Kelley and I went to hand over rounds at KCH (surgery) Thursday at 7:30 AM, the made rounds with some of the surgical interns and a resident. The students (medical and clinical officer), interns and residents are overworked and understaffed. They have very limited resources. I read one entry by a nurse in a patient's chart: we will resume random glucose tests when the glucostrips can be located. Can you imagine NOT doing blood sugars on a severe diabetic in the US? And having you reason be 'we can't find the strips?' They also did not have a BP cuff (Kelley had one). The intern I was with (same one I was with when Luke was with me) did not even OWN a stethoscope (I gave him an extra one I had). Not one of them had a pulse oximeter. The charts are complete chaos and often tests are missing. They scramble around to find paper to write on to put in the chart (no electronic medical records here!). They were taking their personal notes on patients in old day-planner type books from several years ago. Pens are at a premium. Last time Luke and I were there, there were no blood tubes for the FBC (full blood count). This time it looked as if the liver function tests were not being done. CT scans were being booked for 2 weeks out. The hospital is overcrowded, families have to do much of the care (cleaning, feeding, walking the patients) as the nurses are overworked. And yet these young doctors put me to shame with their concern and compassion for their patients. They were not complaining about shortages, but carrying on as best they could. I am always in awe of these guys - and gals - who work so hard under such trying circumstances. Keep the young doctors of Malawi in your prayers, as being a doctor there can cost you your life due to HIV (needle sticks) and multidrug resistant TB.
After KCH, we all joined up and went to the seizure clinic for the afternoon. Luke helped with checking in (weights, vital signs), and Kelley, Joey and Nancy McGlawn (AoG missionary and nurse) helped in the pharmacy. It was a good day.
Today, Friday, was Kelley's last free day here. She flies home Sunday and we are very sorry to see her go. However, since it was her last day, she needed / wanted to do some shopping, eat once last meal at Four Seasons, and start packing. Tomorrow is an E3 clinic and it will be another killer day.
Enjoy the photos, keep us all in your prayers.
A special shout out to Dan Hamilton and Dan's Smokehouse for donating some beef jerky. On Monday, Tuesday and Wednesday those were a critical part of our packed lunches!
First patient on last day in Khombe - little boy with a broken right wrist. We had some splinting material and a sling. Not sure how long any of this will stay on this active kid, but we did what we could!
Boys in Khombe playing with a homemade gallimoto (car).
The Carey team in Khombe
Kelley applying the slinging material we had.
This lady had what appears to be a goiter, although I am not an expert on goiters. However, she insisted it had come up in 3 months??? I referred her to KCH for evaluation. It was soft and not rock hard, but still.....
In Chivara village we were under trees and a tent. This is the eye chart used to help determine if a patient needed glasses.
Luke practicing what he had been learning from Dr. Carey. 
The group photo at Chivara. Note the tent in the background. That is where we did the medical interviews.
On the way into the village - a corn crib.
Dr. Kelly Hodges and Kathy Bowler at the seizure clinic
This is my station at the seizure clinic. On my side of the table it is myself, a clerk (and translator for me) and clinical officer. We both saw patients. 
This little girl at the clinic had some very nasty skin lesions and was referred to KCH for evaluation.
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