Getting started and getting to know people!

Well, it has been 6 days since landing in Malawi, but the first few days were simply spent in transit to Blantyre, and then exploring the area on the weekend.

on mt muchiru!

Myself, Kelly, and two optometry students/grads walked the city and found some nice spots for ice cream, fanta, groceries, etc on Saturday, and then undertok a big 3+hr hike on Sunday in a nearby conservation area, Mt Muchiru. Led by our fearless guide Edward, who was definitely a great source of knowledge about the park and Malawi in general, we took the "challenging" (VERY steep) climb up most of the moutnain, notquite making the summit. Animals were scarce, but we did see a woodpecker!, Baboon, antelope (just 1, but still beautiful), and Gemet (big, rabbit-like). it was hot (30 i'd say) and sunny, like every day here so far. It cools down a lot ihn the evening which is nice, so no need for a/c or even a fan for sleeping. Take a look at the pictures from thsi weekend.

sunset at the guesthouse

Accommodationa nd food, i should mention, is really great - full bdroom with hot shower, and breakfast included as well as dinner if we request. No problems there! Plus, there is a great restaurant at the hospital for big lunches if needed.

As for work, we started monday AM in the dept of medicine, and it was a very good start! Although we went through the usual "where do we go, who do we follow, where is that??? orientation, once we latched onto another visiting resident from the UK who's been here a while we were shown waht's what. So much of the work is networking and meeting people in the hospital - not unlike rotations at home - e.g. "where are the supplies, where do you bring the blood tests , who can you talk to to get an urgent xray/ct/, etc." It turns out that there is a very impressive amount of teaching and learning going on here as well, with regular sessions for the many Malawi med students and registrars once or twice daily that we go to. And there are a number of visiting and local consultants who expertly oversee the wards and most clinics.

We've been covering a section of inpatient wards with a visiting consultant from Ireland, who has really helped us feel useful as well! Rounding, doing bloodwork, arranging tests, etc. And we also go to the odd clinic - today there was a general medical clinic that saw 63 patients in the "morning" alone (9am to 3pm!). So, getting to see patients and assess just like home is nice, meanwhile having the support of a knowledgeable consultant in the next room and usually a local medical student in the room with me to help as well (with some translation, but just as much clinically, since they know so much of the local trends here). Definitely a more dramatic amount of disease here, and cough + fever = Tb so far, and 80% of inpatients have HIV, so obviously there is a big difference from home. However, compared to previous experiences (Ghana, Thailand) I find it very comforting that there are actually a good number of resources available at this big hospital - personnel, individual specialist clinics to refer to (such as HIV, Tb programs), and investigations usually available like basic bloodwork, imaging incl any Xray, US, sometimes CT and occasionally MRI!!, and a good selection of medications available. That being said, there are many issues that are difficult - the impossibiility of sme patients to make it into the city for followup, poor social situations especially for women, malnutrition and poverty's many other problems...

In any case, it is a good start! I think I will continue to so a mix of wards and clinics to feel as useful as possible, and continue to soak up whatever i can in terms of learning, which is the biggest thing right now!

no photos of the hospital yet (there probly wont be many) but here are some others from the first few days...

downtown blantyre

the malawi medical college guesthouse

one of the surround peaks around blantyre

delicious dinner