To my loyal readers (mainly my mom), I apologize for the lack of blogging lately. I am almost finished with spending two whole weeks at QECH. I have observed and learned so much these last 14 days that it has been difficult to process it into coherent thoughts to share with others. These last two weeks Sam and I have:

1. Started up a system to collect data in the pediatrics and maternity (for newborns) department for the bCPAP study.
2. “Fixed” the last working freezer for lab specimens for peds. The hinge was broken so the freezer wasn’t closed properly so we took out the hinge.
3. Found the physical assets management department (PAM) where medical devices go to be fixed. It is in a very hidden part of the hospital.
4. Attended morning handover meetings for pediatrics, internal medicine, and maternity.
5. Shadowed doctors and nurses at pediatrics high dependency unit and Chatinkha nursery.
6. Became best friends with people at medical records because that is where all of bCPAP charts go after the patients are discharged.
7. Realized QECH is a maze. It is essentially a hodge podge of buildings with a network of hallways connecting it.
8. Introduced the idea of the Sphygmo to people in maternity. Hopefully we can present it to them next week for some feedback.
9. We had a late friday night data entry party with kitties and brownies!

   

 

All in all, we have met some very inspiring people, but uncovered many problems that exist within the healthcare system. We have experienced some successes, but also witnessed some very sad deaths.

Chatinkha

It is TOO MUCH to talk about everything that I mentioned above in depth now, so for now I will talk about Chatinkha (which I found out today is the name of the ENTIRE OB/GYN ward). We have been spending a lot of time in the Chatinkha nursery because that is where some of the the bCPAP machines are. Babies who go to this nursery have been delivered at QECH and transferred directly to the nursery for various health problems. The main ones I have seen are RDS, severe prematurity, and birth asphyxia.

There are three main sections to the nursery:

• High Risk: These are where the babies are first admitted. Babies in this room would usually be in incubators in the NICU in places like the US. However, instead there are around 2 dozen TINY babies. At most, I have seen 4 babies cramped into a bed with a heater. But in general, space is pretty limited, and it gets especially crowded when the mothers all come to feed their child. This room is heated with space heaters.
• Low Risk: Babies are transferred to this room once they are more stabilized. I have seen many babies undergoing phototherapy for neonatal jaundice with Rice’s Bililights.
• KMC: After babies are healthy enough to return to their mothers, they are transferred to KMC which stands for Kangaroo Mother Care. This is quite adorable, because these tiny premature babies are wrapped to the mother, skin-to skin, in between her breasts, and are carried around like a kangaroo baby would be. This is so babies can use the warmth of the mother and also the mothers can constantly monitor the baby’s condition.

Malawi has the highest rate of prematurity anywhere in the world. Prematurity can be caused by a number of issues and here HIV, TB, malaria, malnutrion, and lack of antenatal care are all contributing factors. I have great respect for the doctors here. In the Chatinkha nursery, there are on average 52 babies admitted at a time and only 2 doctors doing ward rounds. There are a few students here there, but personnel is definitely lacking. Many of the babies that I have seen have been quite frail, so it always makes me extra happy when I see happy and healthy babies.

Personal accomplishments
1. Discovered that a loaf of fresh bread at the Walmart-type grocery store is less than $1
2. Bought fresh fruits and vegetables at the Blantyre Market!

Donated Clothes
Ever wonder where your donated clothes go?? Some of them end up being sold in the markets on the streets of Malawi! It is quite bizarre because there are just giant piles of donated clothes all around the city that are being sold. Some still even have goodwill tags on them. I’ve hear you can even find some really great buys here.