|
John L Raybould |
During March and April of 1999 I was a Rotary Volunteer in Northern
Malawi. I was there with my wife Elspeth, assisting with surgical work in five
district government and mission hospitals. A £250 donation from my Club went with me and
was used to mend equipment in Nkhata Bay Hospital, where I was based. The operating
theatre lights, autoclaves, sterilizers and suction machines had not worked properly for
many months. The staff at the hospitals were very welcoming and managed to keep cheerful
in spite of poor conditions and shortages. The health scene, as in many African countries,
continues to worsen. There is less money available and the number of patients is
increasing. The AIDS epidemic continues, (about 75% of in-patients have AIDS related
complexes), and remains among the top causes of death in infants. Another is malnutrition,
which will worsen as the population increase continues and international free food
programmes are withdrawn.
This was my third visit and I saw, and operated on, patients, teaching local doctors and
clinical officers. There is one doctor in Malawi per 50,000 people, in Britain it is one
per 800. Most of the medical work is is done by locally trained clinical officers and they
do most of the routine surgery. The region has a population of 2 million but no
specialists. Malawi has a total of 8 surgeons based in three central hospitals. The
nearest is 500 miles away from some northern districts. Patients with chronic conditions
may wait for years and try witch doctors remedies before coming to hospital. They may be
told that nothing can be done due to lack of skills or anaesthetics. Patients are often
anaemic and it is difficult to obtain AIDS-free blood. In the two months I saw many
patients and carried out 22 major and 44 minor operations - I would work with a clinical
officer, taking him through an operation and so increase his repertoire.
Among four patients with gangrenous bowel who came in as emergencies, one was a 52 year
old subsistence farmer - His local healer had given herbs and made medical tattoo marks on
his navel. After two days he was no better and he went to his local hospital. They were
reluctant to operate and sent the patient on a 5 hour journey over very rough roads to
Nkhata Bay. He arrived shocked but even attempted to help himself onto the operating table
- the toughness of these people never ceases to amaze me. Over 80% of his small bowel was
twisted and gangrenous, this was removed and the normal ends rejoined. His general
condition was very poor and it is a tribute to the anaesthetist that he survived, although
he died next day. Other major operations had happier outcomes.
We were there during an exceptionally wet rainy season, living in a caravan beside the
lake. The lake level rose by three feet during our stay, and several times I had to wade
across the flooded wooden bridge over the local river on my way to the hospital. Living
can be pleasantly simple, though warm! The plant and animal life of the area is
fascinating, the lake and mountains beautiful and changing in the light.
There are three Rotary Clubs in Malawi. The day before leaving I attended a Lilongwe
Rotary Club Lunch. My wife is hoping to start a public library in Nkhata Bay and to
continue her family planning journalism in the local newspapers.
This document was originally prepared by Rodney Howell, Editor 1080 News on 11 January 1999
Electronic 1080 News is edited and maintained by John L Raybould.
Last updated: 29 May 2000
To send comments and suggestions:
