Today we went back to prison. Charles lead the team, of course, and we added Dr. Barrett Jones, a doctor from Partners in Hope, a medical student visiting here, Alice Li, Clifford as my translator, Lewis to help translate for Dr. Jones, and another young lady who was introduced to pharmacy in a trial of fire! Maggie and Marie Maseko also helped in pharmacy - Maggie has some experience but the others were first timers. There was also a new clinical officer or medical assistant from Doctors without Borders who also saw patients. I am not sure how many we saw. I did see a very sick man with a very complicated medical history including HIV and a second infection of TB on streptomycin, with a very recent acute malarial episode who was weak, could no long walk, was barely speaking, and had to be carried by his friends. His blood sugar was OK, but that was pretty much the limit of the tests we can do there. We recommended transfer to KCH as soon as possible. Then both Dr. Jones and I saw Ethiopians (never figured out how they got into a Malawian prison) with severe abdominal pain. The patient he was seeing looked like he could literally die at any moment, mine was not quite as ill but doubled over with pain and abdominal rigidity and guarding. Again, our only choice was to get them to KCH. From the prison, that can be a long, tedious process. We left the medical assistant, Jones Tambula in charge of that! I also had an interesting patient with a cough with bloody sputum, weight loss (he claimed almost 20 kg in a month), and a rash. He is HIV positive. He had markedly swollen but non tender parotid glands. I am considering TB as the cause of his cough, with a possibility of bilateral parotid involvement due to the TB. Apparently that is a rare condition, but not unheard of. And TB here seems to show up in the darnest places! After we finished seeing patients, we got a tour of the new skills center, where inmates will be taught carpentry, metal work and sewing / tailoring. We also peeked into the chapel, where a prayer service was being held, and saw the school rooms. They teach primary and secondary school here, with some adult classes as well. Some of the teachers are inmates, some come from outside. Emily Prince, who came last year and stayed the entire time with me, sent a laptop to Jones Tambula and I was able to present to him today, in her name. He was thrilled! You usually see him in uniform, today he was working as the medical assistant - he is the #3 man in charge of the clinic there. I also found out that Maula Prison is the second largest prison in Malawi! Enjoy the photos!
The young woman on the left (white jacket, black skirt) is our new pharmacy recruit. She is standing in the 'waiting area' before we start.
Maggie and Marie Maseko arranging the medications. Again, a huge thank you to those that have donated money for the medications. These are NOT medications that the prison had, these are the ones I bought here and brought
Diabetic lady with large foot abscess. It is on the dorm (top) of the foot, not on the sole as we usually see in foot abscesses here.
Presenting Jones Tambula with the laptop provided by Emily Prince.
Going over the passwords, etc that Emily Prince set up for Jones, with Clifford looking on.
Showing him all the goodies included (chargers, converter, bag). Emily, he was speechless and beyond thrilled!
Marie explaining the medication to a patient.
Dr. Barrett doing his thing in the wound care area, with Smart and Alice Li looking on!
Pharmacy girls working hard!
Patient with parotid gland swelling. Both sides looked like this.
In one of the school rooms. I think Barrett is reviewing some chichewa with Clifford!
Clifford, myself, Lewis, Alice and Barrett after our tour of the non-clinic facilities. Charles has done amazing work with the clinic and skills building, and he has had help with other buildings, but there is more to do, more supplies to buy, If you are interested in supporting his work in the prison system here in Malawi, get in touch with me.
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