On the first glance it is easy to think that the USA has a better health care system (and overall we do). However, some of the same problems that are faced by Malawians where you can pay to go to a better hospital or go to the free hospital but receive worst care are analogous to what the uninsured face in America.
So, back to my experience in Ludzi, in the morning I would do the rounds with Mr. Mshanga of the in-patients and then in the afternoon I would spend with Mr. Stima with the out-patients.
On my first round, I put on my white coat grabbed my stethoscope and blood pressure cuff and was ready to learn, not really knowing what to expect. It turns out that out of roughly 30-40 in patients about half were mothers who brought in their baby infants and toddlers. Of these infants and toddlers most were in for malaria treatment with the rest in for diarrhea or pneumonia. It is too bad because when questioning the mothers whether or not they sleep under mosquito net to protect their children all of them said “No, it costs too much.” Meanwhile the money they have spent for treatment is about the same amount it is to buy a mosquito net….But even at the clinic; they don’t have their in-patients sleep under mosquito nets. Frustrating, to know that there are simple things that one could do to improve their health but don’t……I always have to remind myself that the Malawian patients are no different than Americans. For example, Obesity is an alarming and growing health problem in America – Americans know that they shouldn’t eat McDonald’s everyday or should avoid eating fried foods, but they choose to continue to eating those same foods.
After going the pediatric rounds, we then continued to the female wards. Their health problems ranged from late term miscarriages, malaria, to treating abscesses. One lady in particular stood out, she was on anti-retro viral treatment and two abscesses, one in her groin area and one on her butt. Abscesses are areas of infections that can be caused by an ingrown hair or even just a small cut. But since this lady was on HIV/AIDS treatment her immune system was down and, as evident by her abscesses, has a hard time fighting off infections. As a result, the abscesses grow and form these deep holes – in this patient one abscess formed a hole that was three inches deep and three inches in diameter. It was very painful, she could hardly walk or sit and had to lie down on her side. The only that we could do was to treat her for pain and keep the wound clean, but with her HIV/AIDS treatment her bodies immunity is questionable.
Finally in the afternoon we saw some out-patients and I had the opportunity to spend time with the lab tech. They brought in a baby suspected of having malaria; she had all of the signs of cerebral malaria with fevers and even convulsions (epileptic like seizures). The lab tech pricks the baby’s finger, draws a small blood sample onto a slide, and then I was able to see through a microscope all of the malaria parasites. It was pretty cool! Well, I mean that it was cool to see the malaria parasite under a microscope, not necessarily because the patient had malaria.
By then it was nearing 4pm and the end of the work day for Malawians. They are on a much different work day than we are – 8am start work, 10 am tea, noon is lunch, and 4pm we are done. What a work day…..
