Salima, Pothawira and the lake

It is hard to get ~4 days into one blog but here goes. We left Wed for Salima and the Pothawira project - it is a clinic, an orphanage and a school. There are ~110 kids in the orphanage and the clinic is seeing about 300 patients a day. This is the project of Peter and Emma Maseko and their daughter, Anne Alaniz. I was able to work with David - he has been a clinical officer for 4 years and has recently finished his first year of medical school. He has a lot of knowledge, although we ran into some very difficult cases. Julie helped in the procedure room with shots, I and Ds, and other procedures. Emily worked in the pharmacy. She is becoming the expert pharmacist!! We worked there morning until about 2 PM, broke for a late lunch and then on Thursday we went to the Livingstonia hotel for coffee and so that the girls could see the lake from that side (Wed afternoon we went to Kambiri for a coke and a walk along the lake). Friday afternoon we went to Salima District hospital, along with Laci and an American medical student, Devin, to see the hospital but most importantly, to each give a unit of blood. This morning, Sat, we went to the fishing village part of Senga Bay. It was a good visit, but we were busy!!

At Pothawira, they are able to give injections of medications, malaria tests, blood glucose tests and pregnancy tests. They also have a VCT area (voluntary counseling and testing) for HIV tests. There are no other tests available at this time. They cannot do hemoglobins  at this time (lack of supplies). The children are all weighed and vital signs are obtained on everyone. The fee to be seen (50 cents for kids, $1 for adults) covers the consultation, medications, tests, procedures, injections, and prescriptions. It is a losing proposition for the clinic, but it allows the villagers to get decent health care but still have a little skin in the game. The entire clinic is chaotic most of the time, but it works!

The country has a central blood bank in the capital, but for distressed cases, where someone is actively bleeding, the time to actually get blood from the capital makes it unwieldy. The hospital tries to keep blood in stock for those cases (usually a hemorrhaging Mom who just delivered). All 4 of us had different blood types! They seemed happy to get the blood. Of course, they don't have the supplies to check hemoglobin either, so they just had to assume that we healthy Americans had plenty of blood!

If you are interested in donating to the Pothawira clinic, let me know - there is always need for money for salaries of the workers, medications, supplies, etc.

I am giving praise for safe travels and the chance to use our abilities, and I covet prayers for continued safety.

A special thanks to the Maseko family for their unbelievable hospitality!

 Gas here is by the liter, but if you do the math, ends up at ~$8 / gallon. My little car uses $100 to fill up if it is on E. That doesn't sound like much to all my truck driving friends, but for me, in a little Rav 4, it seems extreme!

 Sign to the clinic and orphanage

 This is little Joseph Chisomo (JC) - when I was there in Nov, he arrived at the orphanage weighing in at 1.9 kg. My, my he has grown!!

 Blessings, another little child that was dropped off in Nov, thriving at Pothawira!

 Weighing the children at the start of the clinic, Pothawira.

 this patient had a massively swollen left hand after trauma 2 days prior. There were no entrance wounds but the entire hand was slightly warm and ? fluctuant. David decided to start antibiotics (injections) for 2 days and then 'review' to see if it was an abscess if it began to 'point' and allow a more exact area of I and D.

 This leg wound was several days old and the patient had been recieving daily wound care at Pothawira - he had a similar sized wound on the other side, but I was told it was amazingly improved! This day it was being debridged and re-bandaged. See the sterile bucket where the body fluids, etc will drain. For everyone. All day.

 In the states, when a very obnoxious procedure is done we sometimes use a drug called ketamine for 'moderate sedation'. The patient is placed on oxygen, cardiac monitors, we prepare for intubation if necessary, and the patient is monitored for some time afterwards until they wake up and are 'normal'. This patient had bilateral MASSIVE breast abscesses (in the states, she would have gone to the OR to have them drained). She got ketamine IV push along with diazepam (Valium) IV push, the breasts both opened and explored, removing 'a liter of pus' (per Julie), then she was carried out and laid under a tree for her 'recovery'. Eventually, she will wake up and walk home.

 David, a great man to work with! This is 'our' office'

 Julie in the procedure area, with Austin, nurse, in the background.

 Devin (American med student) and Julie giving blood at the Salima District hospital.

 At the lake with Julie, Eddah Maseko and her boyfriend, Daniel, and Emily

Drying fish - dinner anyone?

Mzumazi Village Clinic

This morning we went to Jollyn Kumilonde's village project to do a little 'quick' clinic for the vulnerable women and children she has identified in this area. She does prayers with the women, Bible lessons with the children and then brings tea and bread to them all. She rides her bike to the location.
By the way, when will I learn that there is no 'quick' village clinic. Culturally you cannot have a clinic without seeing the local cheifs, then the village men get to be in line ahead of the women and children (whom we really hoped to treat). To make a long story short.. it was a LONG, dusty day. The local pastor was helping with crowd control and was keeping track of the numbers, but we didn't get those numbers before we left. At first we walked to an area where Jollyn has bought land to build some class rooms for Bible lessons and perhaps other teaching.  We used a 'hall' for the clinic and it was a blessing it was enclosed. They found some school desks for us as tables. We saw more malaria that I expected and I will need to replenish my malaria medications! There were lots of 'general body pain' (GBP), headaches, assorted rashes, and some gastroenteritis problems.  It is winter here, the dry season, and with the dust and the smoke from fires (cooking and burning the fields) everyone coughs. There are many people with eye problems, mostly cataracts but also some infections (a couple kids with possible trachoma - an eye infection). We did see some interesting and strange things - one girl with a big discrepancy in her leg lengths - she has to use a stick to walk, and one leg is obviously much stronger than the other.  We also had a child come in at the last with a broken arm (diagnosed with my xray vision - and the fact that I have felt the swelling in the wrist before). She fell off of a bike yesterday. Some one had given me some casting / splinting material and one piece was exactly the type and size she needed. Isn't God amazing? Julie and Emily had her splinted up in no time!

Tomorrow we run some errands and then leave town for the Pothawira project between Salima and Senga Bay = this is Peter Maseko / Anne Alaniz and family project with a busy, busy clinic (and orphanage). It is also financed by Global Health Innovations among others. Search the web to find more information and videos! We will be there until Saturday, so no blogging until I return.  Keep us in your prayers, as anytime travel is involved it can be a little crazy.

Enjoy the photos and keep us in your prayers!

 Village housing with kids

 Jollyn and Julie walking to Jollyn's land

 The kids are excited to see the azungus (white people) with their cameras.

 Julie, Jollyn, myself and Emily getting ready to start.

 My first patient was NOT happy!!

 Little guy with possible trachoma

 Twins - the boy was fine, the little girl had a nasty facial rash.

 This man was more worried about his eye (cataracts) then this huge mass growing on his arm!

 Pretty family!

Waiting to be seen

 Emily, our awesome pharmacist!

 Julie and Emily applying a splint to a broken arm

Whew, finally done - Emily, Clifford, Jollyn, Julie, myself and a local 'helper'.

Car, Charles, Larry Brown and Buchanan's

Today was a non-clinic day. We spent most of the morning with car issues - paid a previous bill and then had two new tires put on the car. Cars here are hard to maintain and EXPENSIVE to maintain.. but is still beats trying to rent one for 5 weeks!!

Of course, we made a run to the pharmacy, Intermed, to get more meds for tomorrow's clinic, which meant, especially after the car issues, that we needed to go to the forex to exchange more money (I am sure you are seeing a pattern here!).

We were invited to Charles for tea and sweet potatoes, but it turned into lunch and the girls got a little taste of some traditional Malawian food with the rice, greens, beans and village market meat. It was good! Thanks to Charles and Erita for having us over for lunch. Charles helps run the prison ministry. Look closely at the photos of his house. It is very small - he has actually downsized to help save money. Many people in ministry 'take care of themselves first' (I am thinking of American ministers, TV evangelists, Malawian  ministers, etc) but Charles struggles just to get by - he has been loaned a car for the prison ministry, to help take people and things to the prisoners, etc and he struggles to keep fuel in the car and keep it maintained - like he says, people will give to a project, but don't seem to think about what it takes to keep the people running the project 'running'. Anyone with an interest in helping out this great guy, let me know!

In the afternoon, we met with Larry Brown at ABC and he gave us a walking tour of the campus. I saw parts that I had not seen before. The girls got a nice, close up view of all the facilities there. The pool looked good enough to swim in but it sure wasn't warm enough! Remember, it is winter here - the days are in the 70s and the nights in the 50s.
Larry Brown has been in Malawi since 1993 and he has a real heart to teach the students at ABC. He is another missionary that is giving up his pleasures in this life to reach the young people of Malawi, to train them to be Godly men and women and change their country. The only real, lasting change will come through Malawians. If you are interested in directly supporting a long term missionary, this man is worth it!

OK, all for now but continue to pray for us as we leave in the morning for Jollyn's village project to see if we can be of service to the vulnerable women and children.

Erita, Ruth, Charles, Praise and me in Charles's living room.

 Larry Brown, Emily and I at the ABC Academy.

 Dinner at Buchanan's - eat your heart out, Joseph Maenner!

 Praise (in the green shirt) sharing his lunch of rice with some friend, in the shade of a car.

 Ruth, getting a bath after playing in the dirt!!

 Charles's house - the 'kitchen' is a charcoal burner outside, the toilets / bathing area is outside, the water tap is outside (at end of house), Erita is coming out the door, Innocent (Charles' nephew in the green shirt) also lives there, and little Ruth with the blue bowl in the front yard. I don't think Benny Hinn, TD Jakes, Joel Olsteen or even I would want to live like this! We forget the difficulties so many of God's workers live under!

 Praise and friend

Julie and Emily after their traditional meal - Emily is showing off the greens. So yummy!

FLOOD church and Crisis Nursery

Today, Sunday, we went to Flood Church, my church home in Malawi. As usual, Pastor Sean gave an amazing service. The music was great and Humphres was awesome. Mandy, you will be interested to know he lead off with 'Oh Happy Day'. It was wonderful to be back in Flood.

We ran a couple of short errands, then went to the Crisis Nursery to see the kids. They do a great job with those little ones. I was happy to see Martha and Beatrice again. Chikondi has made amazing strides and is now able to understand and follow directions, and we were told that he is interacting / playing with other children. He was much calmer than the last visit. Little Chisomo is moving her legs, although they are still 'stiff'. She is able to stand in her crib! The twins, Cornelius and Tawonda (sp?) were both in a 'serious mood' today. There were new babies, too. We were not there more than a few minutes when a large group from The Grove church in Arizona came in to play with the babies. With them was Blessings, a graduate of ABC that used to be the 'bicycle guard'. It is a small world here!

Tomorrow I have some car issues to take care of, then more errands including another order at Intermed (it never ends!) and a visit with Larry Brown at ABC for a tour and tea / coffee.

If you are interested in donating to the children, Crisis Nursery is under Ministry of Hope (they have a website). If interested in donations to me, Global Health Innovations - check out their website, a check mailed with my name in the memo line would be appreciated.  And always, always, prayers for our safey, that we would reflect the love of Christ on to those we serve.

 Chisomo and I

 Another one of Chisomo and I

 Julie and Chikondi

 Chisomo

 The chaos of Crisis Nursery!

 Martha!!

Blessings and Chikondi

Malawi, 2014 - Prison clinic

Emily Prince and I arrived in Malawi on June 11th, after 2 days of flight delays and cancelations - but we made it! The following couple of days was spent in getting the groudwork laid for our first clinic - renewing my medical license, buying meds, buying groceries, getting the car insured, etc. Julie Hoskison arrived Friday at ~ noon, and Saturday morning we were in the Maula Prison for a clinic. The rules used to be 'no photos' but Charles has worked so hard to have wells dug and two new clinic building built that they were happy to have him take photos. We saw about 190 patients. Lucky Nyrenda came to help as clinical officier, Selina was the pharmacist, assisted by Emily (who will be on her own as the pharmacist soon, I am sure), Julie did some wound care, rash evaluation, and incision and drainage and saw some patients. We had a good day. The prisoners looked as well if not better than when we were here last, although malnutrition and scabies are still huge problems. Many of these guys are HIV positive, but they are getting their medications. Several had TB but were being treated, also. There are currently only two little children in the prison (with their moms) and both of them were positive for malaria! So much that we see in the prison we cannot fix - 'eye problems' (mostly cataracts but a couple nasty infectious processes), chronic pains, and a goodly number of perirectal abscesses / fistulas that had been present for years (HIV patients). I bought soap, made by the prisoners, to be given to the prisoners.
Intermed pharmacy DID find some vitamins for us (after telling us they were out for months) but there were no medications for asthma. We did find some cough syrup with terbutaline and used that heavily! We had only little guy (a child of one of the guard staff) that was involved in an altercation with another child and came to the clinic. It was a productive day and I was happy to see my friends, Clifford, Jollyn and Selina. Charles had picked us up from the airport so I had already given him greetings. Charles is the Malawian in charge of the prison ministry. He has done a great job - the new clinic building is AWESOME - seperate rooms, windows with bars, a 'lab' with a sink, staff toilets. He also got financing for an HIV clinic (VCT - voluntary counseling and testing), and built two wells. If anyone reading this blog has a heart to help prisoners, let me know. It is difficult to fund raise for them, but Charles is financially reliable.
I am hoping the photos load!

 Patient (back to camera) with me and Jollyn. Note the bars of soap on the table.  One of the new consultation rooms.

Julie Hoskison and Clifford in the lab area that we used for wound care and some basic labs.

 Lucky with a patient (a guard). Another new consultation room.

 Selina and Emily using another consultation room as the pharmacy.

 Patients waiting outside the pharmacy for their meds.

Another patient

 He had quite the story to tell!

 Staff child after fighting with another child.

 Clifford and Julie

 Outside as prisoners line up to be seen and for meds.

The team - and an awesome team they are! In front of the new clinic.