite 14 lines of Shakespeare now with almost no hesitation and some intonation to boot. Next week: 32 lines.

NB suggestions for auditions monologues (no Vaginas) welcome.

Eastern ends

2005-12-06T12:53:00.000-08:00

Ah, december and the comfort of kitsch, this time of the year. The purveyors of fine Christmas commercialism seem to have been unusually restrained this Autumn, which could be variously interpreted as gloomy economic outlook, or perhaps a cheering little resurgence of good taste. I now resent the missing barrage of Xmas adverts as, memory unjogged, I have failed to get any presents yet. The usual poverty of ideas for gifts too: CD for brother (perhaps an upgrade to household electronics this year, as he is now betrothed to the one with whom he lives); scarf/book for mum, and god-knows-what for dad. Then friends (bottles of booze I think, possibly something sophisticated, Blue Nun perhaps), flatmates (chocolate/cheese) and of course my (ex) girlfriend, Annabel. Five years... I would like to give her something beautiful. No surprises then folks (not that any of you read this damn thing).

My adventuring friends Ed and Flora have returned from Afghanistan, at last, though perhaps before they were ready to. He seemed well when I shared a dinner with him and Daniel, though a little pensive at times - a lot to take on upon returning home I expect. Strangely though, it renders this lacklustre monologue a bit functionless: in some way it was meant to be a reply to his blog, and now he is back it seems a bit daft to carry on when he is on the end of a telephone (mobile). Still, they are soon to go back to Itlay, to live for a time (that's the way to live life i think - spring in Florence will probably be nicer than in Tooting), so perhaps there is hope.

Post-parting

2005-11-04T11:54:00.000-08:00

Earl's court, Friday night. The air is crisp and with an autumnal bite. Just in time for bonfires really as up to now it has been a bit humid, and not very mellow fruitfulness etc. I am about to meet up with old chums for a hard session of karaoke and cola-pop.

My lady love has parted to foreign lands for a long stint, and so too have we parted. A split because after five years we have to spend yet more apart, and we weren't ready to tie the knot... So we are apart, in order to grow as people, find our true inner selves and so on, possibly each other again sometime in the future. Well, here's hoping.

What news besides? No further musings on street speak of the 'younger generation' i'm afraid readers, henceforth I shall leave that in the trusty hands of Daily Mail columnists, god love 'em. Instead I am occupied by trying to sort m life out and get a job, as well as do a job - some to show for all this.

wag the finger

2005-10-19T20:10:00.000-07:00

the finger wags

2005-10-04T19:13:00.000-07:00

Back from Suffolk. A quiet weekend it was. I admired my mother's new garden. I cooked. Played the drums a lot (ok not so quiet) and went for a nice long walk, managing to get lost in the gloaming in a territory i know so well. I ran for abit, across some meadows, and came to stop under an oak tree. My feet were soaking, but it was quite warm. Owls hooted, and cows made ghastly moans and coughs a few fields away. A vixen screamed. I felt rather at peace, although a little lonely.

Cumbria, land of the sausage

2005-09-27T13:32:00.000-07:00

There was an Archdeacon who said:
'May I take off my gaiters in bed?'
But the Bishop said: 'No
Wherever you go
You must wear them until you are dead.'

Gaiter country, here in the Lake District, by which I do mean leg protectors not crocodilians. My love and I have been striding across fell and vale, beaten by winds and confounded by teh odd slippery rock, squelching over boggy peat and sheepshit. Very invigorating, rewarded with large plates of delicious simple food and ugs of steaming hot chocolate. I think we used the word 'lovely' in excess of one thousand times, to describe just about everything. Scafell Pike is not lovely, it is rather awesome in its jagged uncompromising mass poking up into the sky. It may be a mere one thousand metres in height but having clambered all the way up it it felt like a great deal more - the unobstructed vistas afforded from the top gave a sense of scraping the sky, as we were bathed in blinding sunshine and shoved by a bitter gale. I would have considered ourselves intrepid were it not for the thick streams of tourists of all ages (plus their dogs) covering the mountainsides. Some were magnificently equipped, clad in stiff jerkins of bright orange fabric, sturdy boots, telescopic walking sticks in each hand, tubes running to their mouths from space-age backpacks (presumably providing blackcurrant squash, or tea, rather than oxygen) eyes shielded from the near stratospheric glare by aerodynamic-looking shades. A few others though seemed to manage it in trainers, shorts, fleece and a sunhat.

dog dog dog dog dog

2005-09-18T05:43:00.000-07:00

it's not a dog

rant

2005-09-14T21:17:00.000-07:00

I was watching Doctor At Large today and enjoying it more than perhaps I rightfully should. I relished the joke about 'big breaths' for a chesty (and lispy) teenager, the pictures of musclemen stuck the the wall of the lonely houseofficers bedroom, his partner's lusty wife and much canoodling with blonde nurse who does so with anyone really, as long as there's a slap-up tea in it for her. I also relished Dirk, and his odd similarity to Cliff Richard - that quiff. Then i went for a steady jog around the Georgian streets of fair Islington and strained something in my leg. Then I ate a sandwich, and did some basic bodily functions. Throughout I respired, puolsated and began to chime to the sweet melodies that ride undulating beneath my pancreas, swelling up like a cactus in the rain whenever I sleep, or watch Newsround.

I shan't mention the war. It isn't a war though is it, just a bloody occupation, a semi-suppressed civil war perhaps. My personal loathing for GWB is unabated. It still beats me every time i see his obtuse little face on television, jerking about as bits of words fall out of his mouth in random order. You can see his speech writers mentally scooping the ejected syllables from his bib with a plastic spoon and shoving them back in again. Sadly though, he will never eat his words, even when the whole planet is flooded ('we were not prepared'), there is no food anywhere (despite free trade), no oil (even in nature reserves) and no forests (dug up to find oil). I know Bush bashing is pointless, unimaginative, shifting responsibility, oversimplifying etc, and sour grapes that social liberalism and economic conservatism seem to be failing (so in fact is social conservatism but either one will do if you have your head in the sand), but i can't stand him. So there.

Intensive care.

2005-09-03T16:54:00.000-07:00

Everyone is asleep, except me and the nurses. Night shifts like these I have not known before, where I am not bleeped more than perhaps once a night, and I may even sleep too, in a bed made up for me in my own private room (smells a bit funny) with ensuite toilet facilities (though no mini soap in pink paper wrapper, or paper folded pointlessly into a point). And there I lie, dreaming about noradrenaline, positive-end-expiratory-pressures, chest pathology and naked ladies all in a jumble, only to emerge blearily into a brand new day refreshed (and probably smelling a bit funny), to stagger home via the bus and two or possibly three train journeys to my home where the light beams brightly in all day long.

One of my patients, a septuagenerian in after a large bowel op, is lying on his back arms held up in front of him, as though boasting of a perch of mythical proportions, or trying to bunch subjects up for a group photo. Occasionally he shouts, or waves his pale legs dangerously towards the edge of the bed, and we rush forward by turns to stop him pulling the oxygen mask off, or an arterial line out.
A lot of my patients never leave the unit. This is particularly distressing when someone who you initially had a conversation with slides inexorably into being a body with a cluster of increasingly intractable problems and another cluster of concerned and multiplying relatives surrounding it. Rocks and a hrad places, vicious circles, catch22s in abundance.

Tomorrow I'm going to lie in a park with my lady love, fail to revise for my exams, stick two mental fingers up at any sort of procrastination guilt, and languish shamelessly in a seam of utter dissolution and torpor.

By the way as I no longer live in the East of London i suppose I am writing under false pretences. However i'll keep the name for this blog as i may at least waylay those in search of the Wisdom of the East. Well the only nuggets I can offer are as follws:
1) peel or boil all fruit or vegetables
2) Nag Champa is the finest of Indian incenses
3) Herman Hesse

foot orgasms

2005-07-07T21:24:00.000-07:00

Tonight - well, not tonight but many nights ago - as I prepared to stitch up a young woman's foot, the patients surrounding us gradually left and with them the hubbub that masked the radio's burble in the corner of the treatment room. As the broadcast voices became intelligible, with some interest I realised a therapist was telling us all about our orgasms. Her rahter matronly tones clanging through the subject in an orderly fashion meant it was somehow hard to ignore. Being in sterile gloves I could not fiddle with the radio, so I just pretended not to be listening. I learned about good techniques for fellatio, the fallacies and elusions of the vaginal orgasm, erectile dysfunction, and so on. When my patient began to giggle I did get up and jogged the radio onto another station with my elbow - only to hit a vein carrying Barry White's dulcet tones. Furhter jogging didn't get me anywhere, and I went back over to the patient, holding my bloodied hands out at a sterile length in front of me. I caught her eye, and she held my gaze for a second, looking severe. 'What?' i asked, becoming aware we were all alone. 'You're not going to knock me out are you?'.

there is love in this muddy ground

2005-06-28T05:31:00.000-07:00

Glastonbury festival over with, I am now unsure what direction life is going to take. Feel a little thwarted by the deluge and ensing quagmire that made the prospect of trekking miles to see the Dimwits (or somebody else you'd never heard of but have an intriguing name) somewhat unappealing. As the Glastonbury Daily put it: "Thanks, God". However the chagrin of being rooted to the spot if you stayed still for more than a couple of minutes, of having to queue for hours to get wellies, and being jostled, hectored, and becoming one of the Great Unwashed somehow transformed itself into a gloriously liberating experience, and back in my East london suburb, I miss it terribly. After all, what could be better than three days with your mates with no cooking/washing/washing up, loads of booze, fantastic music, and the slim chance of a bit of sunshine?

Anyway, my thanks to all who I was there with - it was great. Roll on the next one (in two years, more's the pity).

Summer love

2005-06-05T21:43:00.000-07:00

Hello fans.

Are you walking daily by your Saviour's side?
Are you washed in the blood of the lamb?
When you rise each morning are you crucified?
Are you washed in the blood of the lamb?

So it is summer, and just you feel that urge once again to learn of my fascinating perspective on the world. Just got back from Italy where I saw Florence, and my friends Ed and Flora wed (the ones from Afghanistan) in the most ridiculously lovely setting of an abbey in the Tuscan hills. My powers of description rather fail me, at my delight in seeing these two rather wonderful people wed, meeting again all Ed's very likeable friends who he had introduced me to over the years in his usual way of somehow gettin people all together and enjoying themselves. What a knees up afterwards it was too, where I met relatives and more friends and danced into the wee small hours of the balmy night. We were required to sing some songs, to the immense delight of all, though I was shaking and had the most tremendous come-down for about 10 minutes afterwards. Shambling through life as I do you see I cannot cope with the sudden high. For those who enjoy adrenaline performing must be a jolly good fix. My girlfriend looked beautiful too on that day. As I looked about me at the families gathered there in their various generations, my contemporaries (who have rather suddenly, at pipping the quarter century, stopped being representative of youth and that lusty unknowing hope for the future that we can have or even be in salad days), I was filled with a very suitable sense of the passing of time, of a time, and therefore of actually being alive. Probably something todo with the appraoch of death and all that.

So, are you washed inthe blood of the lamb? Beware sinners, beware!

morning

2005-04-01T00:23:00.000-08:00

In mourning, actually, for evenings. Night shifts again, and a with all reular events in ou life, take mebackto the last set of small ambitions dreamt up and subsequently unrealised.

There is apark nearby, a romantic place i thought, as i rounded the lake in the dusk, past couples lovingly enticeing hteir toddlers to toddle, panting dogs straining at leads (or in the midle of the path, whie their owners unembarrasedly look away), and watchd thegeese swoop across the sunset to ski in to rest on the rippling waters. Then again, they fish abody out of said pond every few months, so it can't inspire all with a sense of inner peace and love for their fellow man.

It's abit like King's Lynn round here, except the haircuts are better on the whole. Gem of the imagination of 'Snips' of KL was a two-tone barnet: a feather cut with th top half bleached yellow and the bottom half dyed dark brown. When sitting in a room full of KL belles it hadthe effect of being surrounded by pints of stout.

This evening as I applied traction to a broken ankle, it's owner solicited me, as the provebial son of incestuous union to pull it really hard, yeah, really fu**king hard. He then described himself as a *unt, thanked me and my assistant as gentlemen, and went to sleep.

Spring

2005-03-23T04:19:00.000-08:00

Spring is in the air, in the earth, in the rain and IN MY SOUL. Nothing a bit of sunshine and a nrw pair trainers can't do to lift the spirit. Plant those tomatoes, watch them daffodils and crocuses sprout; remeber to keep your garlic in the dark.

Turkish delight

2005-03-02T10:57:00.000-08:00

At last, something eastern. Today I joined the ranks of genteel londoners with nothing better to do weekdays and went to see TURKS at the Royal Academy. It seemed to go on forever, and after two hours and ten rooms and jostling for position my brain was fairly addled with peony scrolls and jewel encrustations, all whirling about in precise geometries of astonishing workmanship. Some of it beggared belief that it could be made by human fingers - I can see why people get excited by Ming vases now too. Underlying it all was the glory of erudition, exultation of faith and the malevolent interests of power, all equating to the sort of wealth that I think no amount of American dollars could buy in our modern world. Feeling woefully clumsy and ignorant afterwards, I nonetheless was inspired to whip my compasses out and start trying to mimic some of what I had seen immediately. Fortunately a slice of genteelly-priced carot cake and a pot of Tea soothed my ardour so instead my energies have been directed towards writing this for the eager eyes of you, lucky reader.

I adore central london for all the treasures it offers, and that it enables me to avoid spending any time in East london. It is however, as we all know, an essentially lonely place. How shall I connect with my new homeland? How does one find a community in a new place which doesn't really seem to have one anyway? I think escape is on my mind. The immediate urge is to bugger off somewhere exotic: Budapest, Helsinki, Andalucia... what about Swansea, or Wolverhampton? Perhaps a sleety bicycle tour to Stonehenge? Probably a bit far...

Tuesday

2005-03-01T09:02:00.000-08:00

Tuesday, a spledid, magnificent day, wondrous blessed and wholesome - oh, Tuesday, you send me. Though I wish the clouds would part but for a few minutes.

I smell terrible. More specifically, I have to cloying odour of an ashtray about my person, owing to a sleep last night on the floor of a friend who lives in Chiswick. The friend, his girlfriend, his flatmate all smoke, and so did I, and gloried naughtily in it. Yum yum. We watched 'Spaced' and it was ever so funny. I particularly like things that make me laugh. This morning upon wiping the mist from the mirror after a long and vacillating shower I could not help noticing the facial hair was a bit long. Perhaps it is time for a handlebar moustache. And some horn-rimmed glasses. Sadly the nose is small and not comic, but I may yet raise a smile.
Chiswick is a charming corner of London it has to be said. The charity shops take the biscuit. I needed a new tie for wrok, and actually had difficulty to find one that wasn't beautiful. Will be looking spruce now.

I must to work, editing a chapter of a book for another friend who is writing one. I am quite impressed. Not only is she actually writing a book but I enjoy reading it. A little envious too: have we all not considered creating a literary work? Would we all not feel in some way our lives more fulfilled, justified, complete with 400 pages of wit/history/passion/adventure/philosophy (etc) with our name on the spine. No-one has to read it do they? I've had my leaning to writing a bodice-ripper for a while now. Kidnap in the desert, lonely castles, galoping about, shots in teh dark, bronzed thighs and heaving bosoms.

Again I wander off the topic: life in East London. Everyone looks much the same I am relieved to say, the weatehr is awful and I think I may have to start paying coucil tax. There are consolations I expect.

Friday 25th February

2005-02-25T05:33:00.000-08:00

Never one to let an ethereal fad pass by, I thought this Friday would be a good day to launch my stream of consciusness and spelling frailties onto the uninterested world. Inspired by friend Ed, out in the widths of Central Asia who is as I write treading the dusty alleyways of Kabul, sleeping under the stars and smoking hookahs with fierce bandit types, I thought my own exotic narrative - a unique perspective on life in teh outer reaches of East London could not really go unrelated.

So as I woke up this morning at the unholy hour of 5, cursing the treacheries of my hypothalamus after a week of night shifts, my mind's eye anticipated the journey through the suburban sterrts to Tesco. Inwardly I graoned but the thought of a flaky croissant spurred me on. Soon I was out, wrapped tight against the grey air with its soggy snowflakes, vigilant for partially frozen dog shit concealed under "Chomp" wrappers and other litter along my way. The woman infront of me in the checkout bought six bottles of Soave, some cheap vodka (Tesco sadly seem no longer to do their range of cheap booze, labelled VODKA, and GIN etc in honest black letters on a plain white label), two bunches of crysanthemums, and a litre of milk that's suppoesd to lower your cholesterol levels. This depressed me, but i was soon cheered up by a read of the Daily Mail, in particular the story of the citizens of some Cornwall village who have recemtly become propagators of racial hatred in the annual celebration of 'Darkie Day', which seemed to inolve dressing up in breeches and white shirts, bashing and wheezing traditional british instrumnets in a bucolic sort of parade, with of course their faces painted black. Most amusing was the way in which, having had their pleas for a police presence at the festival ignored for years on account of the low crime rate, this year four riot-vanloads of earnest young anti-racialist police were sent in to monitor what was now a festival of crime, with musical accompaniment. Fortunately the situation did not get out of hand, and there were no incidents of policemen truncheoning innocent black people at the festival. But I digress, as that is way out West and here in the East life coniues waxing exotic. Later today Iwill go further afield than my local high street and attempt to find something for my girlfrient to sleep on tonght.
Next week: what is not happening in my village.