Email From Mom

Below is an email Mom sent out that did not go through. If you want to send her an email use the Google one (carolyn.cmv@gmail.com) as it is uncertain if the NormanVaughan one is working for her right now. She has only had access twice though to the internet.

The Subject Line of the email below was "FINALLY!!! - in a sanctuary in Africa!" Here it is...

Literally…… in a peaceful chalet in a sanctuary in the middle of Lilongwe, Malawi, Africa. For the first time in a month I have a day off and I have internet access!!!

For those of you who don’t know, I’m working with MSF (Medicins Sans Frontiers – Doctors Without Borders). I’ve been working on an emergency measles vaccination campaign for a month now. From 4 or 5 in the morning till 10 or 12 at night. By the end we will have vaccinated 2 million children. Every day kids are dying from measles. Big outbreak here.

So this is the beginning of the story, in between, and up to now…

5/3/10 – Monday
It started with the phone call. With my mouth full of toothpaste. But I had to answer. Area code on the phone was 212. Meant it was MSF calling. Needed more help in Malawi for the vacci campaign. Wanted to know if I could leave the next day! No. They checked. Being in NY on Friday was OK. Gulp!! Had to go in to work to quit!!! Oh, my god, it was happening…..new chapter…..life changing….4 days to get ready….Madness….no sleep…..tick off my to-do list…..and thrilled that everyone really, really so proud and pleased with my going to do this work.

5/7/10 - Saturday
I’m on the plane now from Amsterdam to Nairobi. It’s been surreal. Still seems like a out-of-body experience. Am on my 3rd night on an airplane. Anc to NY. NY to Amsterdam. Amsterdam to Lilongwe, Malawi.

No sleep on plane from Anchorage to NY. When I got to NY had a half day for a briefing. Like jumping on an out-of-control fast escalator up! Found out that I’m actually going to Mzambi, Malawi. Don’t know what they want me to do there. NY office doesn’t know. It’s a satellite vacci site that was just set up. There are 1M kids to vaccinate for measles. Three sites are in Lilongwe and now this one in Mzambi. They vaccinated 50,000 the first day. Pretty fun not knowing what comes next! I’m officially “MSF’d”!

Had 8 hour layover in Amsterdam. Volkert, friend of Susan Ruddy, met me at the airport. His house from the 1600’s on a canal. Ahhhh – shower and more importantly, washed my hair! First time since Wednesday. Then fresh squeezed OJ, latte from the cappuccino machine, Dutch cheese, bread, honey… Yummm. Went to market to get chocolate for the field and then to a chamber music concert on the other side of the canal in a piano store turned concert hall. There we were. On the 2nd floor. Massive sparkling chandelier. Long strands of draping glass beads. On either side are long 2-story long heavy, drapes like at Tara in Gone With the Wind. Then a tourist boat slides by on the canal. What a head slap!!

Now I’m on Kenya Air and it’s beginning to sink in. 8 hour flight. If only I could get some sleep. MSF said that it’s been a long time since they have had someone on such a brutal flight schedule….

5/9/10 – Sunday & Monday
Arrived in Lilongwe. Went to MSF HQ. Only 3 people there. Admin person is from Alaska!! To bed early. Next day, Monday, spent repacking in the morning, catching up on journal, lunch and then off to Mzambi. 3 hour car drive north of Lilongwe. Drove up with the medical emergency coordinator for this mission who is from Maine and the logistics coordinator who is from France. Malawi is an English speaking country thank god!


Arrived in time to put things in room, meet everyone, then dinner. After dinner big prep meeting. Everything starts rolling tomorrow with a simulation. Vacci campaign starts Wednesday. Beautiful country!!! I’ll be stationed here for a week and then moved to a new site for another week and so on. Actually have a hotel room with my own bath! (But NO toilet seat on the commode!) It’s not like the hotels we are used to. More like being in Mountainview. I’ll be finding the vacci sites, mapping them out, and setting up. Like location scouting. They will be at a school, or health clinic, or church or wherever. So that’s my job. And there are sites being set up north and south of here so I move weekly. Go out shadowing one day and then I’m on my own!

Real mix of people here from Austria, Australia, Sierra Leon, Nigeria, Ethiopia, France, Sweden, Italy, and Maine, CO, NY, GA, TX. Plus more. There are 14 of us. And there is a sister group of us vaccinating south of Lilongwe. Five of my ten fellow team members from training are in that group but I haven’t seen them yet.
5/18/10
It’s been a week now but like a lifetime! SO much has happened!! And I’m LOVING it!! Fast paced, many problems to troubleshoot instantaneously.

I get up at 5 a.m. and don’t get back to my room till 10 pm if I’m lucky. It’s nonstop. No internet except at an internet “café” and I use that term very, very loosely. But no time to go. So not sure when this email will actually go out. So here is the gist of what my days have been like.

6/5/10
It’s now been 3 weeks since last entry! NO time to journal or update email!! It is totally insane. Each evening I think that next day all will go as planned. WRONG!! Every day a new crises (actually several) and challenges to be solved on the fly. At first I was going out to the bush villages and “constructing” the ques for the lines of people. Like TSA at the airport. But this is for 1000 – 3000 mothers with their children. Each site is at a school or church or under a tree. I actually can’t tell the difference between the buildings. Both are rectangular boxes of red brick and have 2 doors. The schools sometimes have a blackboard otherwise they look the same. And I LOVED, LOVED going from village to village setting up the sites. They actually remind me so much of the villages in bush Alaska. Many similarities. More on that later. The people are so lovely – very gracious, proper (Madam or Mr. always), warm, hospitable, and so appreciative for what we are doing. What fascinates me the most is the loads that the women carry on their heads! Everything from heavy tree limbs, to stacks of branches, to purses, to suitcases, to 5 gallon buckets of water filled to the brim with nary a drop spilled, to stalks of bananas, to sacks of rice, to bags of coal. It’s amazing how easily they lift these 5-gallon buckets onto their heads and gracefully walk for miles and miles and miles tall, straight, and unwavering. Just fascinating.

And the markets! Oh, my goodness! Masses of people with all their wares alongside the road selling clothes, tomatoes, potatoes, maize, cooked food, shoes, fabric, tobacco, stalks of bananas, and….8 – 10 rats skewered on a stick! The towns and houses remind me of the shanty towns in the south from when I was growing up. BUT everywhere they are selling cell phone cards. Cell phones are THE means of communication. Before that it was people walking or riding their bikes to relay messages. Technology in bush Africa is changing their lives!

Everywhere you drive, there are lines of people on either side walking to or from the market. It’s just constant movement like lines of ants. Their days are spent from sun up to sun down walking miles to get water and haul it back, buying at the market, cooking, washing, and sweeping their yards or red dirt with bushes of leaves as their brooms. Everyone smiles and waves. They have for the most part not seen so many vehicles going up and down as we do. Watching it all puts a smile on my face and time and again I see the parallels with bush Alaska.

They have boreholes (like our hand pumps) and outhouses (better built than ours but with holes in the ground). They live off the land. Everyone seems to be related. They carry their babies on their backs. Health care is far away but they do at least have roads. Sanitation is poor. Potable water is sketchy. All day is spent just surviving and tending to their families. Transportation is by bicycle or foot. We have the advantage of ATV’s & snowmachines. They are a very, very hard working lot.

The parts we are seeing are definitely waaaaay off the beaten path. No tourists here. We are seeing rural Africa that most tourist see. Agriculture is the mainstay – tobacco, timber, sugar cane. Malawi is a very poor country. Their last president of ten years really undermined the country. The new president of the last 6 years is totally opposite. Beloved by all and a real leader in all of Africa. He is on mission of prosperity and improving education, health care, and the economy. Things are once again looking hopeful for the country.

Mid-May: Things change….
I was so getting into the groove of traveling to the villages and setting up sites when it all suddenly changed and it seems that everything went into crises management. To set the stage, our “office” is a detached house of sorts. All houses are surrounded by high walls and have gates for entry manned with guards. Everyone works late but on this particular night one of nurses was alone working at midnight when 7 men wielding machetes came over the wall on attack. Our two guards rushed to the office to warn her when an assault ensued. One guard held them at bay at the door barely. One machete slipped through the door but was wrestled away. Then they threw rocks and broke the windows. The attack lasted for about 10 minutes. The police were called but didn’t arrive for 45 minutes because they didn’t have a car! Turns out that it wasn’t an attack against us in particular. They attacked 4 houses along our road.

Next day, our fleet manager was “released” suddenly and I was asked to take on fleet management – this was the LAST thing I wanted to do!!) It’s a HUGE task!! 77 vehicles to manage! Have to get them fueled every day, track their fuel consumption, check that they are running properly, dispatch them on various daily assignments, get cars repaired, flat tires fixed, cars rescued that are stranded, and manage/pay all the drivers. There is a LOT of paperwork tracking fuel vouchers and car consumption liters/km. What I started out with was a mess and took 3 days to sort. Had 2 hours of a briefing then had to sink or swim.

Then two days later, our Field Coordinator had a heart incident and had to be medivaced out to Nairobi. Now everyone is shifting duties to cover for him. Every single day there seems to be some major incident that throws us into chaos in the midst of the vaccination campaign. We deal with it. Somehow.

The next incident to deal with began as I left my room in the morning and was going to breakfast. Was told by some of our staff that the head driver for the car hire company had been out the night before using the car for personal use. That’s a big no-no. We can’t be out at night and the drivers can’t use the cars except for MSF business. They are always behind locked gates at night and guarded. Soooooo…..drama to deal with all day. In the end he was let go and now we had a potential strike by the drivers on our hands. That evening we had a meeting with the drivers. Explained what happened. Listened to their concerns. Addressed them all and rectified some things they were asking for, dispelled rumors, and emphasized how they are the backbone to the success of the mission. In the end, it was a turning point. The drivers rallied, banded, and bonded with us. They have been absolutely unbelievable. Driving all day and also pitching in to help with crowd control, rolling cotton balls, opening syringes, doing whatever it takes to get the job done. Their spirit and loyalty has just been awesome. I love those guys!!! But I still HATE the paperwork!! And as fleet manager I now just work out of the office and don’t get to go anywhere!!

May 21 – Mzuzu – there is a frog in the toilet!
This day we moved to Mzuzu, a much bigger city. We are now staying at a bigger but still very basic hotel, old hotel. My biggest thrill is that I now have a toilet seat and a shower that is intermittently hot! However, we did find a frog in the office toilet! Big as a fist! He refused to be flushed down so finally got an employee to extricate him..

Life continues to be fast and furious and with new challenges. I’m now getting up at 3:45 in order to be at our dispatch area at the hospital from which we send out our 30 medical teams each morning with their vaccines and table/chairs for the vaccination sites. We continue to go out to some rural areas that are extremely remote but also now have campaigns in town. Some of the sites almost become riots. There is a crush of 4000+ people at some sites and the crowds become so unmanageable in some cases that we have to close down the campaign in order to restore order. In one incident, kids were throwing rocks at one of our cars and broke the window. No one hurt. City kids are just different and everyone wants their kids to get the vaccine. Now I have to go to the police station with the driver to file a report. How do I describe the police station?? I don’t think I can. Old, small, cluttered, dingy. No computers. All is written by hand. But our young policeman loves what he does.

Finally, I’m feeling like I’m beginning to be on top of things and start working on my reports when I’m asked to go manage a vaccination campaign with 2 of the medical teams in a very remote village. The area, Kabwa, is completed surrounded by a river but there are no bridges across. Luckily there is a sugar factory in a neighboring town and have volunteered to try to make access for our vehicles. The river bank is about 6’ high and we can’t manage. They knock some of it down and then put planks from the bank into the river for access. I arrive a day before the team to scout the villages and set up the lines. Takes us an hour and half to go 8 miles. Thank goodness we had the health center director with us because we went where there were no roads through tall grass, across fields, skirting big washouts, over rocks, bumpity bumpity bump. The villages are very, very poor and isolated from any health care. They have lots of illness from poor water and sanitation. No infrastructure, no bore holes, no pit toilets, meager food sources. It’s a sad situation but not unlike some of the challenges we face with Alaskan villages. Our nurse said that she saw one child with an infected wound on his leg that was down to the bone and said that he’ll probably die just because he can’t get the care he needs. Women with difficult child labor die because there is no way to get word out or help there. They were all so very, very appreciative that we came to give the vaccinations and that they hadn’t been forgotten. If these kids got measles the disease would run rampant through the population.

So while one area was being vaccinated, I had to go to another area that was about 15 miles away. Took 2 hours to get to. Again through fields, etc. Very rough going. Then we had to park at a village site, unload and pack our coolers of vaccine, walk a km to another part of the river, forge the river, and then walk another 2 km to the church overpouring with kids waiting. I have some great pictures of the local medical team who come from the district health organization wading the river with their skirts hiked up to their bottoms, holding their high heel shoes and purse as locals transport our coolers on their heads. Great fun! And they loved the adventure.

I’ll be putting pictures up on FB of some of these scenes and the kids. One kid was screaming so much that I took a picture of him hoping that it might calm him down. It did – for maybe a half second. Some are just fine getting the shot. Others are screaming bloody murder. That day our teams went to 5 sites and vaccinated 2400 kids within a matter of 7 hours. There are preparers filling the syringes and then 2 people giving shots as fast as they can give one swipe with a cotton ball and then stick. It’s quite the assembly line once it’s all set up.

Now we are done and there is just time enough for me to leave with my driver and get back to Mzuzu before dark. But….as the last car comes down the bank onto the planks, he gets stuck in the sandy bottom of the river. NO way to extricate. We have no winches or tow rope. And when he tries to get a push out he just augers down more so that now half his tire is buried. And if we don’t get him out, by morning the river will have sucked the car in. Once again we rely on the sugar factory to come to our rescue. All their equipment is out in the fields but after they get back they dispatch a tractor which finally arrives just as it is getting dark. He has a cable tow line but no hook! Finally we get it rigged and out the car comes after 2.5 hours of various attempts. But in the midst of all this drama as the sun was setting and night fell, it was wonderful to be wading in a river with a black African sky overhead brilliantly sparkling with billions of stars.

The countryside through which we traveled was lush and green. Lots of timber (pine tree plantation), sugar cane, and banana trees. Plus a large stand of rubber trees and the smell of burning rubber coming from the nearby factory. And again, streams of people walking with everything imaginable on their heads or on their bikes. Trucks are piled high with goods either lumber or tobacco and just like our crab boats can become to top heavy and turn over. Saw one on the road on the way up and another on the way back.

June 2 – Leaving Mzuzu
Got back the next morning at 8 a.m. after a 3 hour drive. Immediately started dispatching cars to Lilongwe, the capitol city. We’re headed out after a very successful campaign reaching 100% of our goal. Now we start in the big city. And…..I’m NO longer going to be fleet manager!!! Yea!!!!! I’ll now be a vacci log meaning that I organize and run 10 different vaccination sites each day for 5 days. I’m a bit nervous though after the incidents we had with crowd control in other cities and this one is the largest yet. So more tales to come our sure! In the meantime, I’m actually getting a day off and came to this wonderful Sanctuary Lodge in the heart of the city but you hear nothing. Lots of trees, lush rounds, quiet well-appointed chalet to stay in. Ahhhhh…..it’s been SO relaxing!! Go back tonight to join the rest and tomorrow the craziness starts again till the end of July now. Don’t know when I’ll be able to send another email update because we don’t have internet at the house where we are staying which happens to be on Embassy Row!! Quite the change!! Lovely big, big house with a huge walled in yard. Sugar cane field on the other side. There are 5 bedrooms and 14 of us. Some of us will be on the floor on pads and others in beds. Will be our home and office.

I also got to see my fellow training class mates for the first time! So much fun to see 5 familiar smiling faces and get big hugs!! Wish I had been able to work with them but now we’ll be together for the next month.

I won’t be staying till the end of the campaign. I’ll be leaving at the end of the month because I have my confirmation to go to Arua, Uganda by July 5 for 6 months to work as the log base/admin coordinator. More paperwork and also have to pay all the bills and deal with all the money. Ugh… but will do whatever I have to. This will make my 4th job assignment. This mission should be much different because it isn’t an emergency. Should be more relaxed and laid back. We have a doctor here who just came from there. Said the group is good team and the community is lovely. No traveling though. Will just be in one spot. Don’t quit know how I’ll respond after all this craziness. Might get bored. But I’m willing to be bored for a bit… 

Other observations, happenings, oddities, etc. :

• 2 gay men got sentenced to 14 years in prison but were released after other countries threatened to pull their monitary aid.
• But…..as strict as the laws are against gays, you see men walking everywhere holding hands! Turns out it is just the custom here to hold hands when you walk together.
• Clothes are washed by hand and draped and dried on the bushes and the grass. Ironing the clothes afterwards kills any parasites picked up.
• All the mattresses are the same – foam about 6” thick put on solid wooden bed frames. No Sadlers here! And no choices to make. All are the same…
• Road “flares” for broken down vehicles are clumps of leafy tree limbs. Works!
• In the smaller towns, the electricity is turned off all over town on Sundays.
• Everyone is very fastidious and you see the women sweeping their dirt “yards” with bushes used a brushes
• The hand motion for come here is like ours but upside down: palm is down and then fingers are brought in and out to the palm. Similar to our wave but we have to be careful or else a bunch of people will start following!
• Bicycles are the main mode of transport but at night there are no reflectors and no street lights and they are very hard to see because they are all black wearing dark clothing! Tricky!!
• Names of towns are very, very hard to pronounce. They are very long and you pronounce all the vowels and consonants.
• And people’s names are just the most unusual! – Gift, Innocent, Origin, Socrates, Hippo

Please send me news when you can!! So anxious to hear from you all! Erik, my son, will continue to send out updates. He can call me but I can’t call out. Too expensive and I have NO free time!