Saturday, February 26, 2012
Sitting thirty four thousand feet above the horizon makes for a nice sunset. Peeking outside my little window on the South African Airlines plane, I was surprised to notice the moon, accompanied tonight by a planet (Venus? Endor?), tucked into the corner of the view. I'm sitting next to a middle-aged Zimbabwean man with massive hands who is listening to headphones and quietly singing along in a rumbly baritone as he reads a textbook on finance. Somehow, after napping, eating a hot lunch, and napping again, we're still only about 5 hours into this 14+ hour direct flight from New York to Johannesburg. But I'm not really complaining. I've got plenty of leg room, lots to read, and mostly I'm excited to catch up on sleep. In Joburg, if all goes well, I'll meet up with Amy Gail Williams and Chris Buck, two pediatricians in the relatively small group of people on this planet that have been to the remote mountain region of Mokhotlong, in Lesotho where I spent some time in 2007/2008. We were all part of the Pediatric AIDS Corps, a program started in Houston to reach the many thousands of children living with HIV in Africa. Chris was stationed in Malawi for an amazing three years, and Amy spent a year in the Kingdom of Lesotho, working between the capital of Maseru and the mountainous moonscape of Mokhotlong. She will be joining me as we evaluate how a little NGO, World Altering Medicine (or WAM as it's affectionately called), started by two friends of mine in residency, is doing in helping the impoverished Malawian rural town of Kabudula.
Located a mere 1-2 hours by car from the capital city of Lilongwe (depending on what the rain has done to the unpaved road), Kabudula Rural Hospital has about 100 beds, serves a catchment area of 350,000 people, sees more than 200 outpatients most days, and has no doctors. Aubrey Nsunza, a midlevel practitioner (termed Clinical Officer in Malawi) and lead clinician at the hospital is, needless to say, busy. He sees the sickest patients, treating and operating on those he can and referring many others to the central hospital in the capital. For a few years now, WAM has been involved with the Ministry of Health in efforts to support Kab. Though still in its infancy, our projects up to now have been varied and are going pretty well. We have been helping to purchase medications when they run out. There have been months when there is no treatment for malaria (the biggest killer of children in the area, and a complete course of medication costs less than 2 dollars) or no medication to stop a child from seizing. We have brought oxygen concentrators to the hospital (oxygen via tanks is too expensive for most places in Malawi, so they use portable devices that concentrate oxygen out of room air. These amazing devices are typically used in the home by people with emphysema in affluent counties like the US). We helped bring limited Internet connectivity to Aubrey, and we pushed for Aubrey to get another Clinical Officer to share the huge burden of work (Ms. Fyness Sibande). Construction on a duplex house for clinicians that WAM funded is finishing (even though the hospital has half or fewer of the expected staff for its size, there is not enough housing to support more). We are working with the US Peace Corps to bring a health volunteer for the first time to Kab. Currently there is a shipment worth hundreds of thousands of dollars of used medical equipment en route to Kab, including basic necessary items such as beds, all the way up to an EKG and ultrasound machines. Through efforts by WAM star Sarah Greenberg, we've started working with the local primary and secondary schools, who have a teacher student ratio of about 1 to 100. We're helping with books and school supplies, scholarships for orphans, youth support groups, field days, and have hopes to build the school's (and community's) first library. Amazingly, this has all been feasible through private donations from friends and family (learn more at www.worldalteringmedicine.org), though we are looking for grants as well.
After three weeks in Malawi, I'll head out to South Sudan for a few months where I'll join the team that is teaching South Sudanese medical students clinical medicine. Afterwards, I hope to meet up with Anu Agrawal, long time friend and now pediatric hematologist-oncologist working in Botswana, for some serious R&R on the Okavango Delta.
It's morning now as we finish the long transatlantic flight into South Africa. The sun brings hope, warmth, and a closer look at the duct tape apparently holding the wing together.