Kasungu Prison Clinic

Kasungu prison is located about 1 1/2-2 hour drive from Lilongwe. It is a farm prison and houses slightly less than 400 inmates. Due to poor rains this past year, the crops have not come in as needed and this has caused malnutrition here and at other prisons (Kasungu crops usually help feed other prisons in Malawi). They have one medical assistance who states that they have no medications. While we were there, I found several people that needed to be tested for HIV. The medical assistant said they have 35 known cases. They do not routinely test for HIV at this prison. One young man who told me he tested positive in March was not receiving any treatment (ARVs). He also told me that he was told he would 'have to wait until he was released' to get treatment - release date is 2022 (please remember, this is from the prisoner, and as in all countries, they can be less than honest). Our team consisted of the pre-med student, Ty, along with RNs Tanja Muff and Joey Swartz. We had two new translators - Patrick and Gabriella. Of course, Charles Msukwa was in the lead, making all the arrangements.  I was the only prescribing provider. Joey started off in wound care - unsure how many she saw but did consult with on several and we gave antibiotics along with the wound care and ointments. We had a record of 135 patients, but somewhere between 10-15 had their own health passport (most of the women and guards, and a few of the men) and we did not 'track' them. We are guessing about 150 patients seen, not counting the wound care patients. We left Lilongwe at slightly after 7 AM,  arrived about 9:30, found a spot (used the library), and were set up and working by 10 AM. We worked until 3PM and were back on the road before 4. We ate a picnic lunch on the way home, arriving back here at 5:30.  It was a long day. The vast majority of patients has either scabies or a cough (or both) along with general body pain. Several were severely malnourished and the remainder of our 'super vitamin B' (thank you Emily Prince) were used here, along with niacin, iron tablets and multivitamins. We saw several patients I referred for HIV testing, some bony injuries that I suspect were fractures in the recent past (not taken to hospital by the prison). Pellagra in at least two patients, some nasty wounds, a case of hypopigmentation of the forearms only, some asthma, some diarrhea, a moderate number of possible peptic ulcers.  On the bright side, there were only 11 possible malaria cases and only 2 of those were actually positive.  On the downside, we arrived home to find no water, and it is now after 7 AM the following morning, still with no water! Enjoy the photos!

Joey at the wound care station. The prison has been out of water for about 1 week. They did manage to round up a tub of water for her to use.

The double door on the right is the entrance to the library, where we were stationed.

Checking out a prisoner's health passport. My little cubby hole wasn't bad, a little light to see, a nice desk, a comfy plastic chair!

Joey doing wound care (the green bucket has water it in). This was a nasty hand wound.

Close up of the hand wound.

Lots of  coughing, most dry. This shows you how close we all were. There are books along both walls, mostly US textbooks, out of date, and a large number were from Texas!

Malnourished patient (Gabriella, my translator, can be seen on the left).

Tanj Muff in the pharmacy, Patrick  - in green- is her translator. The book shelf behind has several copies of Texas Science on the shelf.

One of the women prisoners. They only have 9 and we saw them all! One had a little baby (saw that one two). You can see one of the female guards standing to the right of the photo.

Tanja and Joey conferring over one of my 'prescriptions'. I am sure Tanja couldn't read my writing! Joey was still in the wound care area, but soon came into help at the pharmacy.

Ty doing malaria tests. The guy in the foreground is the medical assistant. You can get an idea of how small the area was in which we were all working.  I think calling this a 'library' might have been an exaggeration.

Hypo-pigmentation

Pellagra

The team!

Road side picnic - Gabriella and Ty.

Thanks for all your prayers.  For any of you interested in coming, contact me. For anyone interested in donating (supplies, meds, money), again, contact me and thanks to all have been so generous for this trip!!