So I've been here for just over three months now, most days Ive really enjoyed it and other days I've just wanted to run away and wondered what I'm doing here- overall its been pretty tough going but I've loved it!
Malawian women are some of the nicest i've met (the patients not always the staff), their smiles will light up the room and their gratitude is plain to see and the level of poverty is unmistakable and being able to offer help however small in this settling is so rewarding.
Its difficult to work under these conditions, the level of staffing is so low and resources scarce. It would be better if the same things was missing then you could work around it and just do without but its the constant change that makes it difficult, no antibiotics today plenty tomorrow, lots of blood today none next week, cant operate today because -( insert any of the following) no gauze, no sutures, no gowns, lights are broken, tables broken.......On the wards its bp machines broken, no thermometers, no urine bags ( its amazing how many ways u can use a glove), no pregnancy tests, no urine dipsticks, no gloves! I thought it was just inefficiency at first- and wondered why they didn't just order things before they ran out- but after digging its a far bigger problem- the central medical stores that supply the hospitals have also run out! Partly because of corruption theres talk of some of it being sold off to private clinics and partly poverty the government just cant afford any!
Then there's the staff- when i first got here i thought they were all lazy and unmotivated, i was frustrated because when ever i asked for observations to be done or medicines to be given or babies to be monitored on labour ward it doesn't happen. They would complain that they were tired and it would be 10 am, and by lunch time they are napping at the desk! But these nurses often have to get two jobs to make ends meet and still find it difficult, some have to get two mini buses to get to the hospital and when you consider that the government hasn't paid them ( again no money) for the last two months i wouldn't want to do any work either, and yet they still turn up! I still think more can be done with the little that available if every one was just more motivated and pulled their weight but i'm not sure how without better working conditions this will change.
Although i've not worked in O&G for that many years, in the UK I had never seen a mother die, i have only seen 1 baby born dead and its heart breaking how many die here unnecessarily! It really is hard to stomach or even get your head around- you come in to hospital not because you are sick but just to have a baby- something normal and natural but then u never leave- it just shouldn't happen.
Now here comes the sales pitch to all my medical friends:
What they need here among other things is doctors and although a system cant survive purely on volunteers in the interim while they train their own doctors and specialists it works!
As well as being hugely rewarding and teaching you about global maternal health, u will leave really appreciating the NHS, the hours and be motivated on your return. Its a great learning opportunity, i've delivered vaginal breech's, twins, delivered two sets of triplets in two months, done numerous c-section-most pretty difficult. You learn to rely on your clinical skills and examinations because you cant order a CT, MRI or even simple blood tests like LFT's ( well u can when they have reagents but you will get the results in a week so whats the point) If gyne is your thing the operating opportunities are also vast. So if you want to annoy the deanery by asking for an oope and come out you wont regret it- get in touch and i can give you more information!
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