The End.

My trip to Malawi was a life changing experience, as it was my first time traveling outside of the U.S. and only second time flying on an airplane. I was initially nervous about traveling, but eager to challenge myself physically and emotionally by opening my mind and embracing a new culture. 

 

Part of the Malawian family wearing a Chitenge!














For 2 weeks I attended morning meetings, shadowed physicians on rounds, and scrubbed in on surgeries in the operating room. Given my outgoing personality, I quickly made friends with several Malawians. They were delighted to see that I was not intimidated by our physical differences, and actually willing to greet them and engage them in conversation. This experience allowed me to face challenges, discover new personal strengths, and gain an understanding of the world in a much broader perspective. I experienced the realities of medicine and was exposed to the international side of health by seeing how physicians work with, and train, other health care providers in a developing country. I learned that most Malawians face huge challenges, but combat them with much vitality– which I envy.  

 








 For me, this journey was not just about providing medical care and saving people’s lives, it was about supporting and enhancing the trusted relationship between UNC and the people in Malawi by expressing empathy and care for their health.







I will never forget their smiling faces or the lessons they taught me. I can't wait to go back.

Into the wild

On Saturday morning at 6:30am we went on a Jeep safari tour through Liwonde National Park. To enter the park from the front gate we had to drive 20 minutes down a bumpy dirt road. During the ride, we passed many traditional African villages: small mud huts with thatched roofs, clothes lines hanging cloths to dry, and many barefoot children playing soccer in the dirt. As we came roaring down the road, kicking up a cloud of dust behind us, the children all stopped and starred. The youngest children who had never seen a car before stood there, not knowing what to do; while the older children started running along side the road, screaming and waving at us as we drove by. It was the most precious thing for me to see the joy on those children's faces because of something that I consider to be most mundane: a car. I wish I could have scooped all of those children up and brought them along for the ride.

 

Once we entered the park, we started our 3 hour long safari tour. The first stop we made was at the 4,000 year old Baobab tree. It was huge! 18 meters wide and 35 meters tall. I learned that elephants will chew the bark off the bottom of Baobab trees because it is saturated with water. Surprisingly, this does not kill the tree. 

After that, we saw our first wild animal! It was a waterbuck (also known as kudu antelope). It was the most beautiful thing. He laid there, calmly chewing his food, not even bothered by our car.

 

The next animal we came across were the elephants! There was a large family of them (~60 in that pack) feeding on a tree. The elephants were so busy destroying the tree, they didn't even notice we were there! Lucky for us because that meant we could get closer! Our driver, Happy drove us right up next to the elephants - we were about 40 yards away. It was one of the best moments of the tour. Seeing the family of elephants (even baby ones!) in their natural environment was so surreal. Our tour guide told us that they will go 3/4 days without seeing the elephants because they continuously migrate around  the park, so we were very lucky to have that experience. 

Some of the other animals we saw on our tour were impalas, monkeys, eagles, and another kind of antelope. 

Going on that safari adventure was so much fun! I got to experience the nature of Africa that you only see in a movie or read about in a book; and it was amazing! Even with the dusty air and dry grass fields, Malawi is truly a beautiful country.

My African adventure at Liwonde National Park

This weekend I got the full African experience going to Liwonde National Park in Malawi - about 3.5 hours south of Lilongwe.
Taye, Dr. Shores, John and I left Friday mid-day after attending morning meeting and scrubbing in on 2 surgeries. The first case I saw was a 4 year old child with HPV. Children who contract the HPV virus during birth develop "warts" in their respiratory passageway throughout their childhood, making it difficult for them to breath. With mild, but regular surgery, the warts can be removed. Eventually, as the child grows their


immune system can fight the virus, and they stop producing the internal warts. This surgery was most fascinating because not a single incision was needed - the warts were removed from the child's airway through the mouth using a brochoscope tool. The second case I saw was a 6 day old baby with omphalocele - a developmental defect. Omphalocele is when the abdominal wall does not close during development, and thus, the intestines, liver, and other organs remain outside of the abdomen in a sac. I was absolutely amazed at the skill of the physicians while watching this case. The infant was so small that every movement had to be extremely precise and controlled. Could pediatric surgery become a new interest of mine?

Anyways, after going to the clinic in the morning, we packed our bags and got on the road! We headed south to a game reserve in Liwonde, Malawi. Our lodge was called Liwonde Safari Camp (http://www.liwondesafaricamp.com/). Given that I have been very fortunate with my housing accommodations here in Lilongwe (in terms of brick housing, electricity, etc.), I expected the camp to be very similar in luxuries; however, it was not. I was shocked to discover that we would be camping for 2 nights in a national park - literally, camping. There was no electricity, the roofs were thatched, and we were in the wilderness. While the others were excited for the weekend, I was thinking, "how do people live like this?"
Oh boy, I am such a city girl...

After Timothy (one of the workers) showed us around the camp and we got settled in, we joined the group for dinner (there were 2 other families at the camp that night); they served us fried eggplant, potato chips, green beans, carrots, and chicken. In the middle of our candle light dinner, the owner Fredrick came over with a flashlight to warn us that the elephants were grazing nearby, and that we should stay under the picnic tables until they passed. AN ELEPHANT?!! I started freaking out. Taye (who grew up in Ethiopia and lived in a refugee camp in Kenya for 7.5 years) was like, "oh it's no big deal". Meanwhile, the elephant had made his way even closer! He was just 4 meters away from us feeding on the bushes. Using the flashlight (which didn't bother him), we sat there for about 5 minutes watching him rip the leaves off the branches with his enormous trunk. It was absolutely incredible! I just sat in amazement at the beauty of such a large and powerful creature, and how it was so close! Then, we heard a thunk. The guards had thrown a stone at the elephant's butt to scare him away because he was getting too close to the septic tank. Not even frightened, the elephant slowly turned around and walked away. "Welcome to Africa!" I thought to myself. Never in a million years had I expected to experience something like that! It was then that I realized, this weekend would be good for me. I could survive without all the materialistic and luxurious things, and be just fine! All I had to do was keep an open mind and be willing to try new things!

That night was not a peaceful sleep. I woke up multiple times to the sounds of animals nearby (elephants trumpeting, warthogs snorting, monkeys fighting, and dogs barking). Poor Taye (we slept in the dormitory) was woken every time I got scared. "What was that?!" I asked. He would reassure me that we would be just fine, and tell me to go back to sleep. He was used to sleeping with wild animals in his backyard, so for him, it was of no concern. But for me, I was worried that the elephants would trample our hut! Fortunately, they did not (or I would not have lived to share these stories!). Eventually, under my mosquito net and mud hut, I made it through the first night!

We woke that morning at 5:30am so that we could go on a safari jeep tour by 6:30am. This story will come next!











Our view from the camp - Liwonde National Park













Beautiful evening sunset

A typical day at Kamuzu Center Hospital

This week at the clinic went well! I am enjoying my time here in Malawi, and am learning so much! I could not have prepared myself for what I was going to see and experience here at the hospital (KCH) - I am certainly pushing my boundaries and exposing myself to the realities of medicine.

Here is an outline of a typical day...

6:15am - wake up!

7:15am - drive to the University of Malawi for morning meeting
      Morning meeting is a time for all of the medical students, residents and physicians to come together and discuss all of the "special case" patients that were seen at the hospital during the previous day/night. The residents present each case to the group, and as a whole, we discuss the outcome or best treatment for the patients.

9:00am - cross the street to Kamuzu Center Hospital and begin rounds!
      The surgery wards are divided into the male ward (floor IA) and female ward (floor IIIA); During rounds, the physician (Dr. Melanie) will see each of her patients (yesterday she had almost 20!) at their bedside and review their charts and any test results that were aquired the day before; then Dr. Melanie informs or directs the nursing staff (which we call the "sisters") how to care for the patient. What is interesting, is the fact that they don't use computers to record the patient's history - it is all written by hand. Each patient has a little yellow or blue book which they carry with them where ever they go that has all of the doctor's notes or comments written in it.

12:00pm - lunch break!
       The local women cook traditional Malawian food for lunch! It costs about 300 kwacha for a plate, which is about $1.00, and a soda costs 150 kwacha. The meal usually consists of white rice, hard grits, meat and vegetables.

1:00pm - surgery begins!
       Interestingly, the operating room is called the Theater, which has 4 operating rooms. To enter the theater, we must wear scrubs, boots, hair net, face mask, and gloves. Over this past week, I have seen about 6 surgeries; some were: an exploratory laparotomy (they had to cut out some of the patient's small intestine because it was damaged by a knife stab), removal of a breast tumor, hysterectomy (removal of the uterus), and a bladder repair on a 13 day old baby boy.

Dr. John Samuels (general surgeon) in green - lived in Malawi for 2 years
Dr. Melanie Sion (surgeon fellow) in blue - working here with UNC Project Malawi for 1 year

Surgeries usually end around 5pm (on Wednesday they ended at 8:30!), then we go home for dinner. Dr. Shores has certainly made us feel right at home - cooking steak, curry vegetables, and spaghetti some of the previous nights.

Until next time!

Day 1 and 2

When we arrived to our house on Saturday, I was greatly surprised! The UNC Area 6 house is nothing that I had expected - it's a home away from home! Dr. Shores and her colleagues have worked very hard to provide such a lovely home for those working with UNC Project Malawi, and I couldn't be luckier.

After we got settled in, we took a trip to the local market to get something for dinner. We bought 2 chickens, fruits, and vegetables. We had a chicken, rice, and curry vegetables for dinner. The curry vegetables were good, but the chicken not so much... it was very chewy. We later learned, by Taye (1st year medical student from Ethiopia) how to pick a more tender chicken - by looking at the size of the spurs on it's legs! Smaller the spurs, the younger the chicken and thus more tender the meat. Now we know! The Malawians were probably laughing at us for picking such old chickens...

On Sunday I woke up to the wonderful sound of roosters! Nothing like a personal alarm clock that you can't shut off. That day we took a trip to the Lilongwe Sailing Club at Kamuzu Dam II. John and Melanie took the sailboat out, while I laid in the hammock and received a Chichewa speaking lesson from the Malawian working at the club, Deses. Luckily for me, those who have had secondary education or higher know how to speak English, so it makes it easy for me to communicate with most of the locals. So, I learned how to say a couple of greetings, and goodbye. The first thing that I have learned here in Malawi is that everyone is very nice! They are so friendly, and extremely grateful that we have come to visit! I have never felt more welcome than I do here.

My Journey to Malawi!

And my journey begins! Mom and I arrived at the Raleigh/Durham airport at 4am! There, I meet my fellow travelers - Dr. Carol Shores and her boyfriend, John. At 6am, off we went! We flew ~1.5 hours to Washington, D.C. on a very small plane. I was fortunate to sit next to a neonatal intensive care nurse from Duke, because the turbulence made me queasy! I felt like I was riding on a spinning carnival ride...

Once we landed in Washington, we had a short layover then boarded the plane for Addis Ababa, Ethiopia - a 14 hour flight! The airplane was huge! I am so thankful that God protected us as we made the tremendous journey across the Atlantic ocean! Here is a picture of the path of our flight from Washington...

Unfortunately, Dr. Shores, John, and I had to sit in the very last row! I sat next to a student named Austin, who was traveling to Zimbabwe from Alabama along with 13 others students as a part of a mission trip. Their group was going to build drinking wells to supply clean water to those less fortunate - how cool! We had lots to talk about, he was very kind and we got along great. He was excited to learn that I would be his traveling buddy, because on his last flight he had to sit next to a cougar hitting on him! haha. Meet Austin...

The views from the sky was breathtaking - it was so surreal. I got to see both the sunset and sunrise during the flight!

After landing in Ethiopia, we made our last flight to Malawi - 4 hours! I slept the entire way... When we landed in Malawi, 2 UNC-project members were there to greet us and give us a ride back to our house: John (a surgeon) and Melanie (resident from Duke). It was less than 5 mins and I already looked like a foreigner  trying to get in the car on the wrong side!  In Malawi, the steering wheels are on the right side of the car and you drive on the left side of the street. It is absolute chaos! It was about a 30 minute drive to our house in Area 6.












Coming up next... my first day in Malawi!

Everything happens for a reason

A couple weeks ago I celebrated my boyfriend's 23rd birthday at Hiro's Japanese Steak House. Of course no Asian cuisine is ever complete without a fortune cookie! So I grabbed a cookie, opened the package, and cracked it open. Inside it read, "You will soon be crossing the great waters". WHAT? How did the cookie know?!

I am not one to believe in luck, but instead, I believe everything happens for a reason. God has a plan for me, and this is just another sign he stuck in the road. At first I overlooked it, but now I realize exactly how fortunate (no pun intended) I am to have been granted the Carolina Covenant Scholarship, and to have been offered this wonderful opportunity to travel to Africa. This is going to be one of the most unforgettable experiences, and I can't wait to share it with you!