The UNC Project-Malawi is a collaboration between the University of North Carolina (UNC) and the Malawi Ministry of Health. It provides free medical care to more than 1,700 patients every week at Kamuzu Central Hospital (KCH), Bwaila District Hospital, Lighthouse HIV Clinic, and antenatal and gynecological clinics; as a pediatrician in training, I will spend a month there providing care to children on the pediatric wards and in the emergency department, treating conditions ranging from dehydration and malnutrition to malaria and HIV.
The UNC Project-Malawi promotes exchange between residents from the US and physicians in Malawi, in hope to improve practices, standardize therapies, and ultimately reduce mortality. In addition to treating children in the hospital, I hope to make a difference by contributing to this collaboration to help improve care for the children KCH serves.
Among the least developed and most impoverished countries, Malawi has a population of 18 million, more than half of whom live below the international poverty line. Its healthcare system ranks 185 out of 191 countries, according to a World Health Organization report, and most Malawians have limited access to healthcare. HIV, malaria, diarrheal dehydration, malnutrition, and sepsis account for a significant number of admissions to the hospital. As a tertiary referral center located in Lilongwe, the capital of Malawi, KCH admits up to 100 children every day. Recent collaborative efforts between Malawian partners and US-based institutions, including UNC, have reduced the pediatric mortality rate at KCH from >10 to <4% since 2011. To achieve further progress and improve survival rates of pediatric patients at KCH, more standardized medical care for the most common medical conditions afflicting the Malawian children is necessary. This is possible through UNC Project-Malawi's research, training and patient care.
The mission of UNC Project-Malawi is to identify innovative, culturally acceptable, and affordable methods to improve the health of the people of Malawi, through research, capacity building, and care. It does so by collaborating between UNC and KCH, allowing physicians to work together and learn from each other, through our differences. The expected impact is better patient care and lower mortality rate, by improving and standardizing medical practices.
In addition to providing care and improving practices at KCH, I hope that traveling to, and practicing medicine in another country will allow me to treat conditions and diseases not commonly seen in the US; it will also help me learn to treat people with backgrounds and beliefs different from mine with respect and cultural awareness. I hope this will be the first global health trip of many, and I can continue to contribute to healthcare in Malawi and around the world in the future.
I worked in the pediatric wards of Kamuzu Central Hospital in Lilongwe, the capital of Malawi. We treated children for a wide variety of illnesses, including infections, gastroenteritis, malnutrition, and trauma. Many diseases, such as malaria and TB, are uncommon in the US.
It was quite overwhelming when I first got there. Even though medicine is supposed to be universal, how it is practiced is quite different. Very soon, however, the local trainees would come to me for advice, and it ended up being a collaboration between me and them to figure out the diagnoses and come up with management plans with what was available.
It was hard to see so many sick children, and it was incredibly rewarding to see them get better. I learned so much from the local physicians and trainees and enjoyed working with them tremendously. I had to rely more on clinical skills and critical thinking and less on tests and imaging, and improvise with what we had.
When I was not working in the hospital, I got to travel to Lake Malawi, Liwonde National Park, and one Saturday, I went to an orphanage with the community health workers. The children there did not speak a word of English but loved playing with and getting chased by a foreigner. We helped clean their school, had fun doing it, and watched the hospital team played against their local team in football after.
The mouth went by quickly, and it was an incredible experience. The people there were so kind and appreciative of us. The children were amazing and resilient. I hope I will get to go back one day.
