Well, the last three weeks have been eye opening, tiring, and very humbling for us. We have just completed week 3 of 6 at Kamuzu Central Hospital, which is in the capital city of Malawi, Lilongwe. As we mentioned in our last blog, in order to become registered physicians in Malawi and practice medicine in Malawi, we have to complete a 6-week “orientation” at Kamuzu Central Hospital. Since Jenny is Board Certified in Family Medicine, she is doing 1.5 weeks in the four main departments: Ob-Gyn, Surgery, Peds, and Internal Medicine while I have been rotating around the peds department. Jenny has completed Ob/Gyn and just finished Peds on Friday. Over my last three weeks in the pediatric department I have spent time seeing and rounding on patients in the General Peds Ward A & B, High Dependency Unit (intensive care), Emergency Zone, and the NRU (Nutritional Rehabilitation Unit). This time has given us a good opportunity to become more familiar with different tropical diseases and conditions that exist in Malawi. It has also given us a good idea of the medical infrastructure and health care system and what services can and cannot be provided.
While this has been a good learning experience, it has probably been one of the most difficult experiences in our lives. I have worked harder in the last 3 weeks than I ever did in a day of residency or medical school. The pediatric ward is extremely busy this time of the year in Malawi because it is the peak season for malaria, malnutrition, and bronchiolitis.
On Friday, there were 570 children admitted in the hospital. Space is limited but always available, even if it means there are 3 or 4 children on one hospital bed or crib. I have a lot of respect for the people who work here all the time and they work incredibly hard all day long so that all the children are seen. The staff of physicians is small (about 6-7), but interns and bachelors share the load. An “intern” is a doctor that has completed medical school and is completing the required 3 years of clinical training prior to independent practice. They rotate through all the departments for 3 months at a time. A “bachelor” often has been a practicing clinical officer for many years and has entered a 3-year training program to gain an additional educational degree in a specific field of medicine, such as pediatrics.
While there is an overall lack of human and medical resources, they work hard to try to improve the outcomes for the children they see with what they have available. The medical students, nurses, and the nursing students help to care for the patients but a lot of the time because of the volume of patients you wear many hats as the doctor, nurse, and respiratory therapist.
I remember the first time I wanted to put a child on CPAP (continuous positive airway pressure) for breathing support I had to track down the parts and tubing I needed. There are multiple spots to locate all the proper connections, but because of the volume of patients, most of the tubing and nasal prongs are washed daily and hung to dry on a line outside the Emergency Zone to be used again.
We have a couple pictures of the outside of Kamuzu below but of course we did not want to take any of the patient care areas because of cultural beliefs and patient privacy. Someone asked me to describe the ward the other day and it is just too hard to do. It is a place that you have to experience first hand to understand.
To change the subject completely, everything is going well with Jenny’s pregnancy so far. We still haven’t been to the Ob-Gyn yet, but that is planned for this week. Jenny had an unofficial scan a couple weeks ago and everything looked good and the baby is just the right size. We still don’t know the gender but maybe we can find out in the next couple of weeks. Besides her complaints about heartburn and scrubs that don’t fit, she is doing well and trying to stay as healthy as possible while we are at Kamuzu. Keep her and the baby’s health in your prayers as we finish up the next 3 weeks there.
She is thankful for all of the B-day wishes as well this week. Again, thanks so much for all of your messages on Facebook, emails, and prayers. We are really looking forward to serving again in our clinic at Child Legacy in a few weeks.
Take care and continue to keep us in your prayers
Jared & Jenny
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