Cotton, Catholics, and a Malawian Hospital

• Pmyers's Profile
• About this blog
• Entry from Balak

Trip Start May 29, 2007 Previous
Entry Trip End Jul 18, 2007 Next
Entry

  Balak, Malawi
Tuesday, June 19, 2007

The day began with a tour of the Great Lake Cotton Company (GLCC). This is the major cotton processing company in Malawi. The GLCC obtains its cotton from markets across the country. The cotton is then delivered to Balaka where it is processed. Once in Balaka, the process begins by removing all the rubbish from the cotton. This task is performed by hundreds of workers by hand. The trash-less cotton is then transported to the gin where the seeds are removed. What's left is pure cotton. The isolated cotton is then compressed into bails, packaged, and shipped. Each day 185 metric tons of cotton is processed. The GLCC prides itself on its efficiency. They even use the cotton seeds to make cooking oil. The company employs 600 people and helps drive the Balaka economy.
 
From there we progressed to the Roman Catholic area of Balaka. This section is home to several primary and secondary schools, clinics, housing, and campuses. I am still not sure I grasp the concept of a campus even after visiting one. Today, we visited the Andesa campus. Within this campus there was a band hall where the world-renowned Alleluya Band plays, a farm, a metal shop, a furniture manufacturing area, a car service section, a water purification system, a lumber mill, and an ice cream parlor. I guess a campus is like a strip mall only with industrial services.
 
The clinic was next to see and the sign was quite amusing. The sign out front proudly said, "Clinic / Herbal Garden / Chicken Farm," in large bold font. This is an herbal clinic that prescribes natural treatment. We spoke with the Herbologist and inquired about his methods of treatment. They were interesting.
 
It was Zabi's again for lunch. We are becoming quite familiar. She is a pleasant and cheerful woman who LOVES to cook! Everyday she greets us with great excitement. To give you a visual, she bears a striking resemblance to the woman on the Aunt Jemima maple syrup labels. She takes good care of us!       
 
Once lunch was consumed, the hospital was next. The district hospital in Balaka is 2 km down the highway from the clinic. We had the privilege of exploring the hospital today. Our escort was Dr. Paul Siali and he is the supervising physician of the Balaka district hospital.
 
With respect to healthcare, Malawi is divided into hospital districts. Each district provides health services to its surrounding area. The Balaka district is one of seven hospital districts in Malawi.
 
Dr. Paul is originally from Nairobi, Kenya. He was educated in Kenya and then joined Doctors Without Borders and volunteered in Sudan for several years. Following his tour in Sudan, he began working with the United Nations (UN). To meet the objectives of the UN's Millennium Plan, Dr. Paul was directed to an undermanned area of the world in need of physicians, i.e. Balaka, Malawi.
 
Here, Dr. Paul has been charged with overseeing the renovations and expansion plans for the district hospital. The hospital was originally a clinic devoted exclusively for treatment of leprosy. When leprosy became less prevalent and other conditions began to surface, the clinic was converted into the current district hospital. According to the books, the hospital has the capability of servicing 150 inpatients and around 300 outpatients. In reality, during the average day they host 250 inpatients and up to 600 outpatients! How's that for being overextended?
 
Dr. Paul made sure to answer all of our questions. The operations for the hospital were explained to us in great detail. In Malawi, there are very few actual physicians. Most physicians from Malawi finish there education and then leave to countries to pursue their careers elsewhere. Thus, the brunt of the work falls upon 'clinical officers' (CO's).
 
CO's are trained by physicians and veteran CO's for two years. Once trained, CO's can diagnose, prescribe medicines, perform surgeries, and do most of what a normal doctor does in America. Until these 'young bucks' have completed their two-year training, they are referred to as medical assistants. 
 
Even surgeons get two years of CO training before getting thrown into the hot seat. I can't imagine learning everything to know about general surgery in two years. These surgeons perform any and all surgeries for the hospital. There is no such thing as specialized CO surgeons. They have to do everything!
 
The hospital hierarchy is as follows: physicians, clinical officers, medical assistants, and nurses. Much like the physician situation, there is also a severe lack of nurses. Most nurses trained in Malawi migrate as well to pursue a more fruitful career.
 
By the way, Dr. Paul is the only physician in ENTIRE BALAKA REGION! I could not believe this! Being undermanned is wildly inaccurate. They have NO ONE!
 
We spoke with Dr. Paul about this. He expressed that physicians trained in Malawi have no sense of national responsibility. There is no loyalty. It is widely known that there are enough doctors, yet most all of the physicians educated in Malawi desert their country. How tragic!
 
Earlier in the trip, Aaron asked me if I would still be a physician in Malawi. I explained that if you have a God-given ability to help, heal, and comfort others, no other elements should matter. Do what you love and love what you do regardless if you are washing cars for 8 bucks an hour or performing open-heart surgeries for millions. I know I will make a good physician! I care and genuinely want to help others.  
 
This was highly disheartening. I know that some enter the field of medicine strictly for the prestige and financial reasons, but to hear about this situation was shocking! Abandoning those that need you for personal gain is sickening.
 
I am glad I learned the intimacies of Malawi's health care. Even in the great US of A there are areas that badly need physicians. If my future allows, I would like to serve my country and assist in these deprived areas. With knowledge comes accountability. Physicians are responsible to all people, even the rural and urban shorthanded areas.
 
The actual tour was most interesting. The hospital had the following areas: women's inpatient, men's/children's inpatient, outpatient, anti-natal (for high risk births), delivery, post-natal, radiology, laboratory, Antiretroviral (ARV) distribution and counseling, theatre (surgery operating room), casualty and orthopedics, tuberculosis, administrative, laundry, kitchen, and volunteer testing.
 
The radiology department consisted of a single tiny x-ray machine. The ARV area is for HIV treatment and the consulting of HIV positive patients. Casualty and orthopedics handles the setting of broken bones, suturing, and minor surgeries. Some patients are in emergency situations and others are not. Test for HIV, TB, parasites, hemoglobin, electrolytes, and others are performed in the laboratory. Volunteer testing offers HIV tests for walk-ins who are curious. This is a part of their public health outreach initiative.
 
Two hours of talking and touring later, the tour was complete. Dr. Paul welcomed us back at anytime. I expressed interest in observing some surgical procedures. He said this could be arranged. Dr. Paul also invited Aaron and me to his home in Balaka this Friday to attend a gathering he had planned. I felt honored to be asked. I am not sure if we'll be able to attend.
 
I hold Dr. Paul, Dr. C, and Mrs. C very highly. They are wonderful examples of selfless individuals. In Dr. Paul's case, not only is he serving in a severely deprived area, he has forgone a successful career in his home country to fulfill worldwide needs. As for Dr. C and Mrs. C, they are 79 years old and STILL serving their country. They serve not to make money but because they are NEEDED! They can all be described in one word; noble. The world would be a better place if there were more people in it like the aforementioned individuals.
 
Someday I hope someone can say the same things about me. I will have fulfilled my responsibility as a physician then. My duty served.
 
On Sunday we will be visiting the Ntcheu district hospital. It is located about a half of a kilometer from the Chilopora's house. Through conversation I discovered that Dr. C himself designed the hospital! WOW! An esteemed physician and architect! Mad props Dr. C. What's even more impressive is that he oversaw the construction of the hospital against the will of the government. It was NEEDED! People were dying and the government was doing nothing. Dr. C saw the suffering and did the only thing he could do...; THE RIGHT THING! Everyone can take a page out of the Chilopora book. Personally, I am taking as many as I can wrap my fingers around.
 
It looks like we are going to shoot some pool over at TJ's (a newly opened pub up the street from the Chilopora's home). It was an incredible day! Soak it in Phil. Soak it in. The journey is still unfolding. More to come.      

Print this entry Share Lilongwe hotels

Previous Entry Next Entry