It’s been just over two weeks now that I’ve been here in Blantyre, and after overcoming a brief bout of illness, I’m eager to get as much done as possible in my remaining time. With Bridget and Kathleen returned home safe and sound, the task has been left to me to continue the work they began.

Of course, in carrying out these tasks–which ranges from managing the bCPAP clinical trial, repairing medical technologies, and everything in between–not a day has gone by here that I haven’t learned something new, or at the very least confronted a concept or custom that challenges long-held assumptions. I’m amazed, for one, at how quickly one settles into a routine–how entirely novel experiences become normal in short order, even in such a distinctly unfamiliar environment. Fraying, paper-based medical records bound by strips of yarn now present a (reluctantly) accepted standard. Similarly, that vast families quite literally live on the hospital lawns is something I now notice unperturbed.

However, perhaps what I’ve been awed by most is the ability of the staff at Queen Elizabeth Hospital to make so much out of so little–to be frugal innovators. In some cases, to be sure, this results in less-than-ideal care. But it also allows the physicians here to maximize the use of what they do have, such as with the lawn-seat-turned-wheelchair shown below.  Thousands of Malawians’ lives depend on this makeshift ingenuity–and so, too, might the broader goal of making health technologies accessible in such low-resource settings.