Child Legacy and more

For those of you who do not follow me on Facebook, just a quick update. Thursday lunch with the Whiskas and then dinner with Dr. Young and other friends. Friday we did rounds at KCH again (taking Claire with this that time), then to ABC and home for a quiet evening. We found out at ABC that the E3 clinic had been canceled for Sat, but it was too late for us to organize another village clinic on Sat.  We decided instead to go tour Child Legacy, outside Msundwe trading center. They have made a lot of changes since our last visit 2 years ago. They are delivering babies and hope soon to be able to do C-sections (awaiting some additional equipment for the blood bank). They now have 2 US doctors - one in pediatrics and one in family medicine. They were gone for the week-end. They will be leaving for good in Dec. so if anyone is interested in coming to Malawi to take their place, let me know or contact Jeff Rogers at Child Legacy. He is very interested in OB especially, but will need a pediatrician also to take the place of the leaving doctors. The main clinical officer is Lucky, an old friend from Daeyang Luke, and he gave us an awesome tour.  Child Legacy is located in a very rural area, but the project has its own water source and is completely 'off the grid' as far as power is concerned and is powered by both wind and solar. They have a huge agricultural program and grow  / raise their own food. The lady in charge, Afsahan, is simply brilliant, with a very inquisitive mind and some great ideas. She is 'exporting' her ideas to surrounding farmers and villages, and helping a local school start their own gardens. They do not use the hybrid seeds, they use permaculture methodology, with everything having multipurposes. The large fish ponds provide not only food but also a nitrogen rich fertilizer for the gardens. When you enter Child Legacy, you turn off a dust road surrounded by very poor villages, into what appears to be a garden of Eden.  Jeff and his wife have done an amazing work there!    After Child Legacy, Joey and I stopped by to see the kids at COTN, Chitipi again, dropping off some photos, a couple of soccer balls and some suckers. Enjoy the photos!

Dinner at the Youngs - from the left, Bau, Clarie, Tanja, Diane, Jim (in back), me, Nancy and Archie.

Child Legacy, Jeff Rogers showing us the new learning center, under contruction.

Lucky showing us the outpatient waiting area. It is a Saturday so it is not as busy. They charge 500 kwacha (less than a dollar) for everything done IF you come business hours, Monday through Friday. At night and on the weekends, it is 1000 kwacha. Maybe we should start something like that in the US? During the regular hours, they see about 250 patients a day.

In the 'waiting area', the patients are registered and their vital signs and weight are recorded.

One of the new surgical suites, just awaiting the completion of the blood bank to start doing C-sections!

Lucky showing us one of the exam rooms for pregnant women, complete with the bedside sonogram!

Fully equipped ambulance. They use this to transport patients from Child Legacy to town (KCH). Trust me, a fully equipped ambulance is a rarity here!

Joey and I with Afsahan, getting tour of some of the grounds. Not only do they raise food, but also have planted useful flowers and herbs. They have succeeded in attracting butterflies and birds, along with bees (they have ~12 beehives) to this once dead area. Most of the 'flowers' serve more than one purpose - beauty plus attracting wildlife or, in the case of some of the plants, repelling mosquitoes or other bugs. All the pesticides they use are made on site and are organic.

Some of the wind turbines for wind power.

The main 'solar' area, although there are solar panels scattered over the entire complex. This house has the huge batteries to store the power.

Jeff Rogers and myself

Asfahan and myself. I don't know if we were talking or simply laughing!

COTN, Chitipi, little Mikey, asleep in his crib.

COTN, Chitipi. The kids after the sucker hand out. Steven is in the front in the red shirt, holding the picture I gave him of himself. You can also see the new soccer ball.

Thanks for all the prayers that are being offered for our safety. Thanks for the donations of medical supplies and medications (especially the vitamins we cannot get here!).

M'nima village clinic

On Tuesday we drove the 1 1/2  hours from Lilongwe to outside of Salima town, to a village called M'nima. Kathy Nunnley has a project there, Feed Hope, and had asked if we could do a village clinic. There were 6 of us volunteers: Joey Swartz, Claire (newly minted MD from the UK), Tanja Muff, Ty (premed student from US) and Trey - high school graduate from US. We also had translators Eve and Lewis and of course, Charles Msukwa who is the great co-ordinator of everything! We used the Feed Hope building, which is nice, new and spacious, but only has light from the sun. We ended up seeing slightly over 150 people, with the most diagnosis probably 'general body pain' followed by malaria. We also saw a smattering of other complaints. This time of year (dry, windy and dusty, with fires everywhere) cough is always a big complaint. Some diarrhea and abdominal pain, a few infected areas (toes, buttocks, etc), and the usual rashes. Poor Claire ended up with some complicated patients. My most complicated patient had been totally evaluated at the local district hospital but not 'cured' and the lady 'couldn't find her book' (health passport) explaining what they had found / done, etc.  I recognize that a mobile clinic is NOT going to ferret out the more unusual problems - we really aim to treat acute problems, and offer some relief of pain (even if chronic) and can give short medication courses (month or so) for things like blood pressure.  We did find a small child with cleft lip, and my translator, Eve, took the mom's number - Eve will call the Mom with the information about upcoming 'Operation Smile' clinics. We also found a young teen age girl with some sort of birth injury involving the right side (paralysis and contractures of right arm / hand, atrophy or non-development of right shoulder and upper back) who apparently has some sort of tonic/clonic seizures. We fortunately had some seizure medications for her. When we set up the work stations, the best light was coming from the open doors, so the malaria testing station was there. I set up my table next to them! Never again! Oh, my, it is the loudest place in the building with all the children crying!  We finished and were packed by about 5 PM, with no lunch breaks. We snacked on the way home, but didn't arrive until after dark. Those of you familiar with driving in Malawi after dark know how stressful this can be! Praise the Lord, we made it home safely. Enjoy the photos!

HSA giving out the registration 'paper' as the crowd gathers!

Claire examining a patient - as you can tell the baby is not very happy about the whole ordeal!

Checking the blood pressure on a patient. This is predominantly Muslim area, and many if not most of the villagers are from the Yao tribe. We actually had to have a translator for our translator in one older lady who only spoke chiyao (or whatever it is the Yao speak) Note how close I am to the malaria testing station!

Claire with another little patient. He looks a little happier than the other one!

Tanja and Joey, along with translator Davies, handing out and explaining medications to a patient.

Another view of the pharmacy staff hard at work. They had a low table, again! and so many of the meds had to be on the floor. This is truly a back breaking job!

Malaria testing, with their patients on the floor, while Eve and I are interviewing another patient. No HIPAA here! and the noise factor can be quite something else!

Trey making friends with one of his 'victims'.

More of the crowd waiting.

Trey did quite a bit of 'floor time' at the malaria testing station!

More pharmacy translating! Davies was a great help to the pharmacy team!

Close up of the malaria testors! Ty in the blue scrubs, watching Trey do the actual finger pricking.

Hope you all enjoyed the photos. You can find Kathi's project online, I believe. And of course, you can always donate to me through Global Health Innovations, just be sure to attach my name and Malawi missions to your check!

Seizure Clinic, KCH and Chitipi

Thursday was the seizure clinic again. It is a bittersweet clinic, knowing that a few of the patients have ‘gotten their life back’ because of the antiseizure medications, but most of them will live a life of disability, even if the seizures are controlled. One sweet little guy we saw was normal until he had cerebral malaria, then he developed seizures and paralysis of the left side. His seizures are slowly coming under control, and he is in physiotherapy – he can now more his left leg! There is hope for thie litte guy. Most of the others cannot expect this sort of improvement.

Friday morning we went back to KCH and attended morning hand over rounds and then ward rounds on 1A. Earlier in the week the team had compiled a list of surgery cases for Tuesday – 8 cases. Turned out that one of those was so complicated and long that all the other cases had to be canceled. One of the men we saw last Monday and got surgery (I suspect he was the complicated case) died Thursday night in ICU. The other cases were either sent home to return this coming week, hoping for surgery, or are stuck in the hospital. There are a few ‘mystery’ cases on the ward, one in particular is very sad. It is hard to run a hospital with limited resources – CT scan not functioning, limited OR space, many specialists not even available. The staff, from nurses to students to interns and residents to full fledged doctors do amazing work under the most difficult circumstances. One of the nurses confided to Joey that many times patients die because there isn’t enough staff!

Saturday Joey and I went to the COTN (Children of the Nations) orphan home and farm outside of Lilongwe. It is called Chitipi. They have about 42 kids in the orphan home and another, smaller home with the teen age / young adult girls.  I know the sponsors of several of the kids at Chitipi, so I try to see them and bring them greetings from their sponsors. I also bring gifts to not only those kids, but things for all the kids to share. Joey Swartz and Kelley McGowan helped with that this year, with suckers, trucks, balls, cars, jump ropes, etc. A good time was had by all!  If you are interested in sponsoring a child through COTN, I can attest that, at least in Malawi, these kids get excellent care. A child in the orphan home seems to really thrive. They have feeding programs in some of the villages for at risk kids. They still live with extended family, but COTN seems to keep a close eye on them, too (harder when it is 500 kids in a village) and I know they have taken at least one girl OUT of the village and into a home because of sexual abuse by a step Dad. The village kids get basic medical care, the ones in the homes get great medical care.  A simple sponsorship CAN change a life! These kids were excited to show me the pictures of them and their sponsors (aunties and uncles) when they had visited or even just photos – they could point to their sponsors and name them! Ideally each child has 3 sponsors. These kids are so precious! If you have been following me on facebook, you will have seen my sponsored ‘child’, Henry Lidson Masamba. I started sponsoring him when he was about 4, now he is 21. He is away at secondary school in Dedza, about 1 ½ hours from Lilongwe. Last year he came down with cerebral malaria (a potentially fatal condition), and was put in the Dedza district hospital, COTN was notified and they came, fetched him to Lilongwe where he got better care and survived! He is Chewa and traditionally they are very short people. He is probably close to 6 feet tall. I am convinced it is a combination of consistent good nutrition and good medical care.  I believe that there are two ways Malawi, and Africa as a whole, will thrive – Jesus Christ: preached, believed, and His teachings followed; and education!  Prayerfully consider making a difference in a child’s life through sponsorship! You will  be blessed! Enjoy the photos!

This is the little one at the seizure clinic who has gotten the use of his left leg back. Pray that the same happens for his left arm!

We are always surrounded by God's created beauty. This is an Oleander Hawk moth, quite a large moth, sitting on our drive way the other morning.

Handing out goodies at COTN, Chitipi.

Esnart and Caleb with some of their goodies!

Checking out some of the stuff. The boy in the striped shirt is Blessings, and the one at the end of the table, wide-eyed and smiling, is Joseph. I have told his story on face book, but basically he was found at 3 months, living with his grandmother who had been giving him orange fanta (and only orange fanta) and was terribly malnourished. He is now a healthy looking, fun loving boy!

Here I am with Selina on the left of the photo and Esnart on the right. What precious little girls!

Jump rope! Thanks Kelley for the long rope. Jo Swartz has posted a video of this girl jumping. her name is Mary and she is quite good! The girl holding the far end of the rope is Esnart. Notice the laundry in the background - these clothes are all washed by hand.

Jo Swartz holding Daniel, I think he came at 3 days, he is currently the youngest child at this orphanage. And growing like a weed! He gets lots of love and attention from everyone!

The 'mama' at the teen age girls home. Their house is in the background.

We found some of the girls from the teen age girls home 'resting' in the shade, but they were more than happy to those for a photo. They are getting not only food, shelter and a safe place to live, but help with furthering their education!

This is Steven, sponsored by Devin Kennedy. He is a bright-eyed little chap, always with a smile!

Two of the girls hamming it up for Jo and her camera, I think the little one's name is Marsha. She was very outgoing, not to mention too cute for words!

Mnzumanza Village

Wednesday we went to Mnzumanza village, outside area 25, near Lilongwe. Ione Podgore has a project there where she feeds 750 children breakfast and lunch, along with Kathi Nunley who helps with the hostel for secondary school girls (food, shelter, etc). Anyone interested in either of these projects, please contact me. Remember that the statistics show 75% of Malawian girls /women are sexually molested during their lifetime. Girls walking long distances to school are at risk (along with the difficulty in rainy season, etc). Having a safe place, close to school is a huge benefit for these girls.
We set up the clinic in the dining hall, which they use mainly as a gathering place for meetings, etc. The kids usually eat outside when the weather is nice. The team was Joey Swartz and Nancy McGlawn, RNs, then newly minted MD from the UK, Claire, along with a premed student from Mississippi. Charles Msukwa helped organize it, and we had the awesome talents of two of our regular translators, Lewis and Jollyn. We saw 154 patients. Ty did almost 100 malaria tests and about 2/3 were positive. Malaria seems to be hanging on this year, longer than usual. We also saw an assortment of other illnesses, including a lot of chronic problems, especially GBP (general body pain). When you live a life of hard work, hoeing, carrying everything from water to firewood to maize on your head, you tend to have neck and back pain.  Thankfully, we only saw one child who I think was malnourished. I am sure that is due to the feeding program that Ione has started!  Enjoy the photos.

Claire checking a patient. Hand's on thermometers! We need extra help next year, folks! We can teach you to take temps / BPs and do malaria tests / count pills! You don't have to have skills, you just need a willing heart!

Three cuties in the village!

Lining up to be seen.

This little old lady was so weak she was having her granddaughter help her. Ty saw them coming and ran outside to help her. She had malaria and had become dehydrated due to vomiting and diarrhea, along with fever. Fortunately I had some of the powdered pedialyte and we were able to orally start rehydration, along with antiemetics and malaria medication. We have used the pedialyte before and it seems to be more enjoyable than the ORS.

Breakfast anyone?

Me examining a patient with neck pain.

Nancy McGlawn examining patients  preparing for wound care.

Joey Swartz and her local translator, Stock, handing out meds in the pharmacy.

Ty doing malaria testing.

Checking a BP on an elderly patient.

Clarie and I consulting on a case.

Fungal infections are always present, this one was pretty bad.

Claire examining a patient.

Local hospitals

I have not posted in a few days, but if you follow me on Facebook, you will see we have been busy! Two mornings spent at Kamuzu Central Hospital with morning hand off rounds and then rounds with the surgeons on the floor. It is amazing what they do with so little. I have had the pleasure of meeting physicians not only from Malawi, but also the UK, Cuba, China and Pakistan. I have heard their reports of limited time in the surgical suites, power outages, no CT scan, no equipment. We are not allowed to take photos in the hospital, for obvious reasons, but the overcrowding is severe. You can search the hospital on line and usually turn up some images. For those of us who have been there, it is not so much about the overcrowding, the torn sheets, the lack of space, the lack of privacy, or even the smells, but is about the vast amount of suffering humanity, with a small but dedicated group of providers trying their best to alleviate some of the suffering.

We spent Saturday in Dedza, with the young man I have sponsored for years through Children of the Nations. His name is Henry (Lidson) Masamba and he has become a fine young man. He is in secondary school at Umbwi school in Dedza. We picked him up, got permission from the head master, and took him the Dedza pottery for lunch.

Sunday of course was church at Flood, followed by a very lazy afternoon. Monday was KCH, and today we went to Daeyang Luke Hospital to introduce Nancy McGlawn (missionary at AOG who is an RN and has spent almost 30 years in Africa) to Dr. Sue Makin, a missionary doctor, also with years in Africa. They were both in the Congo at the same time and I thought it would be good to introduce them! Well, seems like Sue and Nancy hit it right off, and are already planning some future activities dealing with Sue's passion of screening for cervical abnormalities. Cervical cancer is the number one cancer in this country. They don't do PAP smears (not enough pathologists, etc) but can do the VIA (visual inspection with acetic acid). If they find abnormal uptake ('white patches') with the acetic acid, they can treat and hopefully prevent these abnormal areas from becoming cancerous. Anyone interested in doing something to support this work, let me know!

While at the hospital, I ran into two old friends - Grace (RN) and Dennis (RN). It was good to see them and makes me want to go back and do some time at DLH in Casualty!

Enjoy the photos. Tomorrow, another village clinic.

Me and Nancy McGlawn on the balcony, top floor of Daeyang Luke hospital.

Joey Swartz on the balcony of DLH. Note the reflection of mountains and clouds in the glass door.

Grace and I. She is a fabulous nurse!!

Dennis, another great nurse at DLH

Sue Makin, myself, and Nancy McGlawn.