I will return to Lilongwe, Malawi Africa for 4 weeks in September 2025 to work clinically in the Department of Paediatrics at Kamuzu Central Hospital (KCH). This trip is a rotation that is part of my Combined Pediatric Emergency Medicine – Global Health (PEM-GH) fellowship training. This is my fourth trip to Malawi in the last 2 years, I have been extremely lucky to form a longitudinal relationship with the local physicians and medical staff. In Malawi, where I am a fully licensed pediatrician, I will help guide clinical, educational and research efforts related to caring for acutely ill children within the Kamuzu Central Hospital (KCH) Department of Paediatrics.
Specifically, I will participate in the coverage schedule as a consultant physician. I will lead rounds and help provide oversight and teaching to local trainees. I will supervise 4 MMED candidates (i.e. pediatric residents) and up to 10-12 interns who are rotating through the department.
I will also participate in didactic teaching of medical students and interns in the field of pediatrics and pediatric emergency medicine. I will work with the multidisciplinary quality improvement team at the hospital to help implement QI projects in the wards including projects related to emergency resuscitation and implementation of a pediatric early warning system based on vital signs.
Malawi has just over 40 pediatricians serving a population of over 20 million. There is no well child or routine pediatrician visit structure in Malawi, which means patients often present with disease later in their illness course and with severe disease. I will provide direct clinical coverage 5 days a week for 4 weeks for a pediatric department that evaluates 100,000 patients per year and only has about 1-3 fully-trained pediatricians available. The Department of Paediatrics at KCH is the largest in the hospital with a census of 300-400 patients who face high morbidity and mortality rates. As the central referral hospital for the country, we care for common conditions such as malaria, pneumonia, gastroenteritis, malnutrition as well as complex congenital and rheumatic heart disease, tuberculosis, new oncologic diagnoses, HIV, and many more. Malawian children will be benefit from this project by receiving pediatric care that may not otherwise be able to receive. About 50% of the population of Malawi is under the age of 18 years, so improving the care of children is essential in improving the healthcare of the country.
I expect to oversee the care of hundreds of hospitalized Malawian children throughout my trip. In addition to direct patient care, I expect to have a positive impact on my colleagues in Malawi. I will help alleviate clinical duties for local pediatrician consultants. I will also encourage local trainee growth and development as future physicians who will eventually join the workforce in country by providing oversight and teaching. I expect to grow as a clinician and improve my fund of knowledge of the care and management of tropical diseases. I will have the benefit of working with colleagues who are different from me culturally and went through a different medical training structure. As I continue to spend time in Malawi longitudinally throughout my fellowship, I am gaining skills in how to build capacity and do sustainable global health work as a United States physician. After I return, I hope to use what I've learned to continue to support my Malawian colleagues remotely through education and research support.
I had a successful clinical rotation in Lilongwe, Malawi where I worked at one of the tertiary referral hospitals as a pediatric consultant, caring for a daily census of 200-300 admitted patients under 12yo.
I was able to help the team on the ground evaluate and stabilize critically ill children upon presentation or transfer. I also led rounds in the acute care setting.
I led a hands on, low fidelity simulation session for intern medical officers rotating in the pediatric wards focusing on PALS principles and resuscitation. I provided direct mentorship for interns and editing of educational presentations. I also provided mentorship for pediatric trainees from the United States who were rotating in the hospital in Lilongwe.
I am extremely grateful for the opportunity to come work clinically at KCH as well as continue to build capacity via teaching and mentorship.
