Tuesday we attended the Annual Daeyang Luke Medical
Conference at the Daeyang Luke Hospital (DLH). We had attended one of the first
conferences here several years ago and found it beneficial and
informational. Many of the speakers were
South Korean physicians, but with a mix of Malawians and other nationalities.
The ‘MC’ was Dr. Chisoo Choi – a doctor from the IN HIS IMAGE family practice
residency program in Tulsa, OK. Their
common goal was to inform and improve medical care in Malawi. For those of you
who do not know – Malawi medical schools operate on the British system – 6 years
of training from college to the end of med school. They then have one year of
internship, and then they are officially ‘done’ – any additional training has
to be obtained outside of Malawi. A major problem – once they go elsewhere to
finish training, they often stay in that country (or go further abroad). They have a vision of starting a Family
Medicine residency program by 2014. This
would be a huge boon to the nation, although when you see some of the numbers,
you realize it will take many, many years to adequately supply this country
with physicians! They hope to have 4
residents enter the program by 2014 (and it is a 3 year program). Currently
they have a 6 week teaching block in the medical school to introduce students
to the concepts of family medicine, treating the entire family and psychosocial
environment.
Interesting things we learned about Malawi:
(Please realize I am quoting stats from the meeting, not
doing any research on my own!!)
It is the 10 poorest country of 176 countries in the world,
with a per capita income of $859.
There are 260 doctors for the population of 15 million. (or
about 1 doctor for every 300,000 people)
1,100 women out of 100,000 die during or immediately after
childbirth (compared to 14 in S. Korea)
58 children out of 1,000 die in infancy
92 children out of 1,000 die under 5
Malawi has the 9th highest HIV rate in the world
(estimated at 14% of the population, but felt by many to be grossly
underestimated)
The #1 cancer killer among women in Malawi is cervical cancer,
with 45.4% of all female cancers being cervical (followed by Kaposi’s at 21%
and breast at 4.6%)
Men’s cancer killer is Kaposi’s at 50.7 %, followed by
cancer of the esophagus at 16.9%
There are only 2 pathologists in the country (making any PAP
smear screening for these women extremely difficult). However, you can train
doctors, nurses, clinical officers, etc. to do VIA (Visual inspection and
treatment) to find AND TREAT precancerous lesions with reasonably inexpensive
tools. Dr. Sue Makin gave the lecture on
cervical cancer. She had fallen two days before and broken her ankle – one of
the visiting Korean doctors was an orthopedic surgeon – they contacted an
Malawian orthopedic doctor to be ‘in charge’ while the Korean actually did the
surgery to repair the ankle with screws and plates. That was done on Monday –
Tuesday she was lecturing (albeit sitting) and taking IBUPROFEN for pain. Attention all ED patients – No, you do not
need Norco for your sprained ankle, sorry!!
I was immensely impressed with Dr. Makin.
Malawi appears to be one of the most forward thinking
African countries when it comes to treating
HIV/AIDS – they have gone beyond the basic recommendations of (? WHO or some other world AIDS group) to
aggressively treat and keep treating pregnant and breastfeeding women and other
at risk groups. Did you know that if one partner is infected and the other
non-infected, treatment of the infected partner is 96% effective in preventing
transmission? And aggressive treatment
of pregnant Moms can decrease transmission rate to child by 75%, and totally
eliminate transmission in breast feeding? To find and treat these women and
other at risk people (serodiscordant couples), Malawi has doubled the number of
access facilities in the last year or so. That, in an extremely poor, mostly
rural country is AMAZING!!! I want to
give a couple of plugs here – Dr. Perry Jansen, founder of Partners in Hope,
is, I personally think, in large part responsible for the incredible work being
done in Malawi with HIV/AIDS. His is a non-profit organization that not only
treats folk with HIV/AIDS, but is also instrumental in research and policy
development. If you have a heart for the Malawians as they struggle with this
incredible burden of illness, consider donating to Dr. Jansen’s project. He and
his family have been in Malawi for many years.
One of the speakers at the conference, Dr. Colin Pfaff (South Africa)
works at Partners in Hope and gave a most excellent presentation.
I also found out that DLH has a CT scanner – WOW! They have
had one since Jan of last year but only got the fiberoptic cables set up for
telerading the images to Korea (to be read) in May. OK, sorry for the doctor
talk – that means the machine is there and able to take the ‘pictures’ but they
had no way to send those pictures to be read by a radiologist until May. That
is very exciting.
Did you know that South Korea (through their airlines, I
think) charges $1 per person /per flight to help developing countries? The
organizations that want the funds then apply for grants to obtain the money for
their project. Project Malawi (www.project-malawi.org) has been given
2 million dollars for the next two years and has some great projects underway ,
including male circumcision (reduces HIV transmission by >50%), and maternal and child health programs. I was
impressed with their speaker as she went through the plans AND the methods they
are using to see if their interventions actually make a difference in people’s
health.
We also had a lecture from Dr. Lungu (who used to be the
medical director at DLH but has moved
on) about the best way to use short term missionaries. He actually pointed out
that Paul was a ‘short term’ missionary, traveling from church to church, but
kept in touch with the churches so that he knew the problems that needed to be
addressed when he returned to that area.
Good lecture! We also got to meet Susie Kim, the Principal of the
Daeyang Nursing College. She is a bundle
of energy and I look forward to spending more time with her. Her enthusiasm is
contagious!
After the conference, we spent some time with Mrs. Choi and
Dr. Makin in the Podgore house on the campus of DLH. It was delightful. Mrs.
Choi had many questions about Malawi and I only hope we answered them in
helpful ways! We finally got to meet
Spy, the housekeeper who has served the Podgores for many, many years on their
multiple trips to Malawi.
This was an inspiring day spent among folks who want to make
a difference, who want to make the world (especially Malawi) a better place.
Praise:
The chance to be here for the conference
Seeing old friends and making new ones
Prayers:
Wisdom as we consider our future plans in Malawi
Continued safety during our travels and time here.
In the Podgore's DLH house - Joseph, me, Spy and Mrs. Choi
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