Malawi 2013, arrival and Pothawira - starting with a bang!

 Lymph nodes in neck and under chin

 Entrance to Pothawira

 All the little girls in their new dresses!

 Katie working on an abscessed foot

Laci, Meredith, me and Emma at the lake

 Getting ready to distribute clothes

 Cute purple baby - has a little impetigo but otherwise well! (the purple is gentian violet)

 Jennifer, the baby I think has CP and is probably blind

 Distributing clothes

 The twins - getting bigger!

 Little Joseph Chisomo

Lake Malawi

 Peter with pellagra patient

 Arm rash of pellagra

 Neck rash of pellagra

 Lunch at Livingstonia - Katie, Meredith, and Laci

Me, holding little JC - he looks like he is waving but was actually just stretching. The auntie for him (orphans have one auntie for each 10-11 kids) is in the background.

We arrived safe and sound in Malawi on Tuesday at about 1 PM. Customs was a breeze – thank you all for praying for safe passage. We managed to get everything done (money exchanged, unpacked, phone on, etc) pretty quickly and by Wed morning we were on our way to Salima and the Pothawira project. We arrived a little after lunch, and with Emma’s help, distributed all the clothes that were given to us for the orphans. It was truly a miracle, but we had enough for every girl to get a new dress. Lots of smiles from the girls! If you think the pictures look a little strange, it is because the girls did not take off their clothes – just put the new dress on over the old. Of course, they took the new dresses off and didn’t wear them the rest of the day. A huge thank you to those that made dresses for these children – Debbie Bondurant and her friends in St. Louis and Linda Readinger in Azle. (Linda, you may notice in some photos we are wearing your neck coolers –they were / are life savers!  And you will also see one of your quilts for the newest, tiniest baby at Pothawira!)  These kids all have sad stories, but one little girl, Jennifer, is particularly tragic. Her mother came in ‘fitting’ (seizing) and then died at Salima District hospital. A posthumous C-Section was done and a child delivered. Peter says there may have been some hesitation to do the C-section, as that is not done often here. The little girl has pretty obvious cerebral palsy and (I think) may be cortically blind as well. Her future is not very bright, not here in Malawi, where only the strongest can survive and prosper. Pray for her!

There was quite a bit of excitement at the Pothawira project. First of all, a little guy was brought to Peter’s house about 9 PM the night before we arrived. He was born on the 10/24 on the way to the Salima district hospital, but then his mother died. They had kept him for several days, but the grandmother could not take him home – she could not feed him, and the father is away working (and it is unknown if he even knew his wife died and his child was doing poorly). The earliest weight we found in his health passport was 1.6 kg (about 3.5 pounds). They had kept him for ~10 days and then brought him to Peter – we weighed him Thursday morning and he weighed in at about 1.9 kg (4 pounds, 2 ounces). He is tiny. He was given the name at birth of Chisoni, which basically means ‘Sorrow’. Peter and Emma wanted him to have a new name, so I named him Joseph Chisomo or JC for short. Pray for him, he will need God’s help to grow and flourish. We did check on him this morning (Sat) before leaving and he is still taking his bottle without problems. Peter had some donated formula – it is very expensive here but it is necessary for these babies!

A little about Pothawira for any new readers – it was started by Anne Maseko Alaniz (my Malawian daughter) and her parents (Peter and Emma Maseko). It is an orphanage (105 children at present), a school and a clinic. The clinic is run by Peter Maseko, a clinical officer. He sees 100-300 patients a day. The local district hospital is strapped for personnel and cash, and patients often cannot even find a nurse to help them. We heard from several Malawians that they go to Pothawira because ‘they can help you’. The clinic is stage one, and there are plans for a maternity unit and eventually a regular hospital.  The night we arrived, Wed. night, the clinic was robbed and all the cash was stolen, along with a lap top.  Much damage was done to doors, etc, that had to be replaced or repaired.  This ministry can ill afford to lose that amount of money through theft and replacement. There reportedly were 10-12 of them, with guns, and they tied up the watchmen. Fortunately, no one was hurt. We opened the clinic only slight behind schedule on Thursday morning. I saw patients, as did Henry – he recently finished clinical officer training, but is not yet certified and hasn’t had his 1 ½ years internship. However, he can see and treat most things. I found it was hard to get ‘back in the groove’ with the medications, but I am slowly getting there. Katie and her sister, Meredith, helped by doing vital signs. Katie was also able over the 2 days she was in the clinic to do incision and drainage on 4 different abscesses.  I saw the usual assortment of aches and pains, infections and coughs, wounds and abscesses, even malaria (although it is still the dry season so malaria is less prevalent). There is an epidemic of chicken pox in the district now, so they are coming in ahead of the others to minimize exposures. My most interesting / unusual patients were a lady with a rash that turned out to be pellagra (thanks Peter for recognizing that rash!), and a gentlemen with huge lymph nodes in his neck area – he had a history of TB and had just finished another round of TB meds with no improvement. I consulted Peter again and he felt it was most likely a malignancy since the TB treatment had not helped and he had no signs of HIV/AIDS. Unfortunately, it is very difficult to even get a diagnosis, much less treatment for cancer of most kinds. Peter referred him for a biopsy of the lymph nodes.

The afternoons in the clinic are slow, so we left Henry and Peter to run the clinic and we went to Senga Bay and the fishing village, walking along the lakeshore on Thursday and on Friday, we had lunch at Livingstonia and then swam in the pool there. It is summer here and HOT, very hot. The lake area is at a much lower altitude than Lilongwe, and is much, much hotter and more humid. It can be miserable. The pool water was cool and we were much refreshed. The girls spent some time buying curios, ‘stimulating the local economy’ they said! We arrived back safely in Lilongwe Sat. afternoon.  Tomorrow will be church at Flood and then (hopefully) a visit to one of the married Maseko girls, Angellah, and her family.

You may see a new face in a few of the photos. We meet Laci, who is working with Global Health Innovations on the HIT system (a system to help tract babies born to HIV positive Moms). She is living at the Masekos and will be in Malawi for a year. She is a delight! I was excited to meet her and see what she is doing.

Praises:

The existence of Pothawira so babies like JC and other orphans can truly have a ‘safe haven’ and for the clinic at Pothawira to offer medical services to the people in this area.

Safe travels

No issues at customs

No injuries at the clinic robbery

Running water at the Masekos, so we were able to stay with them instead of a lodge.

A new generator at the AOG compound, so we have power most of the time in Lilongwe

Special Thanks:

Debbie Bondurant and friends for the pillow case dresses and clothes for boys.

Linda Readinger for little dresses, quilts, and neck coolers.

Joseph Maenner for the Garmin and buying / loading the Africa maps. I can find things!!