Village Clinics

So, ever since I first visited Malawi I have wanted to do village clinics. 85% of the people here live away from the city and in the village which means access to healthcare is a challenge. In Gusu (the village where E3 is working) it is about 12 miles to the closest health clinic. The last time we were out there a small child less than a year old was very sick. The mom was suspecting malaria but 12 miles is along way to walk carrying a sick child. Her other option would have been to hire a bike to give her a ride on the back, holding the child. Thankfully we were able to drive her into the health clinic so that the child could get the proper treatment.

So....the last two Thursdays I have been lucky enough to go out with Ministry of Hope to do mobile clinics with them. They are working in 4 villages where they have set up feeding centers. For those of you who have been here before imagine the place where they feed the kids at Yossa. Each feeding center has a building with a roof and 1/2 height walls and a maize mill.

I really wish I had some good pics to post but I was so busy the whole time we were at the clinics that I didn't manage to get any really good pics. I will try to get some the next time we go out.

The first week we were able to see 200 patients and this last thursday we saw 220 patients. First we weigh everyone, take their temp and other vital signs. Then they get sent to see the clinical officer (this week we had 2). From the clinical officers exam they either get sent over to the lab area for simple tests like malaria screening, urinanalysis etc... or they come to the pharmacy to get their medicine. The last two weeks I have been the pharmacy. We bring lots of medications in huge bins. Then we set them up kind of like tables and dispense the medicine from there. They have me do the pharmacy since I have been working in the country long enough to be familiar with the medicines, plus I can speak enough chichewa to tell them how to take most medications. It takes 2-3 people working in the pharmacy just under 6 hours to fill 220 prescriptions, just in case you were wondering.

We are able to move people thru so quickly because of all the workers that come along each week. We have 1-2 clinical officers, 1 malawian nurse, 1-3 american nurses, 2-3 med students, 1 lab tech and then other people who are here from the US for the summer to help out with the weights, temps, recording things etc....

It is really impressive to see how well the system works on such little resources. I was totally excited to be able to go out and actually use my nursing skills in the community and I am hoping to make it a regular part of my schedule here. It is a nice change of pace from working in the clinics here in the city. The only downside.....the pit toilets. But so far we have survived those! I will really try to get some good pics to post so you can really see how it looks.

Thank you to all of those back home who are supporting us as we are here in Malawi! It is because of you all that I get a chance to something as rewarding as this!

Becky

The patients just keep rolling in.....

So officially here in Malawi it is "winter" which usually means the end of malaria season. But for some reason we are still seeing alot of malaria patients coming in very sick and being admitted for IV Quinine. Some of them have already been on anti - malarials and just don't get better. Others get really sick right from the beginning.

At the start of today we had 0 patients in our inpatient unit as we had discharged them all over the weekend. By the time I knocked off at 6:30 pm we had 9 more patients.

While a nurse and I were trying to start an IV in a 1 year old who had really bad pnuemonia we got called down the hall by another child's parent because the kid was seizing. Thankfully our covering doctor was still there. We gave rectal Valium which seemed to stop the seizure but then the only way to arouse him was by a sternal rub and even then all he did was move his arm. It is hard to say whether the seizure was caused by the high fever or by cerebral malaria since his malaria count came back at 4+ which is the highest it can go. We will pray that he has a full recovery but only time will tell.

Unfortunatley we were not able to get the IV in the other child with pnuemonia so we ended up giving his meds IM and keeping him on nebs and O2 overnight. If he still needs a line in the morning we will have one of the clinical officers put in an internal jugular.

Two of our patients that we admitted have cancer which is a bad thing to have here in Malawi. There is no oncologist here in Lilongwe and the best we can offer someone with cancer is to either go 4 hours away to Blantyre or to fly out to South Africa. Neither one is very feasible when you are in alot of pain with limited financial resources. One of the guys we have been treating since January just with morphine for the pain. Every month or so he comes in for and increase in the dose. We have nothing else that we can offer to treat him so it is very sad. The other guy came into with probable prostate CA. His bladder was so distended that when I cathed him I got out almost 2 liters of urine. I don't know how he was even walking around like that. Once he is stabilized we will refer him out for treatment.

The rest of the patients were malaria patients. Usually treatment is straight forward. IV Quninine x 3 doses 12 hours apart and then discharge home as long as they have no fever.

I thought maybe you would like a glimpse of what it is sometimes like at our ABC clinic. And those were just the ones that got admitted. We saw many more as outpatients in the clinic who were treated and sent home. Days like today are very busy but are also the most rewarding.....

Becky

A Very Busy Week!

Well this past week has officially left us exhausted!

On Monday the academy had their final house competition which was basically a huge field day/track and field meet! Not exactly the best day for "winter" to blow in to Lilongwe. Yes it was actually cold (in the 40's ) with drizzly rain and wind and by 5:30 pm we had to end the event prematurely due to the weather! I have to admit.... I was actually freezing and couldn't wait to get home. I was actually missing my hottub!

On Wednesday I met a really cool nurse that is here with her husband for the summer. She wanted to come to Partners in Hope with me so I had told her I would pick her up after dropping the kids at school. Unfortunatly the guy that gave me directions to her guest house said to turn after the Peoples market instead of before the Peoples market. So after driving around unpaved dirt roads for about 45 minutes I totally happened to find her guest house just by chance. We had a great day at Partners and I was able to help her and her husband find a place to house sit while they are here. For some reason traffic was horrible that night and I managed to get home just in time for the power to go out! Dinner that night....PB and J!

Thursday night was astronomy night for Kimmy's 4th grade class. We made it home just in time to grab some quick dinner and head back to the school. Ryan took his telescope and helped the kids see some of the planets. The kids had a blast because their teacher had a huge bonfire built and they got to make s'mores. It was really dark since it was a new moon so lots of stars were visible. Later that night we went to the concert finale for the college bands and choirs. There were so many people that they were spilling out onto the front lawn. It was great to see and hear but made for a very late night considering that we are up at 5am most mornings.

This was the last week of classes for African Bible College where David teaches a business class, so after the final papers were turned in on Tuesday him and Sam (he co-teaches with David) were left with a huge pile of papers to grade before graduation. Their class was supposed to be limited to 30 students but being the only business class offered there was high demand and they ended up with 62 students in their class.

Friday after a meeting for the clinic at ABC I spent the majority of the day helping 3 other ladies from the campus and a handful of college kids decorate the hotel for the senior banquet. We had to blow up 120 + balloons to hang in bouquets from the ceiling (helium not available), banners to hang, tables to decorate etc.... Then it was back to ABC to pick up the kids from school. I am not usually that forgetful but I actually got half way home before I realized that I had left Linda ( the girl we transport to and from school) at the college so I had to turn around and go back to get her. Then Ryan had a friend spending the night so we had to go to to his house to get his stuff which officially got me home with about 1/2 and hour to get all dressed up for the banquet! For everyone who knows us you know that dressing up isn't exactly in our comfort zone but dressed up we were!

Saturday we had to be at the golf course by 8am to set up rental tents which took us until 1pm because we managed to get a nail in one of our tires and had to get it fixed! Then we ran home, showered and headed back out to college graduation at African Bible College. David could have walked as a professor but decided he didn't want to. It took 3 1/2 hours to graduate 42 students. There were lots of speeches by people like the US ambassador, and religious advisor to the president. After graduation we had to go take down one of our tents and then reset it up at a new location! I managed to get out of that since Ryan was home waiting for dinner!

Today David, Sam and Jay headed to South Africa for some business stuff. They are actually driving so we are praying for their safety! They will be in Johannesberg until Friday....when the World Cup starts. After having lunch with some friends from church and tearing down all the tents from yesterday I am heading to bed early so that we can start all over again in the morning!

I thought life would move at a slower pace here but we have managed to keep ourselves very busy. Thankfully the kids are out of school in 1 1/2 weeks and we will be moving closer to town very soon!

We are still waiting to file our fostering paperwork. Hopefully next Monday will be the day that we can get that done. Also still no word on when Gift's police case will close. I am possibly going to go on a village mission with Ministry of Hope Crisis Nursery (the one where Gift is) on Thursday so I will let you know how that goes!

Thanks to all our friends and family who have been praying for us and supporting us ......we appreciate it more than you know!

Love Becky