4 weeks in Blantyre

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September 4th 2008
Published: September 8th 2008
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Hey again!
So I have spent the last 4 weeks in Blantyre doing an orientation at Queen Elizabeth Hospital. It has not been my favorite thing to do so far in Malawi, but I have learned a lot. And I have seen a lot, but I will spare you the gory details.
Usually, my typical day, Monday-Friday consists of me getting up around 6am. Putting on my lovely nurse’s uniform. Walking about a mile (uphill, in the rain - jk, it isn’t rainy season yet) to where the mini buses park. Paying about 50 kwacha (many times they try to charge me more because I am a mzungu) to ride to the hospital. Wandering around until I find the ward I am supposed to be at by 7:30. Waiting in the sister’s lounge (nursing station) until the charge nurse arrives…any time between 8 and 8:30 hopefully. I help damp dust (mop and clean the wards) until sometime between 9 and 10am. Usually at this point, if I am lucky, the doctors do rounds and then I can follow them around until lunch. It is a teaching hospital, so there are a lot of med students, and they usually speak in English
The gangThe gangThe gang

Hanging out in Lilongwe at Iron Chef. Ken is dressed nicely. Left to Right: Me, Cathy, Salima, Jillian, Ken, Jen, Brian K (back), and Katie
so this is when I actually know what is wrong with the 50-60 patients on my ward because the charting is not like what we have back home. From 12-1:30 we eat lunch (I tried to tell the nurses that at home we are lucky to get a full 30 minutes for lunch and they didn’t believe me). After this I usually wander around the ward until the nurse says I can go home, which involves another minibus ride, and a walk that is about 2 miles because the buses don’t stop near the transit house…
Anyway, my first week of orientation was in the pediatrics (or paediatrics, everyone here thinks I cannot spell - which I can’t - because all of the words are in English English, not American English…) ward:
Monday: Special Care Unit (Malawian version of an ICU)
Tuesday: moyo, or the Malnutrition Ward
Wednesday: A & E (under 5 clinic)
Thursday: In the morning I was in the Nursery, and after lunch I was on the Surgical Ward
Friday: Oncology
That weekend I traveled to Lilongwe and saw some of my friends that live in the central region. I had to also take care of some administration issues involving $$ (or really lack of $$). It was literally a 24-hour trip. I traveled up with some education and environment volunteers that were going to Lilongwe on their way to in-service training or COS conferences. That evening I met up with my friends from my health group, and we went to a GAD (Gender and Development) fundraiser called ‘Iron Chef’. It was basically a cooking contest (I never watched the TV show) where some of the volunteers had to cook a 3-course meal incorporating 2 secret ingredients (chocolate and honey). With my luck, however, when I got to the table they had run out of food…I think we had twice as many people at the fundraiser than they expected. Luckily, the host cooked up some macaroni and cheese, so I was content and didn’t devour anyone. They also had a chitenje (this is a piece of cloth about 2 meters long that villagers often wear) contest, where some of the guys dressed up in chitenjes like a fashion show. Ken won. In all it was a good night and it was good to see my friends.
The next day I traveled back with two education volunteers that are going to COS (close of service) in the fall, and Katie who was in Lilongwe for her birthday. I was exhausted by the time we got back to the transit house and literally crashed.
Week 2 of orientation consisted of 2 days in Accident and Emergency (A&E) as well as 2 days in the Out Patient Department (OPD). This is basically the Emergency Department for Malawi (or maybe just Queen Elizabeth Hospital because I know my hospital is not big enough to have these wards). A&E is for children, but there are also separate clinics held every day. For instance, I sat in on a surgical clinic on Monday afternoon, and the week before I was in a TB clinic. These clinics are a way for patients to be seen by the physicians so they can either schedule a surgery, in the case of the surgical clinic, or get tested for TB or follow-up with their TB treatment. There are other clinics as well. While in A&E I also got to witness how the lab conducted malaria blood tests, which was interesting.
While on that topic I will mention that Queen Elizabeth Hospital (QECH) is very large, which is why I am doing an orientation here rather than at my own hospital (which only has 5 wards, and as of right now doesn’t even have a doctor). They also have a lot of research projects going on. For instance, I believe that John Hopkins University is doing some sort of study on HIV/AIDS. I also ran into doctors conducting studies from various organizations on diseases such as Malaria and Meningitis.
Wednesday I was sick though and missed out on an OPD day… Luckily I only needed 2 OPD days so I was able to get by with missing a day of work. OPD is for adults/older children. Here you get your cases like RTAs (Road Traffic Accidents), and surprisingly they gave a lot of rabies shots for dog bites. All I can say is that it is very different from what I have experienced in America, but there is still a LONG wait to be seen.
That Friday I went to the Blue Elephant, a restaurant in Blantyre that has a good crowd of ex-pats and Malawians. I had an awesome apple cobbler. I went with 2 others, and Justin, who is from South Africa and dating another volunteer named Catherine, had a baked potato that I am going to have to try the next time I go. It was a little pricey though (remember, I am a volunteer).
Week 3 in the wards was my medical rotation. These patients had conditions that didn’t really require surgery, like TB, pneumonia, meningitis, (the TB patients should have been on the isolation ward, but I did still see a few). HIV/AIDs is also an issue in many patients, causing these conditions to be more difficult to treat, as well as other conditions like Kaposi sarcoma…
Last weekend was when I went to Zomba. When I had gotten sick Moni, one of the other nurse Peace Corps Volunteers, came and visited me. She came with her friend Allen. Allen works and lives here in Blantyre, and he invited us, along with Jeanne and a Crisis Corps Volunteer named Bethany, to do a day trip up to the Zomba Plateau. On our way we stopped at a Buddhist Temple just outside of Blantyre, where I met some monks that run an orphanage. They invited me to train in martial arts whenever I am in town! YAY! I just wish my site were not soo far away from Blantyre…
After that we traveled up the Zomba Plateau, and even though it was a little foggy out, it was still stunning. We drove up most of the plateau, but once we reached the top we hiked a little, and Bethany tried to freak me out about snake bites she had sustained in Togo. Yikes. And I saw monkeys, but my pictures are a little blurry so I am not going to post them. Sorry.
This week was my surgical rotation, and has been closer to what I spent time doing my last semester in school so I was a little more comfortable with what was going on…except for when I had to do a rotation on the Burn Unit the last 2 days. Because most Malawians live in the village, without electricity or running water, they usually cook their meals on open fires. Soo, I will let you imagine the type of burns I saw...
There is also a plastic surgeon at QECH who did theatre (surgery) on Fridays. He does things like skin grafts and amputations. In college I never spent time in a Burn Unit (or an oncology unit for that matter), so I learned a lot and was able to sit in on two surgeries. Very interesting, but I will say that the burn unit here I will never forget.
Also, the hospitals here do have a lack of resources, as well as manpower, so they are constantly improvising procedures with whatever materials they may have. So, I won’t get into it now, but if you want to know more email me or call me and I will give you some examples of some improvising that I have witnessed.
Anyway, this weekend was good, probably mostly because I AM DONE HERE IN BLANTYRE. Hehe. Many volunteers were in town so I got to meet new people, and we had a GAD (Gender And Development) meeting and hung out. AND yesterday Cathy came down to visit me (she had been at a wedding in Zomba and visited me on the way home) and Moni gave me a new kitten (which I have named Zuze) to eat my snakes, rats and spider monsters...
Today I will hopefully be heading back to my site in Nsanje! I have another phone now (now I have 2 numbers) so if you want it email me!!

Additional photos below
Photos: 18, Displayed: 18


Crazy time living at the transit houseCrazy time living at the transit house
Crazy time living at the transit house

I met A LOT of people living here for 4 weeks! Becky (right) is actually my site mate, and the only other PCV in my district...hehe.
Blantyre Blantyre

As promised, a picture of Blantyre...um I didn't take many pictures because there are a lot of people on a lot of the roads, and many of them will ask for money from me if I take a picture with them in it... :( sorry.

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