The more time I spend in Chatinkha and the Paeds ward, the more I am aware of the profound impact that the CPAP project has had on the nurseries, and the extent to which the project has grown since it was a design project at Rice a number of years ago. In Chatinkha, the arrival of the CPAPs led to the arrival of a lot of other necessary technology. As the CPAP study could not be performed without functioning pulse oximeters and respiratory rate clickers, now not only the babies on CPAP but also all of the other patients in the ward benefit fromthe availability of the new technology. Devices such as pulse oximeters can make vast improvements in the quality of care that is administered in a ward, especially in one where the patients are so vulnerable that if treatment is not closely monitored it could end up hurting the patient more than helping. Also, since fewer resources are going towards finding a means of affording a CPAP, those resources can now help to fund other necessary equipment or pharmaceuticals that would otherwise be too costly. This effect should not be undervalued in a setting like QECH, where every Kwacha goes towards the lives of the patients. It is common knowledge for those familiar with CPAP that the device saves lives; it may be uncommon knowledge the number of ways in which it does so.

Along with my work in Chatinkha and on the CPAP data collection, I have had the opportunity to start doing research on supply chains within the hospital. In a large hospital like QECH, a lot of the money to fund disposables and common pharmaceuticals comes from the Ministry of Health. The budget from the Ministry is substantial, but because of the magnitude and scope of the Hospital’s needs it can sometimes be difficult for the Ministry to be able to support medicine that is more expensive or only effective for rarer diseases. That’s where outside NGOs such as Friends of Sick Children and Care International come in. They have more power to help supply specific medication that is equally as necessary as that from the Ministry but less available. It is in this way that the hospital is able to care for the large number of malaria cases that appear every day, and also the few rare cases of cerebral palsy or leukemia that only appear every so often. This research has exposed me to how complicated it is to keep such a large institution up and running, while also providing the best care available to each patient. I am coming to realize that Queen’s is remarkable at maximizing every given resource to the fullest of its capabilities.

All that I have learned in the past week about the CPAP and Queens has also given me some valuable insight into my overall impact on the community around me during my two months. At my arrival, I was very enthusiastic about having the chance to be hands-on and watch the work I was doing correlate directly to helping someone. After volunteering in my past for a lot of different international organizations, I couldn’t wait to be the one on the ground delivering the much-needed help. Since I landed, my understanding has significantly matured. The community here is not dependent on my help. They have been sustaining themselves for longer than I’ve been alive, and they will continue to do so long after I leave. My task has never been to come in and change the environment to stimulate development, but rather to encourage the development that already progresses in any way that I can. The other interns and myself are only here for two months, and so whatever goals we set out to achieve must be able to survive long past our departure. This realization has helped me shape the way I have structured my day and the tasks I plan for myself. Now I look for projects that not only make use of my knowledge that I bring, but also the projects I know will be sustainable beyond my assistance to them.

A CPAP at work in Chatinkha Carissa and Aakash on the walk home from Queens