How was your trip to work today?


0_0_0_0_519_390_csupload_50338231On the “Good Hope” with John of the Lake

One hundred miles North of Mzuzu, the “M1 highway” (at its best more like a welsh B road on a bad day) snakes out of the mountains down to lake Malawi.  You take your life in your hands on this road, especially so since uranium was discovered near here and is sold to the Chinese.  Each day giant tanks of sulphuric acid are moved up this pothole-riven road from Namibia. Apparently an essential part of the Uranium extraction process. Every few miles you see a burnt out car or lorry that has failed to make the entire trip and simply fallen of the side of the road.

Lake Malawi is a huge lake over a 1000ft deep in places in the middle of the African rift valley.  The lake is 365 miles long and 52 miles wide.  To give you an idea of scale, you could probably fit the English Channel into it.  On many sections of the lake, the mountains drop straight into the sea and it is not possible to build any kind of a road along the lakeside.


The lake is currently the subject of a territorial dispute between Tanzania as oil prospecting is about to begin.  Many people living near the lake expressed concern to me that Tanzania might invade and wanted to know what Britain would do.  They did not seem pleased when I suggested that Britain would probably sit on the fence with this one.  The ramifications of boundaries set by the colonial powers England and German live on.  In those days, we were talking Nyasaland and German East Africa.

This remote area of lakeside is home to small fishing communities.  Life has changed little for them in 1000s of years.  It is only comparatively recently that plastic goods from china and cheap cathode ray tube portable televisions have made any kind of an impact.

Mosquito nets are provided free to expectant families and those with children under five here.  Now I bet when you texted “Nets” to send £3, to the Tony Blair Faith Foundation or Oxfam to provide netsyou, thought you were saving folk from Malaria. Right and wrong! Here by the lake some of them have become the first choice for fishing!  I saw many hanging out to dry ready for the next trip (the green ones).

Many western notions are challenged here.  For example, people seem to have to make a choice between subsistence fishing and malaria protection.  Children of around seven years old go to school in the morning and then out on the canoes to fish in the afternoon.  When does this become child labour?  Fishing in a log canoe with dad?  Helping on mum’s maize plot?  Helping on a tobacco farm?  Earning a few kwacha making football shirts?  The papers suggest that 1700000 people will need food aid here later this year.  Middle class moral choices often carry a price tag beyond those living at the subsistence level.

People rise early here, so I am up at 5am to see the sun rise over the lake and then an early breakfast before testing the Audi on yet another untarred road to reach a small fishing village Mlowe.  Home to the David Gordon Memorial Hospital Ambulance boat.  I am invited into the home of one of the fishing families while the boat is made ready for our trip.  As you can see, people live simple lives here, but are amazingly welcoming.

We are due to travel on “The Good Hope” is one of the latest fine examples of Scottish Boat building.  Back in 1970, 40% of the worlds shipping was built on the Clyde.  Now Scotland has a niche role in the global market.  The Good Hope is an innovative boat with an aluminum hull filled with foam for buoyancy and is self bailing.  It has a drop down door at the front to aid landing in remote areas.  It travelled from Scotland by container to replace the previous ambulance an old lifeboat.


A Scottish Charity called the Raven Trust paid for the Good Hope.  A pugnacious individual called John Challis, a former mariner, runs the Charity.  He now spends three months a year here, coordinating and distributing containers of supplies from the UK (hospital blankets, school books etc).  He is the proud patron of “Challis Dodgy Tours” which brings dentists, doctors and eye specialists from the UK to support the hospitals through short field visits.  John has also encouraged engineers from the UK who with local labour have helped to improve some of the roads to the hospitals.  John is full of stories such as the day the baboons watched women cooking Sima waiting for it to be cooked before deciding to stone them and steal it.

Here John is measuring the Jetty at Mlowe, which he built 8 years ago.  Storms have damaged it and we discuss plans for a longer and stronger one.  He has an engineer friend coming out in a few weeks to help local labour start building the new jetty.

Today we are travelling to Tcharro Clinic, the wind is up and our departure is delayed whilst we relocated to a safer embarkation point.  A force 4 wind does not seem a lot but its enough to make you feel a bit green in this boat. Our party comprises, two UK dentists researching dental needs with a view to extending services here. Two UK teachers delivering books and learning materials to a remote school.

Tcharro was an 8-hour walk up and down hills from the nearest road at Mlowe.  The Good Hope can do the journey in 2¼ hours.  It is an improvement from about 100 years ago when the first missionary doctors visited the remote lakeside community by wooden canoe.  I got to try out one of the wooden Canoes during my lunch break.  The locals must be made of strong stuff and slightly smaller as I struggled to fit in the canoe, which could be offered at a health clinic as a radical exfoliating experience.  The lake was fun to swim in though, incredibly warm.

It is difficult to explain just how remote the clinic is.  There is no mobile phone signal here and people keep in touch with the outside world using short wave radios.  As you can see at month end, drugs are in short supplies and people living around here have access to only the most basic facilities.  My purpose in visiting was to consider how Primary Health Care could better fit into the Health Strategy I have under development.

So often the needs are not strategic but very very practical, for example, the one working autoclave at the hospital was not pressurizing correctly so the maximum temperature was around 100C in 130C, using it at 100C creates a nice culture ground for some bacteria so it would probably be better not to use it all.  In the end, we decide to ship it back to the main hospital and get it repaired and tested.  We also found the water pump not working and a solar lighting system paid for by the Japenese not working.  Kit is often supplied from the first world without thought of how it will be maintained in a resource poor underskilled environment.

Here you are constantly reminded of how fragile life is.  As we leave a woman in her, 20s lies face down on the beach in mourning and wailing at the top of her voice.  Her brother died the night before in a road accident and she is about to face a long journey by bus to the funeral in Johannesburg a1800 miles away.  Her friends sit close by to offer comfort and support.  We offer a lift back to Mlowe saving an 8-hour walk.  Of course, others wanted a lift back too.

The boat was soon loaded with people and sacks of small fish, similar to white bate called Lasepia.  The occasional head poked out of the sack to remind you of their rotting presence.  I had tried some the night before and would need to be near to starvation to try them again.

A young man sat next to me on the return journey.  He was taking some buckets to the next village to sell.  He had purchased ten buckets at MK800 (£1.77 each) and would be selling them at MK1000 (£2.22).  In effect £4.50 profit for two days work.  John and myself tried several times to explain he needed to put the price up.  The effect of the currency devaluation means that when he comes to restock his buckets he will have to pay about MK1200, more than wiping out his profit on this trip.

We arrive back in Mlowe as sun was setting for the three hour drive home along unlit mountain roads. This was probably the most amazing and unusual trip to the office of my entire working life.

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