The Good Life

Weather - Average temperature 24 degrees Celsius

- Rainfall 3 drops

Highlight of the week

Chicken tikka masala

Lowlight of the week

COVID pneumonitis kills one of our patients.

What would Tom and Barbara Good make of our new life in Zambia? Simple? Sustainable? Swap Tom to Keith and Barbara to Ginny. The scene is set for a new version of the Good life. Our vegetable patch is flourishing with coriander, lettuce and pawpaw. Our garden bushbucks and warthogs anxiously eye our freshly sharpened kitchen knives. Vicky and Alistair are our equivalent of Margo and Jerry Leadbetter. This episode might just grab your attention if you are of a certain age.

“How are you settling in?” Our neighbours chant to us. So welcoming. Yet, how do you answer this simple question? “Really well…” seems to hide the complexities of our progress so far. Yet within a week we already had a new routine. Is the new routine complex, or is it simple? Is this the new normal?

A day in the life of the Birrells in Zambia is pretty simple. We have adjusted to the local pace of life, and a relative lack of mod cons. Cooking has been stripped back to basics. Opening a tin of tomatoes is just not necessary. We have a steady supply of fresh tomatoes and a host of fresh ingredients. In the new routine, happily we have plenty of time to cook from scratch. Our vegetable patch in reality belongs to Kapani lodge and supplies tourists, not doctors, with delicious and fresh fare. Our own green grocers, Ziyelesa and Thomas, deliver to our door three days a week. And the local market in Kakumbi village sells a wide variety of fresh goods. Charity is our favourite market vendor. She provides us with amazing ripe avocados, eggs and bread.

The best fruit is from Charity

Home delivery from Ziyalesa

Junk food doesn’t get a look-in in Kakumbi village. Unless you count nsima of course. Nsima is maize flour, mixed with water and a little salt. Tasteless and unappetising, nsima provides a high GI carbohydrate hit for the working person. For the less active, nsima symbolises type two diabetes on a plate. As you might expect nsima is not at the top of our shopping list.

Our days start at zero six hundred. Either the alarm clock wakes us, or more likely we wake as the baboons land heavily on our tin roof, just as the sun teases them with its arrival. We wake with a start. The baboons love that crazy half hour on our roof. It fires them up for a day of dodging leopards or scavenging for tree fruit. Although we might wake with a start, our energy levels are quickly high. There is no breakfast until we have limbered up. High Intensity Interval Training, or yoga, is served before breakfast. Keith had wanted to buy a bike, but the elephants and myself said “no”. Running, or biking, outside might be necessary for the locals when the wildlife is getting hungry. But for us, it is far more appealing to exercise in our air-conditioned bedroom/ gym. We have resistance bands, exercise mats and a skipping rope. Breakfast is the next course. Pre-soaked cold porridge, bananas and strawberries and a nice cup of coffee. We are set up for the day.

Our commute is more scenic than the A19. Sand tracks, mopane thickets and water holes brimming with buffalo or hippo. We occasionally stop on the route to let elephants and pre-historic giraffe cross. But we are yet to realise the zebra crossing gag. The sand track evolves into a badly pot-holed tarmac road. We barely get up to 30 kilometres per hour before reaching the clinic fifteen minutes later.

Our commute

We arrive at the clinic at zero nine hundred. A few patients have gathered. Keith and I divide and conquer. Each of us works with a local clinician. These clinicians are nurses or medical assistants. Their Nyanja is far better than ours. Our medical, and on the job, training is far longer than theirs. Most of our colleagues are freshly out of training. I try to concentrate on the children. Keith sees the over 17s. Most of the kids I see have a history of cough and fever. To date, a few of the children that I have seen have tested positive for malaria, but none have had a significant chest infection. I’m far more stingy with prescribing antibiotics than most. But prescribing no antibiotics in a fortnight has to be some sort of African record, even for me.

All ready for a days work

I suspect that if I was not here, the majority of these babies would have been given antibiotics, “just in case”. Treating viral upper respiratory tract infections with antibiotics is often an easier option for time pressured clinicians, especially if antibiotic use is normal practice. Safety netting families for the symptoms and signs that might suggest that medication, and review, would be needed, requires a change in mind-set for clinicians and patients alike. My mission might have been to share this behaviour with the local staff to give them the confidence to use the virus word, but…. I offer an explanation of Thandi’s symptoms. Thandi’s mum struggles to accept that this virus is OK to leave to its own devices for now. She is anxious that there is a new virus in town. Patients and clinicians are having to adapt quickly to deal with this new virus. Telling patients that they only have a viral infection is no longer reassuring.

Clinic is normally finished by twelve thirty. Our journey home is broken by a trip to Mayana stores to buy butter and a quick stop at the market for two of Charity’s best avocados. Lunch might be last night’s left-overs, or a fresh avocado salad with egg on toast. If the sun makes an effort to warm up South Luangwa, then we are usually obliged to cool off in the small pool that is shared with the other residents of the Kapani compound. The afternoon is also the time for us to do the occasional home visit. Supporters of the Luangwa Safari Association medical fund may ask us to do a medical assessment on a client or a patron. Daytime visits involve a standard payment for this consultation that is paid into the charity to sustain the fund. Supporters of the fund also pay a modest annual levy. The fund pays our expenses but no wage. The out of hours fees are double and the out of hours calls are predominantly more urgent and exciting. So far, we have had about 3 calls per week most of which are routine in terms of how quickly we need to visit.

Our social life is starting to pick up. Before COVID hit South Luangwa valley, and the world, there had been a weekly pizza night at Croc Valley lodge. The pizzas at Croc valley are still on ice, so to speak, but we have already been for sundowners with our immediate neighbours and had a meal with new friends. We have yet to entertain anyone in our own new home. But it won’t be long I suspect. What will they think of our versions of Joe Wicks meal plans or Ainsley Harriott’s meals in minutes?

My appetite for reading has been voracious. And I will soon have emptied my initial cache of books from my Kindle. But, after initial teething problems, our Wi-fi service seems good, so I’ll be asking for recommendations for further Kindle downloads. The Times somehow realised that I am in Zambia. How do they know that? So, I’ve succumbed to a tempting offer, only available to readers out of the UK. I am now a Times subscriber. The weekly jumbo cryptic crossword is my guilty pleasure. Keith is trying to convert his Swahili into Nyanja. My brain is currently too busy being fried by crossword compilers and tropical medicine, so I’ve called a rain-check on the Nyanja lessons for now.

Doubtless Tom and Barbara hoped that opting out of the rat race and materialism might save us all from global warming and stress. Keith and I now find ourselves out of Boris’ grasp for 6 months. We hope to be able to live the good life, detached but inexorably linked to the rest of the world. We reckon that we can sustain this new way of living for 6 months. Living simply, yet not totally out of the loop.