Mission Malawi: 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.