Monday, September 24, 2012


My patient died last night.
What does an 11 year old boy think about while he is dying?  He lies on a plastic bed in the merciless fluorescent light, surrounded by the relentless noise of babies crying and machines beeping, with the occasional sound of mothers wailing when their children die.  He watches tubes inserted, seizures, and CPR in the surrounding beds. Does he have hope?  Is he afraid?  Is he thinking of football games he’s played, or his school friends?  Is he missing his dead mom? 
My heart breaks that his last moments were spent in that chaos and filth.  I pray that he just felt tired, and that he fell asleep, and felt no pain.  I am so truly, profoundly sorry that I couldn’t save him.  Please don’t write to me and tell me about how it’s not my fault.  I know with my head that there was a complicated path that eventually lead to his death, and I know that I am only human, and that we are limited here.
And yet, my son is 11.  He is solid, and boisterous, and robust.  He has dreams, and a future. ALL boys should be pestering their little sisters, and building forts out of sticks.  They should feel safe, and have faith that they will be protected and loved while they go about the work of growing up.  Instead, this sweet soul lay in that war zone, holding his grandmother’s hand for several days before he died. 
I wish I could have altered that path.  I am so sad that we, as human beings, have allowed this to happen to our children.  I pray for that little boy’s soul. I don’t have a great concept of heaven, and I don’t pretend to know what comes next.  But for him, I hope he is with his parents.  I hope that he died painlessly, and that he is now whole and strong.  I am grateful for the time I spent taking care of him. I am honored to have witnessed his quiet courage.  And I am so terribly sorry.

Saturday, September 22, 2012

The view from the front line

The view from the front line is horrific.  It is like a nightmare.  The room is hot and damp with the smell of vomit and urine.  The walls are filthy, and crawling with insects.  Children lie, as many as eight infants to a hospital bed, on wet chitenjes, filthy tape securing dubious IV lines in awful places.  Some children are on bubble CPAP, and have large plastic tubes secured with graying bandages occluding their noses and forcing in oxygen.  Anxious mothers, many of whom cannot read or tell time, are entrusted with giving all of the oral medications, and feeding their children through nasogastric tubes.   They sit by their bedsides, filling the narrow spaces between the beds, among the beeping machines which run from extension cords that cross the room.  Rusted IV poles, which come disconnected from their stands when you touch them, teeter over the bedsides, with often-neglected, empty IV bags hanging from them. Oxygen is divided among children using a “splitter”, so that each child’s oxygen input might be less than ideal, but is better than none.  The mothers do not sleep.  Children seize, or vomit, or thrash in feverish delirium.  Some die, and new ones always arrive.  Sometimes there are no nurses for the 40 patients, and often there are few doctors or clinical officers.  The sharps containers are on the floor, and are often overflowing.  There is garbage everywhere, and flies land on the eyes and mouths and sores and bandages of the sweating, dirty children.  Cockroaches scurry underneath the beds, and yet still the women sit on the floor to eat or try to nap.  There is a guard who stands at the door to the makeshift “emergency zone”, and he tries to minimize the crowding, but still the room is full and hot.

On the first bed is a boy who breaks my heart. He is 11 years old, and he has the haunted, hollowed-eyed look of starvation.  He weighs about 35 lbs.  He is very bright, and wants to be a doctor. He has been having profuse, watery diarrhea, which we have been unable to stop, and has become severely malnourished and dehydrated. I am fairly certain that he is dying.  And still, when you ask this sweet child how he is each day, he is unfailingly polite, and slowly opens his eyes and says, through cracked lips, “I am fine, and how are you?”

His “gogo”, who is probably in her seventies, is mostly toothless, and is sharp as a tack, stands by his side, day and night, fanning him with her cloth to keep the flies away. She feeds him oral rehydration solution, and now fortified milk, from a plastic cup. She gives his meds, probably about 25 total pills per day, as scheduled, and she never complains. She laughed as she showed me her ankles today, which are swollen almost to the knee.  He lies sometimes with his head in her lap. He lies on his side and you can see every bone in his body, every vertebrae on his back.  His hip bones are alarming, and he is often mostly naked, as he is unable to control his bowels and must be changed frequently.  Although he is 16, he has no dignity, no privacy. He is so weak, and so thin, and he has had such diarrhea and so many fevers.  He lies on that bed in the unrelenting noise and filth, and suffers. I hate watching him suffer. I hate watching his patient, courageous, trusting grandmother suffer. Although I know the odds are against him, I pray so hard that he survives this. I pray that his pain and suffering end, that his dreams of a future are realized.  I wish for him strength and peace, courage and a life into adulthood.

Tuesday, September 18, 2012

Off the cuff

I never take the time to blog.  When I do, I often write most of a story, then stop, revise, edit, revise, and never actually finish and post them.   I probably have 6 half-done blogs on the computer. So tonight, I will post whatever I write, and not hem and haw over details until I have lost interest.  It will be an “off the cuff” post.  

It occurs to me that my motivation for writing is usually an event that is particularly overwhelming, and therefore usually negative, so the impression I must give of myself is of a woman who lives very close to the edge and views horrific tragedies daily.  I was, in fact, fairly close to the proverbial edge last year, but I’m climbing down now.  This year, despite the profound anxiety I had before our return this summer,  has been significantly better than last year, for several reasons.  I think the key to “success” with five kids is routine, and we have established one now that is comfortable and familiar.  This is not to say that I don’t have a majority of days where I sit in shell-shocked silence and observe the din that surrounds me: babies banging on metal pans with metal spoons, the wails of injustice being perpetrated upon one of our children  by a parent or sibling, the relentless mantra of motherhood in the background:”Mom?” Mom?” Mom?”all combining in a painful cacophony.  No, this is not Disney.  We have developed a fairly stable nanny/housekeeper situation, and are learning to more effectively manage the madness required to care for five children with two full-timeworking parents.  We have a nanny for the twins during the day named Mary. She shows up at 6:30, when we are getting the children ready for school, and takes care of the twins while we play the fun “hunt for the school shoes” game and try to convince Aine she must eat something other than popcorn for breakfast. Mary stays until 3.   Lucy, who cleans the house (thank God), works from 10 am until 6 pm, although we are usually home by 5 or 5:30. 
We have been teaching all of the nannies to cook “Azungu” food, which consists so far of pasta sauce, mashed potatoes, and Aine’s staple, “Mama Soup”.  Sometimes, if we plan ahead and have been able to assemble all of the ingredients, she cooks dinner for us before we get home, or shortly thereafter.  This area of our lives clearly has untapped potential, but it requires somepre- planning to take the time to teach them to cook, and so we have not yet pursued tit further.   Lucy and Mary work Monday to Friday, and on Friday Martha comes.  She now sleeps in a small room just outside the house, with a baby monitor, and stays through Sunday evening.  This means most nights Dave and I (well, let’s be honest, mostly Dave.) listen for the babies ourselves now, with the exception of the weekends. Friday night is always family night, which means we watch a movie and eat junk food. Saturday is date night, and once a month Dave and I stay at a local hotel for a night.

My children seem happy, and adore each other (for the most part).  They seem to be thriving at school, and they have a group of friends in our complex that they love and play with daily.  The twins are a toddling, drooling, biting, grinning disaster.  They waddle through the house and slide down the carpeted stairs at lightning speed, leaving a trail of detritus and destruction in their paths.  They worship their older brother and sisters.  I have never seen a big brother who is better than Eamonn.  He picks the babies up when they cry.  He holds them up to the light switch and revels in their delight at the predictable magic that is electricity.  He doesn’t want us to put them to bed at night without him kissing them goodnight. He is like a small adult; he sees and delights in the wonder of watching the babies grow.  And as a bonus, he never has to change their diapers or stay up at night with them.

Life in Malawi has gotten easier.  Petrol and diesel, although not ubiquitous, are much more available than they were last year.  Plus, we have been loaned another car, which has truly transformed our lives, and probably drastically affected our fitness level.  The cost of living continues to be outrageous, and it hasn’t gotten very hot yet, but so far neither Dave nor I have had any kind of emotional outburst since we returned.  We are much more Zen. 

So if I have given the impression, through my blog posts, that life is unbearable, or that I am depressed or on the verge of a nervous breakdown, I apologize.  That's so Last Year. I am much happier here, now. My work is fulfilling, and feels meaningful.  We spend a lot of time together as a family, and our lives are much simpler.  I feel like I fit in here.  I like that the pace of life is slower in Malaw i(except on the roads.  That drives me crazy. People drive SO SLOWLY here, and it incenses the New-Yorker in me).

On that note, it is almost 8:45 pm, and therefore past my bedtime…

Wednesday, August 8, 2012

Drama in the Dark

A quick one:

On Sunday we had no electricity for about 12 hours, from 8 am until 8 pm. There was a rumor that this was because Hillary Clinton visited Lilongwe that day (for about 5 hours), but I have thus far been unable to correlate the two events.  It was a long, somewhat boring day, especially challenging because no electricity means no coffee, and life is just harder when you’re under-caffeinated.  We did arts and crafts (then spent twice as long cajoling the kids into cleaning up after themselves).  We built blanket forts in the living room (then spent twice as long cajoling the kids into cleaning up after themselves).  We brought pizza back for dinner (then cleaned it up ourselves, because it was just easier). Eventually, at about 6:30 pm, I decided it was bedtime.  I lay on the bed and let the twins crawl on me and drool in my hair, while the girls brushed their teeth in the bathroom.  It was pitch dark by this time, so they had a wine bottle with a tall wax candle in it burning on the edge of the sink (only the best for the Fitzgerald kids).  Suddenly, from behind the closed door, I heard a loud crash, and the sound of shattered glass.  This was followed closely by the high-pitched sound of AIne’s voice as she screamed “Fire!!!” There was the muffled sound of movement and then the anguished cry from Malawi, “I pooped my pants!!”

I leapt up, startled twins dragged in the crook of each elbow and flashlight in hand, although I did not see any obvious signs of fire. Putting the babies down outside I opened the door.  Both girls were standing in the bathroom, afraid to move, surrounded by shards of broken glass.  There was no fire.  Poor Malawi stood looking forlorn and physically uncomfortable, her jeans unbuttoned.

Aine had knocked the wine bottle over with her elbow while brushing her teeth. Always expecting a natural disaster of some kind (no idea where she gets that from), she had screamed in anticipation of fire.  Malawi, who had just started to settle down onto the potty, leapt up and soiled herself in the process.  Unable or unwilling to deal with the enormity of the situation (did I mention that our bathroom floor is dark brown?), I extricated the girls from the room and Malawi from her pants, then made the executive decision to abandon the bathroom until electricity was restored.   God Bless my husband, he cleaned the majority of the mess while I had a quiet nervous breakdown.

On the upside, it makes a good story.

Sunday, July 29, 2012

The value of a "better" death

Why am I here, and is it really worth it?

How many times have Dave and I asked ourselves that question?  Some days, when I have experienced some small success, I think perhaps I have been valuable.  Other days, when the overwhelming magnitude of the cycle of poverty and disease hits me, I feel insignificant and ineffective.  Occasionally I do actual math (always a stretch fort me), and try to calculate the cost to us of our presence here, in true financial terms, and the number is staggering (on the order of several hundred thousand dollars in lost income potential/loss of retirement savings/loan interest accrual during deferment…there is a blog coming soon about our financial meltdown).  What if I had simply donated all of that money to someone, and stayed home?  Could we being doing something different that would make a bigger difference in the lives of the people we serve?

My visit home was very revealing and a little depressing to me in some ways. Several people whose opinions really matter to me asked me that dreaded question, the one that resonates in the dark of my room at night when I can’t sleep. “Why are you here?”  The futility of our contribution in the face of the enormity of the world’s problems is submitted as evidence that I should not be in Malawi.  Our effort, our money, our sweat and tears, are truly a waste of time.  Nothing will change. People will still starve.  Children will still die of malnutrition and preventable diseases.  The problem is too big, and the solution is too complicated.  Life is too short to spend working against the inevitable.  And secretly, when the house is quiet at night and I am alone with my fears, I am afraid that they are right.

I was volunteering in the makeshift “Emergency Room” at the central hospital one weekend day when a small girl was brought in.  She was about three, and was naked, but wrapped in a wet chitenge.  She had been at one of the local hospitals in the outlying districts, and had been treated for malnutrition.  When children get Kwashiorkor, which is one form of starvation, their body often swells from lack of protein in the blood.  When the swelling goes down their skin, which has been stretched by the swelling of the body, sloughs off and peels.  This leaves them without a layer of protection against bacteria and even fungus, and they are like burn victims, very likely to get infections.  This child was cold, and lying in her own urine.  Her skin had sloughed off most of her body, leaving bleeding, weeping tissue underneath.  She had a rotting bandage over her arm, and when I took it off the skin peeled with it, revealing a deep wet hole in her arm, where an IV had been left to fester.  I could see the muscle beneath the hole. Her eyes were half-open, and flies continued to land on her lids.  Her torso, damp, cold, and peeling, was crawling with ants.  I put my fingers to her wrist, and felt a pulse. Although I knew there was likely no point, I appealed to the nurse standing next to me for a dry blanket to keep the flies off of her face.  “She’s not dead yet, you disgusting scavengers,” I thought as I worked to rid her small body of insects and untangle her from her wrap.  Together the nurse and I warmed IV fluid bags in a hot-water bath, wrapped them in blankets, and placed them around her little body.  We put in a new IV, through which we gently bolused her with warmed fluids.  The nurse brought out a metal contraption that we placed over her and covered with blankets, forming a tent to keep the flies from returning, and to seal in the heat we were hoping to generate with the fluid bags. We gave her a dose of antibiotics, and placed her I a soft clean bed in the “ICU”.  We warmed milk, and I fed her through a nasogastric tube.  I was overjoyed when, a few hours into our efforts, she opened her eyes and looked at me.  I talked to her in what I hoped was a calming, gentle voice, knowing that she had likely never seen a Mzungu before, and assured her that we would keep her safe and dry.  I told her that her mama was nearby.  She seemed to understand me, and I left that night feeling hope and filled with gratitude for the opportunity to have taken care of her.

She died that night, which saddened but did not surprise me.

My question is this: What was the value of my intervention?  The little girl died.  But she died clean, and she died warm, dry, and free of insects.  She died having heard a kind voice, and having seen eyes smiling at her.  Is that worth all of our money and time and sacrifice?  What is the value of dying a “better” death, if that was all I could provide in that setting? 

I do not have the answer.

Sunday, July 22, 2012


So, for the last month, I have been living the dream.  I have had store-bought Starbucks most mornings.  I have shopped obsessively in bright, well-stocked department stores and had ice cream in some form almost every day.  I have spent time with family and friends, and have been truly astounded by the size of the community that we have here in the US, and especially in North Carolina.  We have had people cook us dinners, watch our children, do our dishes, offer us their cars, and bake us cupcakes.  Through the generosity of friends and family, to whom I shamelessly sold African artifacts I had brought from Lilongwe, I raised over $2000 which we will use to help families in Malawi.
It was not, however, the idyllic vacation that we had envisioned.  In the 28 days that we were home, we had 7 doctor appointments, 11 dental appointments (4 with procedures, and an hour away), filed our taxes, I started the fellowship application process, we met with social workers and did paperwork to ensure the twin’s American adoption, we shopped for new clothes and shoes (2 pair each) for all 7 of us, our a/c broke three times, Dave moonlighted 60 hours, and we hosted a total of 15 people over 3 weeks.  All of this without the help of our nannies, and with the use of one Prius, which could only hold 5 of us at a time, and which required new registration, 4 new tires and a jump-start before it was drivable.  Dave took care of it the day after we arrived home from our 40-hour odyssey. 
The plane ride was predictably hellish, with the twins sleeping consecutively, rather than simultaneously, and only for 2 hours at a time.  At one point I let poor Dave sleep, and I kept both twins by myself in the front seat of the plane.  I rigged a barricade with the toddler beds I’d pulled off the wall, and smugly watched the babies destroy the area, while I sat back and ate my fist airplane meal, pleased with my ingenuity.  Our big children watched movies for 12 hours.  When we were exiting the plane the stewardess looked at my pasty, bug-eyed older kids and said, “Oh! You had more?  I thought you just had the babies!”
 The drive from DC to NC (we had to pay for 6 of our tickets home, about $9000, and couldn’t afford to fly our family that last leg)  was much longer than it needed to be, as we stopped at nearly every fast food establishment we passed on the 300 mile journey.   When we finally got to our ridiculously big old house, and I sat in my beautiful, enormous master bathroom, it hit me that there were countless families we knew who would give anything to live in that room.  Perhaps because I was exhausted, I sat on the edge of the tub and had a good old cry.  Sweet Dave, who has learned to accept my mercurial nature and my occasional emotional meltdowns, was supportive as usual. 
The first week I was home I wasn’t much more stable.  I had this acute, unrelenting pain in my heart at the thought that this world could co-exist with the one I had left.  There are simply no similarities between the two places.  And the hallucinogenic effect of sleeplessness and jetlag left me feeling surreal and emotionally labile.  I cried a lot.  People here are so blissfully (willfully?) unaware of their unique experience in the world.  We drive on gorgeous, well-maintained roads and highways lined with wildflowers.  Our children do not starve to death.  We have eradicated or mitigated most major infectious pathogens through aggressive and largely effective public health campaigns.  If our house is on fire, the fire department will come rescue us.  If we are in trouble, we can call 911 and the police will arrive.   We can be reasonably certain that, barring some unforeseen weather event, we will always have easy access to abundant, clean water and a consistent supply of electricity.   If we go to the hospital for a blood transfusion, it is unlikely that they will be out of blood.  Perhaps to our detriment, food is accessible, cheap, and ubiquitous.   America is truly, as our family calls it, the “Land of Milk and Honey”, and I have never in my life been prouder to be an American as I am after living in a place where the government truly doesn’t work.   And yet, as I reveled in the benefits of being home, I also felt deep sadness at the complacency that needs to exist here in order for the differences between the two worlds to be perpetuated.  I felt guilty for enjoying it so much, when so many people we know are so incredibly poor.  We take more than our share here. 
But, then I got some sleep and sunlight, and spent time with my family, and the world brightened.  The next day I was on line at a local grocery store by myself, waiting to buy a spiderman video for the kids, when I realized that I’d left my credit card at home and didn’t have enough cash to buy it. “Don’t you worry, honey,” said an elderly white southern lady from behind me in line, “you just put that on my bill.”  I was touched, but unwilling to accept her generosity; after all, it was a movie, not baby formula.  She insisted.  This kind stranger helped me for no reason (I had no African orphans with me at the time).  This, of course, renewed my faith in humanity and buoyed my spirits significantly.  I began to relax and enjoy the perks of life in the USA.  Driving is probably the thing that is the most dramatically different between Lilongwe and home.  In Malawi we drive a big old diesel truck with no air-conditioning and a driver’s door that doesn’t open from the outside. It rumbles loudly as we bounce over unpaved roads littered with potholes and rocks.  Most people do not drive, so the roadsides are lined with people walking and biking. I don’t believe there are any two-lane roads in the country, and emissions control is definitely not a priority. Because gas is so expensive, the roads are so bad, and our vehicle is inefficient, we pay over $1 per mile to drive in Malawi.  Driving 72 miles per hour on the gorgeous I40 in North Carolina, with my cruise control set on my Prius, we pay about 6 cents per mile for an infinitely more pleasurable experience.
Eating is also a starkly different experience in the two countries.  Someone asked me what food I miss the most, and I realized that there is no one thing.  What I miss most about American food, and America in general, is the variety.  If there is yogurt at the grocery store in Lilongwe (and there often isn’t), then it is available only in one brand.  If it can be found anywhere else in the city at the same time, it will likely be the same brand and in the same flavors.  In America we have the choice between whole fat, low-fat, fat-free, organic, soy, or greek yogurt, in various flavors and brands.  There was more choice in groceries at the first gas station we stopped at in Virginia than there is at the Lilongwe Shop Rite.  And food here is CHEAP.  It may not always feel that way to Americans, but the fact is that eating is much less expensive here than in many places in the world.  I don’t want to belabor my distress at the price of butter in Malawi (I have mentioned it a few hundred times), but it is emblematic of the cost of eating there.  Unless we live on the local nsima (I think it translates into “constipation” in Chichewe), we pay ridiculous amounts of money to feed our family ($400 per week, and we eat a lot of PB and J).  Food is also so easy to get here. Coming home from a friend’s house at 10 pm the other day, Dave, Eamonn, and I felt hungry. 10 minutes later, we had several thousand calories of Sonic milkshake and Taco Bell in our laps.  Had such a craving hit in Lilongwe, we would have been out of luck, unless we wanted to cook something for ourselves with what we might have in the house.   In general, the quality of food is much higher here.  I’m no fan of genetically modified anything, but the fruits and vegetables in the US are beautiful.  Every strawberry is bright pink and huge, and bursting with flavor; every tomato is shiny red and perfectly ripe.  It’s unnatural (and we greedily scarfed it all down). The food has been so plentiful and delicious and inexpensive, that we have all gained weight.   My Aine has consumed more calories on any given day this month than she would normally eat in a week in Malawi.  Tonight she ate a snack of Reese peanut butter cups and pickles (simultaneously, not combined, but still gross). 
When I was in my “transitional phase” in the first few weeks after coming back, and was so despondant about the prospect of leaving home again, each of the kids expressed anxiety and sadness at the thought of returning to Africa.  “Life is so much better here!” Aine aptly summarized through tears one day.  “I don’t want to go back!”  Finding false platitudes difficult, as I shared her dismay, I counseled her the best I could.  I told her that being home, surrounded by the people we love, and sharing in the joy of family and friends in a place that is comfortable and familiar, is an exercise in truly living in the moment.  We know that our time together in this relative paradise is limited and finite, and we know that we have to leave at the end.  The trick has been, as it should always be, to take deep breaths and take close notice of all that we have in each moment.  I have tried to follow my own advice. Despite the chaos that seems to envelope us wherever we go, I have tried to savor the minutes and hours I have spent talking to my little nephews and swimming at the pool with my kids. I have tried to memorize the sweet crunch of the warm blueberry scone from Starbucks, and the satisfaction of filling my gas tank, at a moment’s notice, with my credit card, for $35. The problem is that even when you savor these moments, they are fleeting, and they pass.  And so tomorrow the Fitzgerald clan leaves again for Malawi (we actually leave Greensboro today).  We will carry the memories of these moments with us in our hearts, and when we miss the familiar faces of friends and family we will recall them, as we wait to return home again. 

Tuesday, June 19, 2012

Going home.

Circumstances have conspired to leave me alone in front of the computer, with no access to internet and little excuse for not writing.  It is, of course, not unusual to be without the internet.  That happens every night.  It is the fact that I am alone.  All 5 kids are sleeping, and Dave is out at his clinic seeing a patient (rare).  So many times this year I have written blogs in my head, or even started them on the computer, but our lives are so chaotic and full that only occasionally do I finish and post anything.  There have been so many emotions this year that I know have gone undocumented.  There have been so many changes that I have not taken the time to reflect on. 
                For the last several months I have been in a better place.  I think it is the sad but inevitable result of being surrounded by poverty and illness:  eventually you don’t cry over every death.  The patients and the people are always affecting, and there are still some that put me over the emotional edge, but I have been more able to go on with my life, without being thrown into a major depression with every bad outcome.  Similarly, the hassles of life here have become routine, and we have learned both short cuts for and to have patience with the idiosincracies of Malawi.  It has also helped that the former president, who many believed bordered on dictatorial, had a heart attack, and was replaced by one of his rivals, a woman named Joyce Banda.  Fuel lines have been better, and there are less scary-looking police thugs roaming the streets with guns, although the store shelves remain half-empty, and the value of the kwacha just dropped 40%.  I also think it really helped my outlook that I knew I was going home soon.  There appeared to be a light at the end of the tunnel of our life here.
 Unfortunately, my glow of tolerance has dimmed.  It began to fade when I realized that this trip is no “light at the end of the tunnel “.   It is a window, letting some liver of light into a dark, somewhat claustrophobic tunnel that we have only half-way traversed.  I don’t mean to sound melodramatic (well maybe I do), but when it dawned on me that we would be returning to Malawi after our vacation, with a renewed sense of all that we are sacrificing and missing, and without the sheen of novelty to ease the transition, I started to get depressed.   As the date of our voyage has loomed nearer, my funk has grown.   
The hole that the absence of my family has left in my heart is huge.   I am almost afraid to see them again.  I’m afraid of having to try to distill two years’ worth of experience and growth and change and love into just a few days.  I’m afraid to remember what it is like to spend time with them, to watch our children run around my yard again, to laugh and reminisce and hug, I’m afraid that every family dinner, every shared joke and shared beer will be tinged with sadness, because it will be the last for another year, and it has already been so long.  I’m afraid of saying good-bye again.
And, the truth be told, I’m tired of life here sometimes, and the thought of coming back to the same stressors make me anxious and sad.  We are going broke; it is ridiculously expensive here, and is only getting more so.  The economy has gone through so much since our arrival that the price of most foods has literally doubled in the last year, and in some cases it has tripled.  We are now spending $170 USD to fill our gas tank.  We have had to give our nannies 40% raises, to compensate for the devaluation of the kwacha.  Electricity is through the roof.  We have been living off of the money that we saved before we came, and we have gone through it at a startling rate.  I am worried we won’t survive financially for another year, and I’m terrified of going back penniless and with huge credit card debt. 
There’s a side to living in a place like this that I think you don’t appreciate unless you experience it, which can be uncomfortable to explain.   I know that I am blessed to be in the position of giver, and it can also be frustrating and overwhelming.  Sometimes I feel like an ATM.  There are so many people, and they need so much.  My measure of poverty is this:  if another human being will eat the discarded food from your plate, then they are poor.  There are literally scores of children, kids the same age as my own, who live on the streets and eagerly accept our scraps.  And I know that I should be (and I am) so very, very grateful to be the one giving, but sometimes, especially in light of our own financial concerns,  I wish people would stop asking for so much.  I wish I wasn’t such an obvious target.  By virtue of my color, I cannot walk 2 feet without being offered something for sale, asked for money, or asked for a job.  I try to understand.  I am walking opportunity.  But being an Azungu in Malawi can be like being a giant dollar sign with appendages.  I long for anonymity.
Tomorrow we go home.  Once again I will see my family, laugh on my porch deck with my brothers, watch our kids run around on the front lawn together, hug my mom and my little brother and sister.  Once again I will have good food to eat, and tons of it.  I am going to eat ice cream or frozen yogurt every single day.  I am going to eat Thai food, go to salad bars, drink fountain soda, and eat Twizzlers until I vomit.  I am going to drink Starbucks twice a day.  Once again, I will have entertainment, and exposure to American culture.  I will go to the movies at least twice per week. I will take my kids to the Life Science Museum, and the beach, and to see friends and swim in the pool.  I will go to the air-conditioned gym EVERY DAY.  I am going to live a life of convenience and consumerism and comfort, and I am going to try to love every single minute of it.
And then I’ll come back.