Jessica worked with Henry, a young man who has finished clinical officer school but is awaiting his final scores - if he passes, he will start an 18 month internship. I worked primarily with Peter. We saw lots of interesting cases. There is currently an outbreak of chicken pox in the district, so many of those kids come into the clinic. There are also skin rashes of other sorts. This is the beginning of the rains and the planting season, so many of the patients are farmers, who are complaining of neck / arm / back pain - but if you watch them hand hoe in the fields, you will totally understand why they have pain! Jessica saw many children with dysentery, several of whom she would have admitted in the US - here we don't have that option! At some future point, Pothawira hopes to have phase 2 - antenatel, delivery, and postnatal wards / clinics along with some neonatal capabilites, and phase 3 - an entire hospital. However, funding (as always) is an issue.
Peter and I saw a horrible ulcerative skin disease - starting on the young woman's arms and has now progressed to her leg. We were concerned it may be TB, so he arranged for her to have some special lab tests done at the nearby hospital. We also saw a 3 week old snake bite - she was bitten on the foot and spent 2 days at Salima District Hospital, was released but her foot has gotten worse (although no pain). She doesn't know what type of snake (it was night time) but in my limited research, it appears consistent with one of the puff adder family because of the continuing skin necrosis. There we also many, many abscesses that needed to be drained, along with coughs, colds, chest pains, abdominal pains, and problems with sexually transmitted diseases (too graphic for more discussion here). HIV / AIDS is of course a huge problem, and many of the patients had that as an underlying or complicating factor. The rains have barely begun, so malaria in not a major issue at present.
In the afternoons we were 'free', as the clinic is very busy in the morning but most people do not come in the afternoon. Usually we ate at the clinic (thanks to Emma Maseko for cooking for us!) but one day we went to the lake and ate at the Livingstonia hotel. This is an old hotel, with a wonderful view of the lake, a nice menu, and a great pool! For 1000 kwacha (a little over $2) you can swim in the pool and even get a towel. It is almost always empty, so we enjoyed the pool to ourselves. It is a great way to relax and cool down after the morning clinic (not to mention all that cholorinated water makes you feel really clean!!) We spent a little time with the orphans. Joseph Chisomo is gaining weight - he is now up to 2.2 kg (from 1.9), and the newest baby, Blessings Chisomo is weighing in at 2.12 kg. Tiny but both look good and I am sure, barring any illness, they will do fine.
The last day we were in Salima was Thursday, US Thanksgiving. We went with Laci Butler (the RN working for Global Health Innovations on a system to track the babies of HIV positive moms). We went to the Lifuwu health center - a smallish village complex by the lake - to pick up samples, then to Salima district hospital to pick up samples. We got a tour of the Salima district - the pediatric ward was not very busy (not much malaria). The maternity is always busy, with 300-400 babies delivered every month. The still have the Kangeroo Care unit that Peter Maseko started several years ago. They have a neonatal unit - they have very small babies in there mixed with sick babies.... they had a 800 gm baby, so very tiny, with the only 'care' being oxygen via nasal cannula. The nurse said they usually do not live at that weight. However, the babe was 6 days old, so there is hope! The pediatric unit had a large posted with the types of illnesses admitted in 2012 and so far in 2013, along with the death rate for each category, and a total death rate. It was depressing. It appears that about 5% of all children admitted die. Before we headed back to Lilongwe, we visited the crocodile farm, down the road from the Masekos. It is always an interesting experience.
We drove back to Lilongwe, encountering a massive storm with wind, rain and hail shortly before arrival in Lilongwe. The bad roads of Malawi got so much worse! The power was gone the rest of that day! However, we had been invited to Michelle Clark's house for Thanksgiving. We had a feast by candlelight and made some new friends. It was wonderful.
I have posted photos on facebook, and I will try to post some here. Be forewarned, a couple are pretty graphic!
Praise / thanksgiving / prayers
Thanksgiving and continued prayers for our safety!
Thanksgiving for wonderful friends in Malawi.
Prayers for the babies of Malawi - Joseph Chisomo, Blessings Chisomo, the tiny newborn at the hospital, and all the children struggling - we do not know their names, but our Lord and Savior, Jesus Christ, knows them all!
Thanksgiving for the people who have generously donated supplies, medications, money, clothes, etc. I give thanks for you all every day = may the Lord pour back blessings on you!
And on her lower leg. We are still hoping to find a cause
Posted in Salima District hospital - causes of admission and death rates in kids. Very sad.
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