Pictures

Baby post c-section being held by female relative of the mother. (Photo taken with permission).
Why you have to change into rubber rain boots before doing a c-section (frequently a bloody/messy procedure).
Before assisting with a c-section.
Catholicism and Medicine have never been combined so well as the crucified Jesus above an eye chart and patient intake table.

Picture from around Mua

This is a picture that I took about a week ago while on a walk around sunset.

Antenatal Clinic prescriptions

I have been struggling with uploading pictures to my blog (it takes a bit of time), but today I spent some time in the antenatal clinic at Mua Hospital. We saw so many pregnant women. Here are the prescriptions given out:
1) Iron+Folic acid (the little red pills). Women take 1 a day for the duration of the pregnancy to prevent anemia (a terrible problem with the amount of Malaria that is around) and promote proper development of the fetus.
2) Albendazole (one dose). Given to eliminate worms.
3) SP (3 pills taken twice during the pregnancy). This is part of the intermittent treatment of Malaria in Malawi. Attempting to reduce Malaria in pregnant women (who are very susceptible).

You can see a woman getting her blood pressure taken in the background. (They also get weighed).

At a different station the women can get 1 free mosquito net (paid for by UNICEF?) and immunizations. A different room provides confidential HIV testing and counseling (done twice during a pregnancy). A final exam room is where the abdomen is palpated and a fetoscope is used to listen to the fetal heart rate.

Arresting Jesus with an AK-47

Yesterday I was privileged to go to a church services in the village in which they celebrated Good Friday by reenacting the Passion (the story of the how Jesus was betrayed, arrested, sentenced, abused and crucified). It was a very touching performance that was both very meditative and beautiful. It lasted for about 2 hours with the performance (in Chichewa, the local language) interrupted periodically with singing from the choir. There were some interesting cultural references and interpretations. One of them was when Jesus was arrested in the garden, the soldiers weren’t carrying spears or swords (perhaps weapons that Americans might view as more historically accurate for the time period), but the soldiers were carrying wooden cutouts of Ak-47 guns. I thought that this was hilarious and also an interesting cultural interpretation of what “a solider” described in the Bible is to them.

Another, perhaps more distressing, cultural difference in the portrayal of the Passion that I witnessed last night, was in the treatment of the actor playing Jesus. The other actors literally beat him up. While in the United States if there was play in which one actor is supposed to hit another, there might be some encouragement/understanding among the director and performers that you will just PRETEND to hit the actor. Not so in this performance. They had branches and were hitting the Jesus actor full-force. They also pushed him to the ground a number of times. I asked the priest about this later. He said that there is informed consent for the actor who plays Jesus – he knows ahead of time that he will be beaten up. In fact, the same actor has played Jesus a number of years in a row, so he knows what he is in for. Sigh. The cost of fame.

The crucifixion. Yes, they actually did tie the Jesus actor to the cross.



Judas betraying Jesus to the priests guarded by the AK-17 wielding soldier.

A nice kind of offering

Since I am staying with the priests while I am working at MUA Hospital, I have enjoyed getting the opportunities to go to several masses in the rural community. It is a really beautiful experience. Since the services are in Chichewa, it can be difficult to follow what is going on at times.

Since most of Malawi is rural (something like 85% of the population lives in rural areas), a lot of the population engages in subsistence agriculture (meaning that they grow food for themselves and their families). With this knowledge it makes sense that many people don't have any money to give during the offering at church. So what they do in many churches in the area is bring an offering of some type of food. This usually takes the form of maize (the primary staple food) or groundnuts (peanuts). However, many other things can be brought such as tomatoes, bananas, other fruit. The priest blesses the offering that each person brings and then passes them to the alter boys to be put on the alter.


Children outside of a village church.



A picture of the offering. It was sort-of dark so the picture didn't turn out that well, but you get the idea of how beautiful the offering is.

Sorry about the long gap in posting

Hi to all (2-5) of my blog-readers out there. I am sorry that it has been so long since I have posted anything. I am back in Africa for the 4th time and want to start blogging again. However, I thought that perhaps I should give you all a brief update since I last posted. My international rotation in Malawi is going to be my last rotation in medical school. During the end of third year and the beginning of 4th year, I wrestled with my top 3 specialty choices: Family medicine, OB/GYN and peds. I decided to apply to family medicine. After a long journey that involved 10 residency interviews and a impressive increase to my Alaska Airlines frequent flier miles, I concluded the residency application process and just had to await where the "Match." Would place me for residency. The match is a computer program that matches residency applicants and residency programs together based on rank lists that they have all created. The "Match Day" is when all the graduating medical students find out where they have matched for residency. This year it was on March 17th. I was very nervous, but I was thrilled to discover that I matched at the University of Washington for my family medicine residency. I think it will be a perfect fit for my interests and am really looking forward to meeting my fellow incoming residents.

After the match I just had to finish up my chronic care rotation (which I did through hospice), pack up and then I was off to Malawi. My original flight had be flying from Seattle to Paris, then from Paris to Ethiopia and then from Ethiopia to Lilongwe, Malawi. However, a last minute cancellation meant that I had to add to fly from Seattle --> Amsterdam --> Paris --> Ethiopia --> Malawi. It was a VERY long journey, but I finally made it! I am still a little jet lagged, but am looking forward to sharing my experiences with all of you.

More soon...