Weekly Update
Well, today marks the end of another fantastic week in Malawi, and the beginning of a fantastic week as well! Aakash and I finished up our traveling last week with two day trips to Neno and Mangochi district hospitals. It was nice to be able to sleep in our own beds for the rest of the week, and it was extra nice to get back to the nightly insanity workouts our team has been doing. Hopefully this week we will be able to keep up the workouts on the road – today at 2pm we left for Lilongwe, the capital of Malawi, and we aren’t getting back to Blantyre until Saturday! While I will miss Blantyre, Emily, Jacinta, and Caleb, I’m also super excited to see the northern half of Malawi. Tomorrow we start data collection at KCH, the QECH of Lilongwe – a hospital that has over 19 CPAPs. I can’t wait to see how they integrated CPAPs into their daily routine, though I’m sure it will mean lots of data collection!
Additionally, last week Aakash and I had the opportunity to work with PAM at the district hospitals. We went around to the PAM departments, introduced ourselves, and showed the employees a brief video about how to repair the CPAP. Caleb and Jacinta are working on a user manual to complement this video, and I hope to be able to join them when traveling is over. Also, we got to see the video implemented in real life; one of the hospitals we visited had CPAPS which were only outputting a pressure of 8, when the ideal pressure is over 9! When we called PAM the guy who showed up knew exactly what to do. He walked up to the CPAP, looked at it, and said “I bet the diaphragm is broken, I just need to replace it!” I then watched and assisted as he proceeded to walk through the repair process, doing everything almost flawlessly. There were also, from what I was able to tell, several PAM interns (high school aged boys) with him as well. As the CPAP was being repaired, I got to explain to these students how the machine worked, and what it was used for. Shannon, Caroline and I have confidence that these technicians will be able to handle problems that should arise in the future; the whole process was an example of the sustainability that Rice is striving towards!
Doctors
I want to spend a little of my blog post today talking about doctors in Malawi. Currently I am reading Claire Wendland’s A Heart for the Work, a book that examines the import of western medicine into Africa. So far I’ve only read the introduction, so hopefully I will have more thoughts on the book in about a week or so. However, the brief amount I have read has already gotten me thinking about the differences between Malawian medicine and medicine back home.
Doctors are named differently! In the US we have interns, residents, and attendings; but in Malawi they have interns, registrars, and consultants. However, the term “intern” isn’t widely used in the United States, the term resident is used as an umbrella term. This is not the case in Malawi, and if someone says they are an intern, a Malawian will assume that they are a licensed physician. Aakash found this out first hand on his flight into Blantyre, when he told the people at customs he was an intern from Rice! He was cheerfully congratulated on being an 18 year old doctor.
In Malawi, as in most of Europe, there is no undergraduate program leading up to being a doctor. People go directly from high school into a five year MD program, and come out as a doctor. Generally, I envy countries with programs such as these: I frequently wish I was a doctor already so I could help all of the patients I see here! However, when I discussed this with one of the CPAP coordinators at Mangochi, he told me that he prefers the American method of schooling! He said that it allowed for physicians with more variety and more combined knowledge – in Malawi you would rarely see a doctor who was well versed in history, but in the United States, history majors can become doctors!
Anyway, those are the two main differences I have noticed in medical education so far, but I will try to gather more information this week, read some more in my book, and report back with more fun facts!
SAFARI
On a side note, this weekend we went on a safari! All five of the interns, plus Becky (a medical student who did undergrad at Rice and is completing a clinical rotation at QECH) took a couple of taxis and drove up to Liwonde National Park. We stayed at Liwonde Safari camp, and spent time on a river safari and a driving safari. We saw lots of hippos, elephants, birds, impala, warthogs, and more. It was a gorgeous atmosphere, with baobab trees silhouetted against the setting sun. We spent much of the night stargazing and bonding. Note to any future interns: if you are looking for an inexpensive, chill, and breathtaking safari, GO HERE. Even the food was delicious; we had the best chicken I have ever tasted for dinner, and in the morning there were pancakes!
Note: My camera didn’t have a charge last week, so unfortunately I don’t have any pictures of our data collection. I’m currently recharging my camera after our safari, and hope to have some CPAP data collecting pictures for my next post, but until then, here are pictures of our safari!
