For the CPAP study, we have deal A LOT with medical records. Dealing with medical records here is a very daunting task because once the patient has been discharged or died, tracking down the charts is always an adventure. Thankfully, Sam and I have become very good friends with the people who work at medical records for pediatrics and they look out for the charts that are marked for the CPAP study. They are our main teachers for Chichewa. However, only the files of patients who were discharged an go through pharmacy end up at medical records. For all other files, we have to look through an assortment of boxes that are placed around the wards. But there are times when files simply get lost. For example, every Friday at morning handover meetings, someone will summarize the deaths from the previous seven days. There was one week that out of the ten deaths, the presenter could only track down four of the files.

Almost all of the wards that I have seen here don’t have staplers, so most of the medical charts are held together with whatever they can find in the wards. The most common methods I’ve seen is tying together stacks over paper with gauze, or bandaging them together. People get quite creative. The typical common method of filing these records are to tie with gauze all the death files from a certain month together and all the discharged fileds from a certain month together. And then these tied up stacks are put somewhere.

To keep track of patient history, all patients in Malawi are given a health passport in which their medical history is recorded each time they receive medical care. The patients are quite good at bringing these with them. Thankfully this system works because tracking down their patient charts from more than a week ago would be a nightmare.

Medical Records