Miyezi angati?- How many months ?

 

On the must do on every Saint Gabriel’s volunteer’s bucket list is a visit to one of their outreach clinics. This week, Renata and I finally went. Around 9 am, we helped as the outreach workers loaded the caravan with mosquito nets, scales, blood pressure machines, HIV rapid test, and other medical tools. Today’s clinic was traveling to Malagande training center, which is about 8km from the hospital. The hospital workers perform prenatal check-ups and under 5 check ups.

When we arrived, there was already a line forming prenatal check ups! In one room, we took the weight, blood pressure, and demographic information for the patients. There had to be easily more than 50 pregnant women there. Each of these women were carrying a health passport, a symbol of the Malawian health care system.

 

While I was recording weight and blood pressure, I couldn’t help myself but to look at the year of birth for each of the patients. The majority of the women were born in 1994-1997, making them around 16 to 21 years. In fact, it was uncommon to see a woman that was older. This is a complaint I hear the clinical officers make all the time: women are just having children too young. In some districts, like Mangochi, it isn’t uncommon to find a pregnant 11 or 12 year old. 38% of Malawian women are mothers by 18 years. ¹

 

 

After we were finished taking vitals, we watched as the nurse checked on all 50 women. We were in an abandoned building owned by the hospital that had very little natural light, and definitely no electricity. Instead of using an ultrasound, the nurse used her hands to tell where the baby’s head was, and used a ruler to measure from the head to the pelvis. And instead of a fetal heart monitor, a pinard (kinda like a stethoscope) is used. The visit ends with the nurse prescribe malarial prophylaxis, iron pills, and giving a date for the next visit. It took us about four hours to complete all the visits, and pack up to go back to Saint Gabe’s.

 

But of course, as is customary, we had to stop for nsima for lunch!

 

1) http://www.unicef.org/pon95/fami0009.html

Intaneti-“Internet”

I would like to take a moment to say how genuinely impressed I am with the internet here in Namitete. For a rural community, they have some decently fast internet. It’s even better than that in my pretty rural town of Saint Francisville, Louisiana. In fact, there was a point where I wanted to talk to my parents but I couldn’t because their wifi wasn’t working for a week.

 

The system for internet is genius. It has 4 steps.

• Buy an internet dongle or a wifi router. Inside of the dongle is a sims card that connects to cellular data. If Renata or I had thought to bring a wireless router, we could have connected multiple devices to one sims card. Some dongles and wifi routers come preloaded with internet.

  

• Insert the sims card into your cellphone. That’s right, you can buy internet with your cellphone. Anywhere, anytime.

  

• “Top off” your sims card with airtime. The company we are using (Airtel) sells airtime at most street vendors. We can find of airtime in Namitete or Namitondo. This is a good system for those living in rural communities. Airtel is not just in Malawi, but all across Africa and India.

  

• On your cellphone, buy mobile internet. 4GBs of internet here cost about 6,600 MK, or about $14USD. With work, we go through about a gigabyte per week, so this amount is perfect.
• Put your sims card in your dongle and you have internet!

  

  

 

This system is an example of technology designed specifically for a global setting. The majority of Malawi is rural, so it is important that cellphones and internet work in these areas. SMS is even used in Saint Gabriel’s Pallative Care Center as a means to contact volunteers spread across the hospital’s service hours (that’s a good 60 km in any direction).

 

I might tell my town to take note.

 

Pamene Zimaswa- “When it breaks”

When things break in Malawi they are hard to fix. Sadly, though, I learned this lesson with my laptop. After dropping it, my laptop would turn off a few minutes after it turned on. The hospital secretary, Kathy, recommended that I give it to Everest, the guy who comes from Lilongwe to fix Saint Gabriel’s computers. He was extremely qualified, she said, and was certain that he could fix it.

 

This weekend, after three weeks of my laptop being in Lilongwe, I finally got it back. Everest tried his best, swamped with so many other computers to fix, but be it either due to lack of knowledge or lack of the proper tools, I received a phone call saying that he had “failed to fix my computer.” In fact, the problem was worse: I couldn’t turn on my computer at all.

 

When I went into town to pick up my laptop, we saw Richard, the hospital lab technician on his way to get the machine that counts hemoglobin fixed. When we saw him again in lab the next week, he said that the engineer couldn’t fix it, and that hopefully the hospital would buy a new one.

 

 

The thing about technologies is they break. Regardless of how durable you attempt to make it, sooner or later nature will take its course and your technologies will break. So either someone’s there to fix it, or it gets stored indefinitely. For example, looking at Hannah Abrams blog about the lab from two years ago, most of these centrifuges are now broken and are sitting in the lab collecting dust.

 

Or they go to the maintenance office. Here you will find Duncan and Flora, the two hospital technicians. Duncan deals with mechanical issues and Flora with the electrical. In the maintenance office, there are broken technologies piled high.

 

Duncan told us that things that should take them a few minutes or hours to fix takes them days and weeks, just because they don’t have the right tools. Flora agreed with this, and said that, a lot of times, they simply don’t have the parts or the proper tools to fix them. These are simple things like solder and proper sized screwdrivers that would be commonplace at the OEDK. The two of them together just don’t have enough time to fix everything that goes wrong in Saint Gabriel’s: a lot of times, the hospital will have technicians and engineers come in from Europe or surrounding countries in Africa to fix technologies.

 

Malawi and Saint Gabe’s just needs more: More doctors, more engineers, more tools, more parts, more machines, and more resources.

Phunziro means learning in Chichewa. Which is exactly what my first couple weeks here have been like. Learning about new people, a new country, a new culture, and new technologies.

As stated in my previous blog, the other weekend, we went to Lilongwe to get new internet! And then on Wednesday, the day before our big presentation at the morning meeting, I dropped my laptop! Luckily, the hospital staff was kind and allowed a technician to fix it, but it’s still in Lilongwe right now. Thanks to Renata for letting me borrow hers.

A major theme of this trip has been me being shocked at both how many resources are present and how few resources are present. While our internet has been pretty fast and allows for Skype calls, back home in my small town, my family has been without WIFI for the past week. The hospital has an amazing ART software and program, but the X-RAY machine has been gone. Perhaps the most shocking was the diversity of the Namitete market compared to the Chipiku store in Lilongwe. I saw Tabasco sauce there from back home in Louisiana! There was also Cajun chicken pasta and Louisiana Fried Chicken in the restaurant we went to. We live in a global world, friends.

People have been asking me so much what I have been doing. Currently our average day goes something like this

7:00 AM- Wake up; eat breakfast

7:30 AM- Go to the morning meeting. The nurses from the night shift give a summary of the patients who have been admitted, died, and of the special cases. After this presentations are given by the staff on a relevant morning topic. This is we did our presentation on our technologies to the clinicians.

8:00 AM- 12:00 AM- Shadowing clinicians, watching surgeries, meeting with contacts, but mostly working on Morphine Tracker Improvements

12:00PM-2:00PM- Malawian lunch time is a little bit longer. You have to have time to go home and cook nsima. Renata and I try to eat nsima at least once a week, if not more. It actually taste exactly like Nigerian fufu, and you eat it the same way, with your hands!

2:00PM-5:00PM- More meetings, and working on Morphine Tracker.

5:00PM-10:00PM- Shower, cook dinner, eat dinner, play some pool, work on med school apps , watch some t.v. or read a book

10:00PM- Lights out!

Sorry it took me so long to upload a blog! It turns out that the internet company here has a limit to how many gigabytes you can use. I didn’t realize this and burned through mine in 2 days.  Needless to say we purchased unlimited internet when we went to Lilongwe this weekend. So be prepared for very frequent pre-prepared blog posts for the next couple of days!

I can’t believe that Renata and I (and all the other interns) are finally here in Malawi!!! It’s been a crazy first week here.  After two solid days of international flights, we landed in Kamuzu International Airport, were we were graciously greeted by one of the hospital workers who drove us 45 minutes from the international airport to the village of Namitando, where St. Gabriels Hospital is.

We are currently staying at the Zitha house which is fully stock
ed with a complete kitchen, en suite bathrooms,  and a television for watching Nigerian soap operas, which are my favorite.

 

I’ve absolutely fallen in love with the village. From the friendly smiles in the hospital, to the casual Chichewa lessons with our housemates, and the friendly people in the market,  the villagers here really embody the idea of Malawi being the “warm heart of Africa”.

What’s that you say? You didn’t know Malawi had a nickname? You didn’t know anything about Malawi?

*A Brief History of Malawi*      

            

Malawi, formerly known as Nyasaland, is a landlocked country surronded by Zambia, Tanzania, and Mozambique. Its one of the smallest countries in Africa and is about  1/3 water.  Initally settled in by migrating Bantu groups in the 10^th century, the country was colonized by Great Britian in 1891. After going through several phases of government changes, Malawi became and independent country on July 6, 1964.  Malawi is largely rural; agriculture makes up a substantial part of the economy.  In addition, Malawi has a low life expectancy, high infant mortality rates, and high maternal deaths rates. (Side note: this is one of the reasons why what St. Gabe’s is doing in the community is so important). The currency is the Malawian Kwacha (1 USD= 440.00 MK) and the official language is English, but Chichewa is most widely spoken. This is especially true in Namiete, where many villagers speak absolutely no English. There is a pretty substantial tourism business for people looking to backpack, safari, climb mountains, or visit the amazing inland beaches. So come visit me!

*End History Lesson*

By far, what is sure to be the most meanigful part of our stay here is the time we spend in the hospital. Dr. Myeba, Alex, and Suave are such good mentors that I know that we will get a lot accomplished. This is going to be a great summer!!!

Hello friends!!! In approximately  18 hours I will be on [several] planes to Lilongwe, Malawi, followed by a 1 hour car ride to the rural village of Namitondo to work in Saint Gabriel’s hospital. There is no doubt that this will be a life-changing experience and I’m truly a mixture of emotions.

First and foremost, I am excited. I am so incredibly thankful to Rice for giving me this opportunity to learn about new people, places, and opportunities for technology advancement. I am so ready to test our technologies and find chances for improvement.

I am busy. Renata (my internship partner) and all the other BTB interns and I have spent the last two to three weeks in the OEDK preparing our technologies. We will be bringing four major technologies: the CPAP heating system, the thermometers made by a GLHT 360 team last year, an updated flow splitter, and the Respiratory Rate Timer that my team and I made this semester (pictured below).

I am nervous and curious.  I am going to a place where I don’t know the language, culture, the food, or the people. I’m uncertain of how daily life will go, but I’m eager to learn.

I am sad to leave. This is the longest and farthest I will be a way from my loving caring family. I know that I am giving my mom and dad major heart palpitations.  I will miss my brother Obi coming back from his first year of medical school. I will miss my sister Ngozi getting ready for Emory University. And I will miss my youngest sister Nneka turning sixteen and rushing to get her driver’s license. I will miss all the little details.

I am ready. See you in Malawi!