Mission Malawi: Kamuzu Central Hospital and more

So much is going on it is hard to keep up. And the internet gets slow here. A short synopsis. Anne Alaniz, Mable Maseko and two of Anne's kids, Jayden and Isabella, arrived Saturday. They brought tons of luggage as they are carrying most of the supplies, dresses, etc for the big wedding next week. Saturday morning Julie and I went to Chitipi children's village to visit her sponsored child, Blessings and his sister / cousin (unclear what from the history) Sellina. I also saw Mandy's sponsored child, Caleb, and his brother, Thomas, plus all the other sweet children at the orphan home. The rest of the day was spent at the airport, getting luggage, getting it home, etc.
Monday Julie left for home (boohoo) and they left for Salima with most of the luggage. They didn't get out of here until late.
Tuesday I was left trying to arrange the rest of my time, catch up on things, go to Michelle Clark's to do a little minor surgery on Doriss's foot and have lunch. Oh, and organize the medications for the prison clinic next Tuesday and order more drugs.
Wednesday I went to Kamuzu Central hospital for the surgery morning report, and then met up with Anne and Maggie to make rounds with the new OB doctor at KCH who has learned how to do radical hysterectomies for cervical cancer. Cervical cancer is the number one cancer of women in Malawi. Thursday and Friday, I went back to morning report and then to Casualty. They don't allow photos in the hospital, so no photos but it was very interesting. I got to work with interns in the Casualty and see all sorts of things. Right off the bat we had a minibus accident (road traffic accident or RTA) with people and police pouring into the department. The department is small with only 4 stretchers. The Casualty also serves as a triage for other clinics - so sometimes you are just reading their outside records or doing a brief assessment and assigning them to other clinics ('book them for surgery clinic'). Fractures go to orthopedics right away. In the last two days, besides the usual RTAs and abscesses (lots of abscesses), we have seen and admitted several babies with hydrocephalus, animperforate vagina, a male infant with hypospadias, multiple hernias, HIV patients with surgical complications (usually involving infection and wound cleaning / bandage dressing), a large fungating mass on a foot that was possibly a squamous cell cancer, a variety of adult urology problems ('book to urology clinic'), a child with a head injury today (minor, thank the Lord, as there is no CT here), did I mention abscesses?, small bowel obstructions, esophageal cancers (number one cancer of men in Malawi), a nasty Kaposi's sarcoma ('book to oncology clinic'), bone pain from various causes, mostly trauma, an child with a nasty ear infection and either an abscess over the mastoid area or acute mastoiditis. An infant with pyloric stenosis. Medicine patients are supposed to go to the medicine clinic (happens most of the time), but the surgery Casualty is where the EMS and the general public walk right in, so we have people coming in randomly to be seen. Remember - 4 stretchers. No lab, X-ray they have to 'go around the building for' (so if they are sick enough to be admitted, they get X-rays after admission), drugs are either given IM or mainline. No antibiotics given in Casualty for infections - only prescriptions. Only IVs I saw started were on patients being admitted and not all of them. They have no otoscope. They are short on suture instruments and sutures. I think I had the only pulse oximeter in that part of the hospital. The C-collars are reused (and look like it). There are no cardiac monitors but they can get vital signs if you ask (but no one could find a thermometer). Generally 2 interns and 2 nurses with some tech type people, although today we seemed to have an extra doctor (besides me, and I don't count). Quite frankly, I had a great time. And I learned so much from them. I did try to teach (these guys are interns, after all) but they already know a LOT. If anyone is interested in coming in the future, be aware that I think a few days at KCH Casualty will be in your future! This afternoon, Charles and his wife, Erita and the newest baby, Emily, stopped by for a brief chat. Enjoy the photos!

Thomas and Caleb with some of the gifts, including those funny hats, that I brought them. Chitipi Orphan home, Lilongwe

Julie showing the kids how to play with one of her gifts. In the blue is Caleb.

Julie with Blessings (her sponsored child) in the blue striped shirt, with Sellina standing in front of him in the pink print dress.

Julie outside with some of the kids, Caleb in blue.

My grand daughter, Isabella - she is wearing my jacket and my thick socks. I don't think she expected it to be this cold in Malawi! Nights are in the 50s (sometimes here in Lilongwe in the 40s!)

Lunch after church at Pizza Inn (no, not the REAL Pizza Inn, lots of places here 'borrow ' the names from American locations - best buy, 7-11, Pizza Inn, etc.