Gav, Em and Joshi play travel ping pong

 

Hello there everyone

Apologies, yet again I have failed at my monthly target to update this blog, so I am now sitting in an airport transit lounge in Nairobi en route from Tanzania finally finding time to write an update for both August and September. Life just does not seem to stop at the moment for us.

In the last blog, the end of July represented the end of clinical work for us in Malawi to enable us both to focus on our research and writing for the remainder of our time here. We have both felt a huge sense of relief, as for both of us juggling effectively two jobs each for 2-3 years, one clinical and one research/study has been pretty stressful and draining. The last 3 years of clinical work have been very interesting and we have both learnt so much medicine since arriving here in 2010, it is good to take a breather. On our to do list before we leave is a budget camping safari around Zimbabwe and Zambia, so to test our toddler camping skills (us, not Joshi) we went to Majete for the night with our tent. Overall we had a lovely time, although we made several basic errors including not putting up a divide between Joshi and ourselves, so when he woke up in the night instead of cuddling his ellie and going back to sleep, he wanted to play and chat. But we were able to get up for a dawn safari in majete, eat croissants overlooking the waterhole and then come back to the campsite for as swim, it made up for the sleep deprivation.

Sundowners at our tent on the banks of the Shire

 

camping is cool mummy

Shire river in the early morning

Battleur eagles chatting

Tasty snack for a male Nyala

Croc and hippo watching with Daddy

Proper bush sunset

But our big roadtrip plan has been slightly altered by the wonderful news that Nick and Helena will be getting married on the 21^st of December, so we hope to manage some but not all of the trip. The wedding is to be in Dulwich picture gallery, a fabulous location in South London and I can’t wait……being away means I will miss the hen and the dress shopping, but being there for the big day will be amazing.

Champagne wave - so happy to celebrate the big news in person

Helena and Nick told us their news over dinner while we were in London on a mad 12 night trip where we attempted to see many of the people we miss so much, plus get work done, plus help our families with ongoing issues that are much easier to talk about face to face than on the phone on a dodgy connection. We spent 2 nights at my parents cottage in Kent, Joshi and Mum loved rushing around seeing the cows and playing in pub gardens, and we enjoyed all the culinary delights of the region – so much so we each gained 2kg in 2 weeks – eek. We saw lots of friends and family at the traditional Dreyer BBQ for which we were blessed with wonderful sunshine, and overall the sight of London in the summer ensured that we think it will look the same in Feb…………..we hope J

 

Mr and Mrs Traub with Mr and Mrs Dreyer

games with Grandpa

Granny pggyback

With Jo, Alex, Oscar and baby Rafa, the day before he was born

posh lunch with Alec

South Bank playtime in the sunshine

Lovely Leo

Hiking in the Kent marshes

the boy who loves to be outdoors, anywhere

lets slide like worms mummy

amazing pub garden for lunch - England at its finest in the sunshine

I managed to get to Liverpool for work for one night, and saw Rob and Jules with their lovely family of now 3 children. The last year has been tough for them as their new son has had some health issues, it was lovely to see him growing and playing with his sisters.

Handsome Mr H

Gorgeous girls

When we zoomed home to Malawi we went straight off to the lake for the MLW annual scientific meeting, our feet hardly touching Blantyre en route. I did manage to make it to my study nurse Madalitso's wedding before the meeting, an eye-opening experience into Malawian culture and etiquette. I turned up to the church only to find her family there and none of my colleagues, then made it to the reception where we gave our gifts and danced around throwing money at the bride and groom to music. I lost my work friends and thought I was being rude for leaving after emptying my wallet and lasting 2 hours, they told me afterwards they stayed 10 minutes and that is allowed! SO different to an English wedding. I am so happy for Mada, she looked gorgeous and really enjoyed her day.

Bride and groom with family

My study nurses Gloria, Vero and Lucy with friends bring gifts

 This year’s MLW annual meeting was the most enjoyable of the 4 that I have attended. All the talks were great, as was the pool-side socializing for us and for Joshi – who spent 4 days hanging out with most of his BT mates, dancing at the disco, having dinner on the beach and swimming in the pool. I gave a talk about some work I have been doing for my PhD that went down well, and the most work was done at the pool-side bar at the end of the day, the best place to have a meeting with a supervisor.

Hard working PIs at the pool

sunset football at Club Mak with Daddy

Kid's beach picnic with Sam, Yona, Amos and others

boogie on down at the Kid's disco

 

Nearly all the Liverpool Wellcome Trust Tropical Centre clinical PhD fellows 2013, plus Professors David and Rob, centre managers Kate and James, and MLW manager Danielle

Sadly just after getting back we had the news that the indefatigable Granny Min had passed away in Joburg at the amazing age of 102 years, and we were lucky that Gav’s contacts in SAA in Blantyre let him use his airmiles to get the last seat on the plane to Joburg with 24 hours notice to get to the funeral. I know it meant so much to everyone that he and Mike both made the trip, Joshi and I were so sad not to go too, but we managed a daily skype to everyone who made it to the funeral. She was a wonderful woman and will be sadly missed.

Four generations of Dreyers in March 2013. We will all miss you Min

 

While Gav was away I co-hosted our first bbq of the season with our friends Maaike and Walter with the help of their daughter, Joshi’s mate Noor.  All the kids loved the games and food and most of the adults relaxed with drinks on the khondi. We were especially happy to welcome baby Ruby, Jo and Dave’s new daughter and a perfect little angel along with her sister Lola who is mates with Joshi. After first meeting Ruby, Joshi asked me ‘can I have a baby sister please’ J



Jo and Ruby aged 5 weeks

Joshi is back at nursery for the new term, and is acquiring new skills every day, our favourite is his spontaneous imaginary games and chat, and we have been celebrated leaving day time nappies behind. He is so articulate and chatty, when I told him in London he was full of beans, he replied ‘no mummy, I am full of carrots’ J. His obsession with cars, tractors, trucks and motorbikes continues unabated, we could hardly move in London for him wanting to stop and watch another vehicle. I loved seeing him play with my friends children in London and it is so good to know we are going home to friends with toddlers the same age who will help him settle in to UK life.

On Clapham Common with Max, Issie and Holly

Train driving with Issie and Max

 

Body painting (started off as finger painting, ended in the paddling pool)

Joshi and Lola at La Caverna

Feeding the school camel with Lola and Ruby

the best bit about making chocolate brownies

Karen's birthday in Majete

temperature in the shade in Majete

Joshi and Pemphero

Joshi and Pemphero with Annie and Mummy

Gav and I passed each other in Chileka as he came back from Joburg and I went off to Tanzania to teach for a week, the fourth year we have been teaching on the East African Diploma of Tropical Medicine, a great experience as always. The course this year has 70 students, 70% pay a full fee and 30% are subsidized doctors from the E.African region and this year there was a fantastic vibe on the course and teaching isn’t too difficult when you have enthusiastic motivated students, good organization, teaching with Joe and Jamie – mates from UK ID training, and cold beers overlooking Kilimanjaro every evening.

 

David Mabey and Hilton Whittle do an impromptu signing of the best seller 'Principles of Medicine in Africa' (co-author Dr G Dreyer) with a view of Kili in the background

The fridge in the tutors house  - not much room for food

Amazing dancing students even on Sunday with a hangover

Professors to be wave their inappropriate prizes for winning the tug of war, Joe Jarvis and Jamie Whitehorn

EADTM&H tutors Moshi 2013

The best view for a cold beer at the end of a busy day in a hot hospital

and a dip in the pool with a view.....

Next trip for Gav is to teach on the same course in Uganda in October and for me to London in November for a meningitis meeting, so hope to see some of you then, if not in December for the wedding, or even in Feb when we make it back home for good. A few more blogs to go until then.

Lots of love to all

Emma, Gavin and Joshi J

Mozambiquan paradise and Mulanje magnificence

I have just read back through the last few months of this blog, it seems a bit like  all we do is go on holiday and have fun. That is not strictly true, we do work very hard in a hospital full of desperately poor and sick people, pushing hard against a system that is constantly under-resourced and full to capacity. Gav is hoping that his legacy here will be a new dialysis unit, and my study is going well, so far....... We recently examined for the finals of the medical school and it was great to see some of our students who we first met as third years graduate, although out of an intake of 60 in 2009 only 26 are graduating this August which is very sad and leaves Malawi continuously short of doctors. We were part of a mass exodus of senior staff from the department of medicine including the Dean of the medical school and the head of department, which meant lots of parties but now a massively under-staffed department.

Gav with Theresa, our outgoing head of department of Medicine

The future of medicine in Malawi? Tamara, Shalom and Chaniyzia, three registrars on the MMed programme

Me with 3 of my Wellcome Fellow colleagues Phil, Toni and Steve

 

This month Gav and I both had our last month of full clinical work, Gav’s contract with the College of Medicine is up so he is resigning and working full time on his MD thesis. My study is continuing but I am also allowed to come off the wards to concentrate on writing up my thesis and finishing off the study – I am due back in the NHS 12 months from today, so need to get my skates on. I am going to be sad to give up the HIV clinic I do, as that is where I feel, apart from my study, I actually do some good work making my patients better and able to live healthily with their HIV infection. I was flabbergasted when a patient came in wearing flip flops and a chitenge clutching a Louis Vuitton handbag, original leather that she had bought in the local market – clearly Oxfam had missed that one.

This blog is about another couple of trips we have made, but  don’t worry, I am not going to wax lyrical about how beautiful Mozambique was, how interesting it was to learn about the history or how much fun it was to see Ros, or how much we enjoyed the fresh tuna with coconut rice or the enormous prawns, I am going to let the pictures speak for themselves. It was one of our best trips ever and well worth the long drive to the coast. We got through all the road-blocks no problem, the only bribe we paid was a copy of Company magazine and a sprite to a border guard who hardly spoke English – who knows what he made of the fashion tips.

 

cheerful Joshi at 6am at the border

 

Dhows at Ilha harbour

 

wreck at Ilha harbour

 

Governor's mansion seen from the pier at Ilha harbour

 

elegantly faded buildings

 

beachside lunch at Ilha

 

prawns!

gateway to the original harbour on Ilha

'big boom mummy!'

Original hospital entrance

the incredibly elegant and decrepit hospital (note tree growing out of window - even worse than Queen's) due to be demolished and turned into a luxury hotel

Chapel in the fort - the oldest European building in East Africa built 1498, still complete with gargoyles

Portuguese elegance at our hotel on Ilha

shopping arcade including wine and book shop

disused cinema

 

18th century law court

Mozambiquans are sassy

walk in the park at sunset on Ilha

1498 - 1st Christians in Africa



First public church built in East Africa

Nuarro lodge where we went after Ilha is an eco-resort in the middle of nowhere north of Nacala. It was founded by a group of divers who were making their way down the coast in a boat looking for dive sites and decided this reef was the best and most pristine they had ever dived and set up camp. Slowly a gorgeous lodge has been built with chalets on the beach and hammocks everywhere. The site is so remote that there are no thefts, so no locks on any doors and the only nocturnal visitors were hermit crabs. The beach is so clean that the only things washed up are perfect pansy shells. We were the only guests for a few days so had this paradise to ourselves, lazy days of diving (Gav), snorkelling (all of us), kayaking and sailing and lying around were incredible, after 7 nights we did not want to leave. Snorkelling and diving on the reef was unbelievably beautiful. Our battery in our car broke on the rough drive and the manager replaced it for us with one from his own car - you don't get that kind of service in most places. We even saw whales on our last day coming in from the cold water to mate in the warm water off the coast, a final sight to end the most relaxing holiday we have been on in Africa ever.

Daily chill out under the tree on Nuarro beach

Paradise beach at Nuarro

Joshi reads Glamour magazine upside down and asks 'Mummy where are the cars?'

Rock pools at sunset at low tide - we found an eel and lots of crabs

Ros at the most incredible secluded beach getaway for our last day lunch

who needs toys when you have giant cushions, the sunshine and a view like that

Kayaking in the unbelievably clear water

Dawn at Nuarro

outside shower essential for de-sanding Joshi

My gorgeous boys

so grown up

our beachside home for 7 incredible nights

how relaxed can you get.......?

crabs at low tide

uncanny resemblance between Joshi and auntie Ros

Dhow at low tide with the clearest blue water imaginable

Nuarro reef seen from the 1930's lighthouse

Lighthouse still going with solar panels

Whale watching on the deck at Nuarro

Nuarro sunset

Baobab tree, the true iconic tree of Southern Africa

 

Almost immediately after getting back from Moz I unpacked and turned myself around for my first Mulanje trip. I have been wanting to climb southern Africa’s highest peak that is only down the road for some time, but leaving Joshi or taking him with didn’t seem feasible. This trip was organised by the fabulous Jen, one of only two consultant psychiatrists in the whole of Malawi, and a mountain regular. We went the steepest route up which involved gentle walking through the tea plantations until it got steeper and steeper and we were climbing ladders up rock faces – but if Karen’s dog Pushkin could do it, so could I. Eating lunch looking down on eagles circling around the waterfall was incredible, as was the beauty of the plateau and the hut when we got there. I only stayed one night to get back to Joshi and Gav so I didn’t go on the next day to do a peak, instead we dashed back down in time to watch Andy win Wimbledon – the perfect end to a perfect 2 weeks.

 

Another classic Malawi shop sign 'the Difficult to understand shopping centre and tea room'

 
 

Villagers in the tea plantations sending off some relatives

Setting off through the tea to the mountain

Karen and Pushkin, aka the most intrepid mountain climbing team in Malawi

Pushkin sensibly avoids the edge

Incredible lunch time view with eagles circling below us

Bip is king of all he surveys (in his head)

cloud forest

 

Brave swimmers in the icy mountain water



Madzeka hut where we slept at the bottom of the picture on the Mulanje plateau



hungry climbers waiting for yummy dinner cooked on the fire



Fresh mountain streams



From the left, Me, Kate, Jen, Toni, and two Italian climbers



View on the way up and down

match point

Yessssssssssssssssss

Jen amazingly produces some fizz to celebrate

Since then Gav has been to Durban for another conference and went to the World Transplant games which was on at the same time– any person who has ever had a transplant can put together a national team and compete, Gav asked the Irish team for directions and 30 minutes later he looked like  this, I think it was slightly less competitive than the Olympics.

Gav also hosted Roberto, who is the International Society of Nephrology's international ambassador who came as part of the funding Gav has raised to teach about peritoneal dialysis (PD) in adults and children. PD is very attractive option for dialysis in poor countries like Malawi as it can be done at home and does not incur costs for trips to hospital etc. Gav took Roberto to the village to deliver dialysis supplies to a patient - I think an eye opening trip for all concerned! Roberto and his wife Martha and son Peter all enjoyed their first trip to Africa, and we all hope that it is the start of a long collaboration.

Roberto and the dialysis nurses carrying 10 litres of PD fluid each

Gav going the extra mile for his job

 

We spent my birthday at the lake on a freebie weekend won in a raffle and did the usual lake-side things, playing in the water, reading, sleeping, drinking beer as the sun sets, and watching some amazing local entertainment including a human pyramid and masked dancers.

 

 

 

Joshi loves to balance everything on his head, African style and is getting pretty good at it

see what Mummy can do.......

on the beach at Club Mak - the best birthday present smiles from my boys

My last birthday sundowner - next year we will be back in London

The best ever title for estate agency? 'people always complain estate agents' in Mangochi

 

Joshi has been a super-star with all the driving we have been doing, all he wants to do is play with anything that comes to hand wherever we go – cushions in Nuarro, shells, plants, animals, the sea, seed pods, other children. When we played with friends recently he picked up  a bat and ball and said proudly ‘look mummy I’ve got a zapper!’  - his only experience of a bat is watching us zap mozzies at dinner time every night.

Bouncing at the Cure childrens' fun day

 

Helping mummy with the shopping

I think you have to be 2 years old to get away with making this much mess face painting!

artist

Next up is a flying trip to the UK and a regular annual meeting of MLW and Liverpool at the lake, then we are both off to East Africa to teach and then we have to get read to wind up our lives here and get ready to move home. We will be back before we know it I suspect.

Lots of love to all

Emma, Gav and Joshi