It's just like riding a bike

Photo of the week - a little bee-eater

Highlight of the week: Work in the clinic is rewarding and not draining.

Lowlight of the week: England lose in the Euro Final

Maximum temperature: 35 degrees Celsius

Rainfall: Not yet

Twelve months out of the saddle. And yet, we are now back in the saddle. Granted, we have been back In the Valley, riding with stabilisers on, for a full month. But now, we are fully back up to speed. Hurtling down the double blacks, with no body armour on.

How do you ride a bike? How do you teach someone to ride a bike? It’s hard to recall how we learnt something, that now comes so naturally to us. I have painful memories of learning to ride with clip in pedals. I fell off often. My legs and elbows were bruised for a full summer. Sometimes bruises lay on top of bruises. But now, I don’t even think about my clip-ins. I feel unsafe if I am not clipped in. My legs and arms are unblemished. It’s just like riding a bike.

We now have one week in the clinic under our belts. The clinic looks the same from the outside. The building is still standing. Perhaps a little more crumbly. There are some new additions. Notably an incinerator. Built with kind donations from the friends and family of Karen and Alan. There is a toilet block, almost back up to scratch. There are crowds waiting patiently outside. Intermittent running water. The tank needs filling when the electricity is on. Staff must remember the schedule. The drug cupboard has lots of bare shelves. No malaria tests. No broad-spectrum antibiotics. But some essential items are available.

We see old faces and new faces. Many of our colleagues remember our names. Perhaps the embroidery on our scrubs aids their recollection? But our brains struggle to remember names. We are introduced to new staff. New names on top of old names. I find myself introducing myself to Enerty. A new looking face. I turn to introduce her to Keith. Hi again Enerty says Keith. His goldfish memory better than mine. We met 5 minutes ago he adds. Whoops. I need to start writing down names!

On previous tours of duty we have worked in different ways. In our first year, everything was paper-based. All patients had books. I would park myself in one room and just see children. Teenagers and tots. But 20s had to see Keith. Especially with their drippy willies. My trusty translator by my side. Sometimes with a pile of 20 books in front of me. Head down and plough on. But when my head came up, I would realise that all the other clinicians were freewheeling in my slipstream. I led the peloton. But the nurses and medical officers were off on breaks. Domestiques without ambition, except to fuel their own bellies. I had hoped to lead by example. But team Ginny had one lone sprinter, one lone climber. Ginny no mates.  

Last year we tried something different. All the books were gone. The clinic had gone paper free. A laptop on each desk. On a local network. Electronic test requests on a good day. And electronic prescribing to boot. But computers are more often our masters than our slaves. The clunky system made us even slower. So Keith and I often opted to work together in one room. Riding a tandem.

This year we are on to plan 3. The plan is still evolving. We mull and tinker. How to be more effective? How to feel less frazzled at the end of the day? Perhaps a room away from the front line? Away from the peloton. A breakaway? No, that’s the wrong image. We are better placed in the support vehicle. Away from the crashes and the pell-mell. On hand to pitch in with support and guidance. Running repairs for the system. Advice and guidance on site. With spares and knowledge. Our support vehicle might be in the slow lane of the TB clinic. The TB clinic is a victim of its own success. A handful of active TB patients means that one room has been lying dormant. Light and airy. Fit for its erstwhile purpose, but also a gift horse for us. A space for second opinions and overflow.

Back to riding that bike. What happens when a wheel falls off? Three wheels on my wagon and I keep rolling on…….  Burt Bacharach turns in his grave as Keith sings the words. Keith’s dulcet tones are no match for Dick Van Dyke. Had Keith had a premonition when he chose those lyrics as he sang in the shower on Tuesday morning. The singing is not unusual in itself. But the words will repeat themselves as the day plays out.

In previous years we have written about the Doctor car. We started with the Honey Badger. The badger nearly deposited Baby Ellie and I into the Luangwa River. But it finally met its end when the front axle snapped one day. Next, we had the Blue Beast. A big blue Toyota Hilux. Two-wheel-drive. The Blue Beast was beset with problems. Its blueness a major impediment. Its rear driven wheels unable to deal with sand or mud. South Luangwan vehicles need 4-wheel-drive. And colour choice is critical. Female Valley doctors are unlikely to be criticized for being particular about the colour of their car here. Tsetse flies love blues and blacks. Even Barbie pink would be a darn site better.

So, this year, we are delighted to have a new car. Mzungu. A white, 4-wheel-drive Toyota Hilux. Mzungu means white person in most Bantu languages. For once, Swahili and Nyanja are in agreement. A favourite term in Swahili is kizunguzungu. Kizunguzungu means dizzy. With the world going around in circles. Mzungu is a somewhat derogatory term, that describes what white explorers and missionaries used to do. To wander around aimlessly. Often in circles. In South Luangwa us Mzungus don’t seem to have moved on much. But our new car, Mzungu is a beautiful car. Responsive. Powerful. 4-wheel-drive. Almost perfect. Almost perfect, until Tuesday that is. When a wheel fell off our wagon. Mzungu is not especially good on 3 wheels. Quite kizunguzungu in fact.

At the end of day 2 in the clinic we left our imaginary support vehicle and jumped back into Mzungu. We left clinic at 12:00. We did not vocalise the Q word. But snuck away after checking that nothing was brewing. We had plans that were to culminate with sundowners. I was driving. It was hot. 33 degrees C. But Mzungu’s air conditioning was blasting. Suddenly, the car did not feel right. There was no engagement between the engine and the wheels. The car was making a dreadful noise. It came to an abrupt stop. And refused to budge. I thought maybe we had a puncture. Keith walked swiftly around Mzungu, checking the tyres. No diagnosis made, the tyres were fine.

We were blocking the road. A main road to nowhere, but a fairly busy one nonetheless. A Hilux is not far off from being a truck. Or a wagon perhaps? With some help, Keith pushed the car to the side of the road. At which point, the back wheel fell off. The wheel housing sliced through the edge of the irregular tarmac. The axle lay right next to the ground. We were going nowhere fast. We had no wheel nuts. We assumed foul play.

We had a problem. So, we needed a man. A man with a plan. Keith got on the blower to his mate Rob. Rob knows more about making things work in Zambia than almost anyone we know. (Gid excepted.) Rob also has a mechanical bent. He is our car fixer. Rob secured Mzungu for the Valley docs. Rob knows how crucial reliable wheels are. He also spotted immediately that theft was not responsible for Mzungu turning into a unReliant Robin. Last week’s puncture had been fixed with a wheel change during a dodgy pitstop. The wheel nuts had been poorly secured. They had made a bid for freedom. We would be unable to go on our merry way without finding some more.

Our mate Kiki joined us to help solve our potentially insoluble problem. Whilst Rob and Keith toiled to purloin wheel nuts from the 3 remaining wheels, Kiki and I went for a stroll. Fortunately, there were no elephants on the elephant highway on Tuesday at 13:00. Kiki, a bushman of sorts - a walking guide in truth - would have sensed their approach anyway. Luckily, Kiki is as skilled as I am, at finding needles in haystacks. A ten-minute stroll secured us 3 wheel nuts. Rob (christened Robin) used 2 jacks under the suspension springs, to raise Mzungu from the dead, and with 5 wheel nuts, Mzungu’s 4^th wheel was restored to health.

We thanked reliant Robin, and bushman Kiki, and headed off towards the setting sun. Back in the saddle so to speak. The sun is now about to set on our 7^th day with the doc phone. The clinic is fine. The tourists are keeping us on our toes. We have already had our usual one major car incident per tour of duty. What else can possibly go wrong? Spoiler alert: The blog keeps writing itself. The tour continues.

3 wheels on our wagon

Buffalo boulevard

Elephants on our commute

Just resting my jaw