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Me and the not  electronic, hard copy X-rays we look at on light boards. Feel like such legit doctors as we do this:) ( but I still have such a hard time telling normal lung from abnormal – but often the findings here are dramatic which makes it easier! )

Me and a baby with spina bifida and his so friendly mom. He came in for pneumonia and we diagnosed the spina bifida and now we are sending them to the central city hospital where they have a special program that can repair the spina bifida. Dr Nagy the pediatrician says, ” he might not be the star basketball player, but we can at least try to help! ”

My favorite patient this week was a 9 year old girl named dorofina. I picked her file off the stack because I thought it would be be straightforward one that I could do. While I was talking to her, her hemoglobin lab results came back. ( for the non medical people a normal Hb is around 12-15, a value of 7 gets people.blood transfusion in the U.S. Here a value of 6 gets people a transfusion. ) Hers was 1.6. Most people here have low blood counts because of malaria but she had no fevers, negative malaria test. We gave her blood and looked in to her old file from December and found she also had low white blood cells and platlets signaling something serious. We are sending her to the one hematologist in the city on Monday. The 2-3 woman who are her family with her are so nice and smile so big when I visit them each day. She has sparkly purple plastic shoes and I learned how to tell her they are beautiful! Chocongola!

This weekend we climbed mount Nkhoma. We did not ‘walk’ it. We ‘hiked’ parts of it but we ‘climbed’ most of it. The path was an incline and through grassy like plants and many stones that were good for gripping shoes. I used my hands about half the time. Most of the time, our guide was a dog. Seriously, one of the staff has a dog who just sees white people heading up the path and joins… And shows us the way! We are going with a group of 3 Dutch nursing students and a family medicine resident from California. Our plan was to hike to a cottage halfway up the mountain, eat dinner and then in the morning hike the hardest part to the top and then return home! We were all totally out of breath on the hike to the hike – which was reportedly the easy part, but still up hill and rocky. Instead of repeating my my brain “o y gosh this is so hard” I played pretend Louis & Clark biologist expedition, admiring and noting the difference plants along the path like I was discovering new species for the first time. Apparently they do not have anything like poison ivy here which was good because we walked through lots of brush along the path.

On our way, we walked along the middle of this hill with no one else around. Then we encounter a see a herd of cows with guy herding them. So many random bright vibrant flowers – more beautiful the some gardens, makes me think of how God clothes the flowers of the field and will certainly take car of our needs. We’d Stop every so often to admire scenery (aka catch our breath.) Everywhere mountain, field valley, and we could see so far. Arrived to cottage ( owned by hospital). Local Man who met us there to give us the keys… His shirt was about 10% holes. Louise gave him one of hers before we left the next day. Inside The hut were plates, charcoal, pots. I got to gather firewood which was my kind of activity. We had brought Preloaded rice, which we combined with tomatoes onion garlic and tomato sauce over the fire. The way we all worked together in different roles to make the meal was such a neat feeling of community and accomplishment. The worst thing that happened on our whole adventure was I forgot the peppers to add to our dinner. However, I was proud I suggested pre cook rice over cooking it there, though others actually cooked it. Even shared some food with dog. Roasted some Marshmallows which were Pink and white for Valentine’s Day?

Bed…930 . Plan Was going to wake to see sunrise at 5:30. I woke up and my watch said 830! My lucky day! They woke up and there were clouds at sunrise so they just went back to bed and I got to sleep. The best thing about the hut was we Left most stuff there for the hike hike. So nice. We let they guy who lived in the hut nearby know that we were heading up and he just offered to lead the way. He was barefoot and wearing a fleece turtle neck ( while we were sweating profusely) and walked up the mountain like he was strolling on flat ground as we all used all limbs. I enjoyed pretending I was hiking the Appalation Trail ( I just read a book about this – Christina I understand how Katz felt that motivate to chuck his pack over the hill… Hahah) I also decided I will never actually hike it 🙂 as we walked I thought “This is one of the most epic things I’ve done.” In hind sight it seems like just a normal hike, but in the moment was epic. Each step like a puzzle to find. The best place to step. I was amazed how my brain did it.

The top was nice and we admired the view. On the way back we did not have the dogs to lead us and we got mildly lost and wandered through some corn fields. Navigating by landmarks. Then Jacob whips out his phone and pulls up goggle maps… I guess we can’t get too lists… Walked through a village and saw women carrying huge flour sacks or big bundles of firewood on their heads and a 6 year old following behind carrying the baby!

Today I saw some very cute babies and wished you could be here to see them because I know many of you would love to ooo and ahh over them. I learned how to say cute baby: awana okongola.. The mothers love to laugh at my attempts to speak the language, but I am trying and learn about 3 new phrases a day.

Every Wednesday morning here we have a chapel service. Quite an experience 🙂 They sing hymns in Chichewa and English. While singing the pastor man is basically hopping from foot to foot around the front of the chapel to the beat:) then the best song was ” let us dance and praise the Lord”, repeated over and over. Each verse had a different Action in place of the word dance which we of course acted out: laugh, handshake, and finally “fly” where we moved our arms like airplane wings. Then a man named Chiconde got up with a box like a clarinet case he opened it, pulled out a tube connected to it and started blowing into it and pressing keys – it turned out to be an instrument ( like cross between an accordion and small piano) and he played and sang some songs on this. I knew about Chiconde even before chapel because the others at the guest house talk about him as the Ray Charles / Stevie wonder of Malawi because he is mostly blind. We walk around the guesthouse singing Chiconde songs.

Yesterday I had a surprise tour of a factory! There is a program here called PB & J for peanut butter and Jesus. They distribute enriched peanut butter/ nutrient packets to malnourished children around the area. I heard others had gone with them to deliver some packets so I wanted to ask if I could go once. I was told I can go later, but first I should “see what they do here”. I was not sure what that meant, but it turned out they are a factory and not only give out but MAKE the peanut butter/nutrient mix right here next to the hospital. It is on the hospital property but is a separate Malawi owned business with 10 employees. They use all Malawi ingredients and start from peanuts which they roast themselves. The locals call the mixture Chiponde. There is another company that makes Chiponde in Malawi, but this company is different because they have some donors so they are able to give some of there product for free to Heath clinics that can’t afford it. I met the owner and loved seeing the small factory – complete with an awesome machine that package the PB in little packets! Also it was awesome to see the Malawi owned business and the high standard they held – we had to wear shoe covers, hats, coats and gloves just to walk thru.

A few pictures! 🙂

Sorry…  I messed up where I posted this so here is the link to it!

Visit to Liwonde National Park

Hello all!

Less internet than expected but I’ve written a few stories to remember for myself and share. I’m not the greatest story teller and certainly include too many details at times but free to skim through anything that interests you! Miss and love you all. Your prayers have been powerful and effective.

Feb 9,2015. 8pm

After traveling from Friday morning to Monday night, we arrived safely in Malawi! The plane flight was fantastic – our international place seemed humongous and so roomy compared to the small plane we took from Columbus to New York. Also, they gave us little pillows, blankets, socks and face mask so we felt quite luxurious 🙂 it is the little things 🙂 I watched the movie ‘The Martian’ which really good – he is being resourceful surviving on Mars and I felt like I was being resourceful surviving on the plane. I kept my eyes closed for about 8h but never really feel asleep totally but felt pretty good anyway. We were met at the airport by Sam, a clinical officer from the hospital who we had been in contact with. He Was super nice and drove us to the grocery store and then to the hospital. Driving was much more American style than Dominican Republic. Sam told us the police here make you pay the fine right when they stop you, so people drive safe. We were met at the guest house by heather Colby – the lady who runs the guest house and later we found out she is also the principal of the nice school here. She is originally from South Africa. Overall, the guest house far exceeds my expectations, bathrooms area very nice, we have our own room for us 3 girls to share, kitchen even has a microwave. Heather’s tour occasionally had details like ‘the water is only on 5am to 10am and 5pm to 10pm’ after which she would add “welcome to Africa”. Things like that have not been that hard to live with though so far.
Right after we got settled we joined the other students plus heather for dinner. Felt like we actually arrived to Europe as all the other students staying at the guest house are from from Netherlands, northern isle of Ireland, Scotland, England. Everyone has accents and it is wonderful. Found out that we can join In these group dinners at the house for 600 kwatcha per night … A dollar is 700 so this is my kind of price! Had rice, chicken and a stew like sauce.

– they really do carry huge containers balanced on just their heads
– women really carry their kids tied on their back with a piece of fabric.
– they save everything. I love it. Toilet paper rolls get saved, not sure for what. All food is compost. “Rotten” food goes on the window sill for the house keeper to decide if it is really rotten of if a piece could be cut out and given to someone nearby who is hungry.
– one girl telling me travel distance in Europe “by boot it is 4 hours”. Me “by boot, do you mean walking?” “No boot, like the thing that floats in water”

Tuesday feb 8
We just finished our first day at Nkhoma hospital! I spent the day in the pediatrics ward. We started with a meeting with the ~10 pediatrics staff- nurses, clinical officers and one doctor. The doctor read from psalm 41 and encouraged the staff to keep working hard even as they have high numbers of patients these recent weeks due to lots of malaria. Then they sang 2 hymns not in English which was some of the most beautiful singing I’ve heard – they sang in harmony like a well practiced choIr even as we just sat in a circle casually singing. Then I joined one of the clinical officers (kind of like nurse practitioners) seeing the less sick pediatric patients. Unlike the U.S. Where we walk around and see the patients in separate rooms, here we sat in the courtyard and the mothers all lined up with their child and brought them to us. Most of the children had malaria and a few had malnutrition- it was very systematic – all with malaria got 3 doses of iv malaria meds, then switch to po meds and sent home. if they had anemia of hemoglobin below 6, they got transfused with blood and rechecked six days later. Then I joined the doctor to see some of the sicker kids. She is a missionary from the USA and seems to have been here a very long time. Saw a child who had recently woken up in a coma from cerebral malaria. From noon to 2 we stopped for lunch. When we went back out from lunch there was a new 5 year old child that just arrived and a Malawi medical student, a Dutch medical student Matye ( said ma-ta) and I assessed him. He has a swollen very warm left knee. We thought it was septic arthritis (infected joint) and called the surgeons to come see him. It was a neat experience because I felt like Matye and I really figured out what was wrong on our own – except for the translating. At the end of our day Matye and I joined the pediatric medical officer Sam caring for a 1 year old with malaria who was seizing. She had nystagmus ( eye twitch) left hand and left foot clenching. They started meds for malaria, gave Tylenol(called paracetamol here! ) and lorazepam to try to stop the seizures. They also wrote down that he should get phenytoin but then just left that instruction written in chart. It was then time for the medical officers to go home so they did. We learned that seizures should try to be stopped asap…. And she had already been seizing for 30 plus minutes. Matye and I got the nurse to give then med, then reviewed every reason we thought she could be continuing to seize. .. ( update a few days later.. She eventually sopped seizing and has gotten well enough to leave the icu area)

Feb 10,
– they write the day 10/2/2016 here so I have to try to adjust to it!
– in the hospital record they write 2/7 for 2days and 3/52 for three weeks! I like it.
– it was Matye’s (Dutch medical student) goddaughters’ birthday today and she speaks Spanish… So 3 Dutch, 4 american and 1 Irish student sang ‘cumplianos Feliz’ for her over the phone! Quite international
– nursing students from North Dakota taught us how to calculate the infusion rate of IVs by counting the drops per minute since they don’t have infusion pumps here
– main patient of the day was 4 yo with high fever, respiratory distress and impressive hepatomegally ( big liver). I have had patients in USA with hepatomegally but never really could tell it just kinda pretended I could feel it. His I could totally tell it was like 4 finger breaths his ribs. He was negative for malaria … Plus I learned that usually also has splenomegally. Right now checking liver function tests… But the machine to test them broke so we’ll see tomorrow.
– was today only my 2nd day in clinic? Wow I feel so much more comfortable and less overwhelmed than yesterday 🙂