Malawi 2010
It never ceases to disturb us and shock us as we realize how the poor live in so many countries - and how extensive diseases progress before there is medical attention. The very first day Jane cared for a 28 year old lady with erosive breast cancer who had literally lost almost one side of her breast to the disease and had never seen a physician. Several patients clearly had lymphomas with enlargement of their lymph nodes in their necks, malaria was common, along with distended abdomens from worm infestation, pneumonia, children with markedly stunted growth due to poor nutrition or HIV, and, of course, the sweet elderly men and women who are still working out in the fields, gardening as subsistence farmers, who complain of back and limb pain. We tried to teach them to add longer handles to their hoes so they didn't have to bend over and cause such daily back trauma. We did see babies and toddlers with measles - not difficult to diagnose as they were miserable with watery eyes, harsh coughs, and the rash of measles (although it looks quite different on their black skins). Just as in America, it seems that the sickest patients always come in at the end of the day. The first day of clinic, a one month old with pneumonia and respiratory distress came in late, and, after giving the baby an injection of antibiotics, we took the baby and mom with us on our bus to the district hospital for admission (and provided funds for return transportation when the baby was discharged). The second day of clinic we transported a child with severe malaria and dehydration to the district hospital - but their power was out and they referred us to a larger facility, where the power was also out. We trust that the child received care in time - as we had been able to only provide the first dose of intravenous quinine, but more would be needed, along with fluids and antibiotics.
The second day of clinic we served in the village of Chionjeza, and were greeted by a large crowd who had waited hours for us to arrive. We used a school - and the small classrooms were quickly transformed into the various stations of a PC clinic - registration, vital signs, treatment area for wound care and IVs, providers, prayer and counseling with health education, and pharmacy. The rooms were small, crowded, and hot - but we utilized a new system to see the patients more efficiently. "All those who think they have malaria - line up here. All those who have wounds that need care, line up here. All those who have Bilharzia (schistosomiasis causing blood in the urine), line up here. And, most importantly, those who have measles - line up way over there, away from everyone else!!" The system worked - and we were able to see all who had come.
The 3rd and 4th days of clinic were in the village of Dowa, a 2 hour bus ride over mostly dirt roads outside of Lilongwe where the missionaries are working to establish a school and a farming cooperative. Everyone on our team thoroughly enjoyed caring for these gracious, kind people who welcomed us, taught us how to use the pump at the village well, laughed at us as we tried to communicate with them, invited us into their thatched roof homes, called us "azungus" (white people), and served us by cleaning the "squatty potties" each day!
We referred many people to their local district clinic for TB testing, HIV testing, hypertension, diabetes...but the clinic is so far away that most patients cannot afford the transportation or time off from farming to go. With all the trillions of dollars that America has provided so many countries in foreign aid, each village should have clean, running water, sanitation, and mobile health clinics! But, unfortunately, the money never reaches the needy! Instead, it is most often the private charitable organizations that are able to truly meet the needs of the people.
Most evenings we arrived back at ABC by 8:30 p.m. but one evening we arrived early so we went to visit the Ministry of Hope crisis nursery where 21 babies who have been abandoned or cannot be cared for by their parents receive love and nutrition. We arrived in time to assist with feeding those little cuties - and you just know that we fell in love with each one. We were also able to visit the community clinic at ABC - an impressive building with exam rooms, xray room /equipment, pharmacy, surgical suite, and a pediatric and adult inpatient unit. The entire building was donated by a church in Whittier, California that provided all the building supplies (tiles, paint, etc), along with the hospital equipment, children's toys, as well as the people to go to Malawi and help construct the building. We had never seen such a lovely, bright, cheery - and clean - medical facility in Africa!
