Bzyazi - the juvenile boys prison

Friday, the 26th of June, we traveled over an hour out of Lilongwe to the 'bush' where there is a prison for youth. These boys have been convicted. There are ~89 boys there. There is nothing much around, except beautiful scenery. Because they are so far from towns, they have been overlooked. The youngest I saw was 14 but I was told there are a couple of 13 year old boys here. Charles Msukwa, who is running Amazing Grace Ministries for the Maula prisoners, has taken on this small prison unit also. He has managed to get H2O ministries interested enough to build a clinic which is almost complete. It will have an exam room, a room for pharmacy and labs and a 'short stay' area with 4-5 beds. He says there are no clinics / hospitals anywhere near the prison, so he expects that women from the nearby villages may start coming to the clinic to have their babies. (can you even imagine that in the US??) There is a borehole (well) but no running water in the clinic. Since the clinic is not finished, the administrator graciously let us use his office space for an exam room, and the small pharmacy area they have, they turned over to us for our pharmacy / lab /wound care. They have almost no medications and little wound care supplies. The boys actually looked pretty healthy, no one was terribly malnourished and most of the complaints were the usual body aches, stomach aches, cough and dental pain. We treated a couple cases of possible malaria - another was borderline and his test was negative. We also treated the guards and their families if they needed treatment. There were a few wounds, but remarkably none were infected. The prisoners and the guards were all most gracious. For those of you who would consider coming with me - the prisons here are NOT like the prisons in the US (at least in my experience). Everyone is grateful that you care enough to come. They are polite and appreciative. The administrators and the guards do the best that they can do with so little resources. Often there is no transport to take a sick prisoner to a hospital. Charles tries to take soap into the prison when he has funds given for soap, etc. If you are interested in any of Charles' prison ministry, get in touch with me and I can get you to the right people for you to donate, for your church, your Sunday school class, whatever. Jesus specifically mentioned visiting people in prison.... these indeed are some of the 'least of these' and you can 'visit' them through your support. Enjoy the photos!

We are standing in the 'waiting area' of the new clinic. To the right are the two exam rooms. This is Louis (translator), Julie Hoskison, RN, Jollyn translator becoming pharmacist, me and Maggie Maseko, med student and translator.

The boys lining up to be seen

Maggie checking oxygen on a patient - being the hands of Christ.

My office, with Maggie translating.

Sign for new clinic, may not be finished by July 1 but pretty close! Thanking the Lord for H2O ministries!

 Julie doing a malaria test.

The team - Maggie, me, Jollyn, Julie, Charles Msukwa and Louis.

Outside of new clinic with guys hard at work.

Seizure clinic

Thursday afternoon we went to the seizure clinic, sponsored by Children of Blessing Trust (COBT) The clinic meets about twice a month and supplies seizure medications at no cost. They do not take care of other medical problems at that time. COBT runs a school for special needs kids, teaches adults with special needs or lack of education due to seizure (you can be expelled from school because you have seizures = you are 'disruptive', so you end up with no education). About 1 in every 100 people in Malawi have a seizure disorder. Sometimes it is simple epilepsy and once their seizures are controlled, they go on to live a normal life. Unfortunately, many of them have a multiple of special needs - controlling the seizures is only one small part. These conditions arise from episodes of cerebral malaria or meningitis, birth injuries / hypoxia / cerebral palsy, psychiatric issues, trauma or just 'we don't know'.  I think some of the kids may have some sort of autism but I am no expert in that field at all. Kathy Bowler is the lady 'in charge' and she is amazing. She can get these kids extra nutrition, wheelchairs and other aids, physiotherapy... She is not a doctor but has recruited Dr. Young to help at the clinic regularly and I have been blessed to be asked to help out several times, along with Dr. Bryony Pannell. It can be very heart breaking when you realize that so many of these kids literally have no decent future in Malawi. There are no 'half way' houses, no special programs for their learning / physical needs, no government assistance for them. Their Moms are often full time care takers so cannot work and the dads sometimes just disappear. If you have a heart for special needs kids, consider giving to this ministry. They have a website. The money is well spent. We have the clinic in the school rooms and you can see they are very basic. Most of the workers are Malawians, so jobs are created. Please also remember that the missionaries themselves have to eat, buy gas, go to the doctor, pay school fees for their kids, buy clothes.... so often people will give to a
building fund but miss the fact that the missionary, with their feet on the ground, need support.
Anyway, I know so many of my friends have huge hearts and someone will come along side of COBT and be of help. Enjoy the photos!

Ready to start: me, medical student Allison, Maggie Maseko and Julie Hoskison

Mom and child

This one was a real hand full. If you are not my friend on Facebook you should be! She was busy, busy, busy the entire time. Dr. Bryony is in the background. We are in one of the school rooms.

The little ones grow up, the seated young lady is still struggling with some issues, although her seizures are much better now

We don't really treat anything except seizures, but this guy was having abdominal pains before each seizure so I just wanted to make sure there wasn't something big going on in his abdomen.

Pothawira - clinic and orphanage

We went to Pothawira and stayed with the Masekos after church on Sunday through Wed afternoon. Julie and I volunteered at the clinic. I think she worked harder than I did -being a nurse there is very hard work. The clinic sees 200-300 patients a day. We also got a tour of 'phase 2' which hopefully will be finished by the time we are back next year. That will include labor, delivery and postpartum. They have been given a very generous donation to get started, but will need additional funds to finish the OR, the nursery and some isolation rooms for the contagious mothers.

We also saw the kids and gave out some dresses from Linda Redinger to the little girls, and baby blankets to the newest twins. Emma Maseko told me there were out of blankets and small baby clothes, so she is saving the rest of the blankets for the next new babies that come. They have 111 kids now, in an orphanage built for 100. They are building an additional duplex for another 20 kids, but it will almost be filled by the time it is finished!

Julie and I gave blood at the district hospital - unfortunately, Julie was a little dehydrated and felt pretty faint afterwards, but otherwise all went well. They need about 10 units of blood a day and get almost no donations. Sometimes family will come with a patient to donate, but  that is not enough. There is a central blood bank in Lilongwe, but it is several hours away and they are often out of blood. Where ever you are, consider donating to your local blood bank!

We arrived back in Lilongwe Wed. evening, bringing Maggie back for a couple of days, and had a very nice dinner with Michelle Clark.

Enjoy the photos but some are pretty medically graphic.

Cute kid at the clinic (he was not a patient)

Giving blood at Salima District Hospital

Julie finishing her donation

Oops, we should remember to drink more water before donations!

The main nurses station of the Phase 2

Julie, Peter and I at the 'back' of the new Phase two

Julie hard at work at the Pothawira clinic

A nicely healing foot wound

Julie unwrapping a burn wound, preparing to replace the bandages. It is winter here, with many children being burned in the open fires.

One of many abscesses we see in the clinic. Usually Peter does these but he was gone for a bit so I got to do this one.

Dinner with Michelle Clark and her Mom

Back in Malawi and going to the Prison

We arrived Wednesday but our bags took a holiday for a few extra days. They arrived this afternoon (Sat). But all is well! It always takes a couple of days to get settled in. I got my medical certificate renewed, bought medications for today's clinic, saw the new Gateway mall (which is pretty awesome), did grocery shopping, organized medical supplies (the stuff I leave) and even had my car worked on. A busy couple of days. Today we went to the Maula prison for a clinic. Charles Msukwa is awesome with what he (and his coworkers) are getting done here. The recruited Doctors without borders to build a new block of exam rooms and a short stay room (sinks in all rooms!) attached to the clinic. The clinics there are short, since the prisoners have to be back in their cells early. Jones Tambula (medical assistant) has started new record keeping which is very helpful. The prisoners seem to be healthier every time I go. We started a little after 9 AM and ended about 2 PM. 5 hours and I saw 56 patients - Julie saw / treated some that I never saw. She and another nurse, Erica, had Smart to help them in the wound care area. Everything went very smoothly. It is always heart breaking to hear some of their stories. People here, when arrested, get put into prison. Then the legal system sorts things out later. Sometimes much later. One gentleman had been in prison several years and still no trial. A 15 year old girl was in prison because her husband committed (and confessed) to murder, but the police arrested them both. Of course, there are some bad guys there too! The nutritional status of many of the prisoners is still an issue. They get one meal a day of ground maize. There is a feeding program at the prison now, but the food has run out. One of the men never got his food, because his cell mates would steal it from him. He truly looked like he was going to die of starvation. I have posted some photos on Facebook, but here I will post some more of the graphic ones. Don't look if you are eating or have a weak stomach!  Tomorrow we go to Salima to start working at the Pothawira clinic for a few days. I will be out of touch but will try to update when I get back.

The exam room I used.

Pellagra, a nutritional deficiency of niacin.

Bullet wound in leg

Very nasty dressing on a clogged suprapubic catheter, Fixed and redressed by Julie!

The treatment room with a sink, shower, and bed. The suitcase is full of medical supplies - donated by wonderful folks!

Redressed, bladder emptied and hopefully catheter fixed.

Chronic perianal fistula - I have seen this guy over the years and it looks like Smart's careful dressing change and cleaning every day may heal this up!

Plantar's warts

Excising plantars warts

The excised lesions (plantar's warts). Hopefully this guy will not get an infection. It is nice to know that Smart is there, working with Jones, to help with these wounds.

The team - Charles, Erica, Jones (guard in back with hat - not sure of his name), Julie and me. Front row is inmate who works with Charles, Smart (also an inmate), Jollyn and Selina. An awesome team!

Another shot of the team that includes Louis (far left, standing) that Charles took.