Block I 2008
Melanie (“Meranie”) Fox, Denise Gavarin, Rania Khan, Drue Orwig, Lance (“Rance”) Richards, Jonathan Nzoma
Tips, Tricks and Survival Tools:
- Malawi time = “Y” x 2 – always double
- Malawi Public Transportation Navigator:
- You get what you pay for
- Patience is a virtue
- Bring some Raid
- Never underestimate the power of a dead fish
- A new meaning to “window shopping”
- Feel free to pack your own live chicken
- Simoni’s vegetarian lasagna is superb (and or course the peanut butter cookies)
- Beware of unexpected, furry, four-legged guests around the midnight hour
- The downtown Blantyre Market will satisfy all your shopping needs and desires – from undergarments to chambo to chamba. The world at your fingertips!
- Try your hand at driving in Malawi – Darwinism at its greatest
- Save fuel, turn off your headlights in the rental car at night
- Don’t forget either a guide or an M-16 during your hike up Mt. Michiru. A great day hike three hours round trip, but take a guide.
- Watch at least one Malawian soap opera
- The Blue Elephant = great music, beer and Rastafarians.
- Best restaurant – Home Needs
- Best nsima – QECH, Medicine Wars vs. outdoor venues
- Simoni’s Best – PB cookies, veg pizza
- Simoni’s Worst – Nothing, an artist at work
- Favorite Outting – Mumbo Island, including travel
- Group Game – Euchre
- Group Song – “No One,” by Alicia Keys, unfortunately
- Best Smelling Ward – Moyo House
- Most Common Quotation – “Where’s Jonathan?”
- Group Movie – “Lord of the Rings,” forward then backward
- Most Accident Prone 2008 – Melanie Fox
- Best Power Yoga Rookie – Drue Orwig
- Best Friend – “They call me Tony”
Block II 2008
Chris Coller, Keri Thompson, Jess Hedeman, Jon Podgore, Jeff Frey, Ryan Krafft, Katie Nicoll, Rich Bryce, Manish Raiji
If you want a good African bus story in terms of #s:
- 600 km — distance Blantyre to Nkhata Bay
- 4 hours – Blantyre to Lilongwe (“This is easy.”)
- 120 people – crammed on bus with 60 seats
- 160 – number of times Malawian Christian song by Violet Tinga Tinga was played in a row
- 10 – bags of smelly fish
- Infinity – number of times people told us that the bus will be here soon
- 6 – hours with no seat standing on bus
- 15 – live chickens on bus
- 2 – number of people defecated on by chickens that were in overhead compartment
- 1 – chicken that got thrown out the window
- 1 – hat thrown out the window (by guy who got defecated on) by woman who owned chicken
- 1 – perfect African bus experience
- Use the fan at night; it makes great white noise
- Don’t be afraid to enjoy a mid-afternoon snack. You won’t spoil your dinner at 8 or 9 p.m.
- I learned that Cipro is a force for good in the world
- I learned that I can cough for 6 weeks straight and still not get rid of all the crap in my lungs
- I’m not sure if I feel better or worse about drinking Carlsberg after touring the brewery
To all who shall read these comments on first arriving: Enjoy! This country will amaze and frustrate you, and warm and break your heart simultaneously.
To steal from Terrie’s wisdom, “Get out of the house! You’re in Africa!”
- Morning report starts at 8, goes until 9:30
- Ward rounds start shortly after 9:30
- There are several peds wards — oncology, special care, peds nursery, chitinka nursery (MCU-ish), accident and emergency, medical bay, the research ward (where Terrie works) and Moyo (the malnutrition ward).
- One idea is to pick one ward each week and go for the whole week. You will get to do more because they will know you are coming the next day. If you skip around a lot, you may get lost in the shuffle.
- You are at about the 5th year med student level, so you may want to befriend a 5th year student and have them show you the ropes.
- In the afternoon, they have lectures and/or clinics or bedside teaching. There are schedules in the pediatric annex on the bulletin board or you can get one from Rose, the secretary.
- Keep in mind that no one will really be expecting you and no one will have a set schedule or set expectations for you. You just kind of have to decide what you want to get out of the experience. Make a schedule for yourself and execute.
- There are several Malawian “consultants” (attendings) and several foreign attendings. Residents are called “registrars.” Most everyone attends the morning meeting.
- Overall, peds is a well-organized department. It is just hard to figure out at first for someone new (which is why I wrote this; hope it helps).
- One more thing — everything you think you know about malnutrition is totally wrong. That’s all I will say. Spend some time with Dr. Heikens on Moyo.
If you want to splurge, go to Mumbo Island off the coast of Cape Maclear. (Get the Malawi rate – tell them you work here.) It is amazing. You get there through Kayak Africa — you can kayak to the island or take a boat. It is magical. Crystal blue water, a tiny secluded island, good drinks and food, private tent/lodges that have private balconies and look out over the water. Amazing snorkeling, hiking trails, bonfires, friendly staff. Seriously fantastic.
Block III 2008
First some helpful info. I arrived much later than the rest of my group and had a different experience.
- Buddhist Temple: Located past Limbe on road to Zomba. Look to your right. It is hard to see from the road but look for a small sign on a dirt road written in Chinese. When you turn on this road, you will see a large pagoda entrance and many blue-roofed houses. The temple is beautiful and there is a large orphanage there. The view is amazing. Set some time to just sit and admire the scenery and 50 Malawian kids doing roundhouse kicks and cartwheels!
- Post: Surprisingly, some of my mail took only 10 days to reach the States. La Caverna has some really nice handmade note cards that are cheaper than postcards. Postage currently requires 4x40k (160 kwacha) stamps. They are big so leave room your envelope! Post office is in town near South African Airways on Glyn Jones Road (I think).
- Internal Med: Crazy department with twice-a-week rounding and much frustration. I switched gradually from hospital work to doing more clinics. As of now, ARV clinic is every day, AM and PM. Tuesday PM – diabetes clinic. Wednesday AM – general med, PM – chest clinic. Thursday AM – neuro, PM – palliative?
I don’t want to say that Malawi was “beautiful” or “amazing” because that isn’t how I feel. This experience has given me much to contemplate and reconcile with my beliefs. The harsh realities and the all-to-human adaptations to life here are far too complex for me to even begin to understand. Every day, my emotions conflicted and swayed so much that I often felt overwhelmed, often to the point of apathy.
My shortcomings in communicating with patients and fear of caring made compassion difficult. I think what shook me so much was that every day in the hospital and on the streets of Blantyre provided overwhelming evidence of the lasting and dramatic effects of apathy, of history and of the consequences everyday actions we take for granted in the States have, halfway across the world.
While I have seen much ugliness here — tourists showing disdain to the despairing and desperate, infants who are HIV+, wives discovering they are HIV+ because of their husbands’ infidelity — I’m amazed at how resilient the Malawians are. I am also comforted by the genuine work and sacrifices many caregivers have made.
While at times it feels the problems of everyday life here are insurmountable and that “progress” is an empty promise perpetuated by the “haves” to the “have-nots,” I’m amazed at how much change has occurred in only a few years and by how much treatment is available, especially ARVs.