Another day in Malawi

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  Balaka, Malawi
Wednesday, June 6, 2007

The past two days have been a bit slower paced than the first day at the clinic. Today began with a large breakfast. The volume of food as well as the quality was most pleasing. I have been eating well.
 
I have seen 6 total patients the past two days. One in particular was very interesting. A woman came into the clinic complaining of abdominal pain. She appeared pregnant. After taking her medical history it was noted that she had a history of uterine tumors. She had undergone surgery and had two previous tumors removed from her uterus. The prior surgeries were made evident by the large scar left below her naval. It began just under the naval and plummeted straight down 3 inches in the direction of the pubic region. There were two, inch long, scars perpendicular to the long vertical one. It looked similar to this:
 
                                                         Belly Button
                                                                 I
                                                           ___I___
                                                                 I
                                                           ___I___
                                                                 I
                                                                 I
 
 
I got to perform an abdominal examination on her right after Dr

Dr. Chonde and I

. C. The abdomen is divided into four different quadrants to the best of my knowledge; the upper right and left quadrants and the lower right and left quadrants. I was nervous when I started because I didn't know what to feel for. I have never palpated a healthy normal abdomen so I had nothing to compare it to. At any rate I did exactly what I do when I approach uncharted waters. I dove in!
 
I palpated the different quadrants of her stomach. My lack of experience was of no concern because when I palpated it was obvious something was irregular. In the lower right quadrant of her abdomen there was a large, rock hard object. As I palpated around this object on all sides, mocking Dr. C's motions, it felt slightly larger than a grapefruit. The lump in her stomach was not a growing child as I originally thought. It was a massive tumor.
 
The right lower quadrant location of the tumor indicates that she has growth in or around one or more of the following areas: the right kidney, the cecum or appendix, the ascending colon, the bladder, the right ovary, or in the uterus as before. It was a great experience being able to feel this large growth, but the fate of the patient overshadowed the excitement. She was referred to a larger hospital. Hopefully the growth is not cancerous and she will be able to have it removed.  
 
We conducted some market research today in the afternoon. By market, I mean the actual marketplace in Balaka where villagers sell their goods. By research, I mean walked around and looked at everything. It was cool seeing all of the different goods people had. Villagers sold anything from fish to fishnet stockings, socks to light sockets, chicken parts to auto parts, and everything in-between

Two Volunteers

. Aaron bought a sweet messenger bag. This would have cost around 20 dollars in America. Aaron paid 550 kwacha for it. The kwacha is the Malawian currency. The exchange rate is 150 kwacha to one American dollar. Thus, the bag cost him $3.67. Great Success! I purchased a few secondary school (high school) examination essay books. Office max isn't down the street anymore so the only paper available to write on is in these small notebooks. They cost 20 kwacha each ($0.14). Very Nice!
 
Tomorrow will be exciting because the orphans come to the clinic. There is a building separate from the clinic that was specifically built for the orphans. This building has a kitchen and a classroom. Each Thursday, the orphans are brought to the clinic and taught. They learn how to prepare a traditional Malawian meal. They also receive a health education lecture from Dr. C, his wife, or an outside lecturer. This should be interesting to observe.
 
Well I am tired and dinner will be served soon. The journey is still unfolding. More to come.           

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