Reunited

June 30, 2009

It is wonderful to see Elizabeth, to meet her college mate Yiwen and to reconnect with the people at St. Gabriel’s. My work began today with the clinical staff meeting and quick introductions to the patients who need physical therapy. Dr. Heim is a surgeon, here at St. Gabriel’s for an extended time period (more than a few years) from Germany. He just arrived in January, but today I saw a few of the many patients he had been able to care for given his surgical expertise. They have arranged a surgery room – a theater, it is called here- for him and he has been busy. My work will support the rehabilitation of patients in their post-op recovery. I will also be training other staff to assist in basic rehabilitation care.

The Malawians have been most gracious with my efforts to speak Chichewa, and thankfully, I have been assisted by the nurses and attendants on the wards with translation when needed. Although I have studied, and have some basic understanding, it is quite a challenge to speak while I am engaged in the complex process of physical therapy assessment and treatment in this environment.  Often, my actions are more easily interpreted than any explanation anyways! The diversity of patients here is intriguing – a man with a below the knee amputation, a young girl with her leg burned in the cooking fire, a young man paralyzed as a result of a tree falling on him, an elderly woman who has had a stroke, and several complex bone fractures.

I have made contact with a patient I have followed in Malawi for three years. He is getting ready to return to work as an accountant. I am glad to hear of his steady functional improvements after an onset of quadriparesis following an illness. I will be training him on a new Netbook with the help of my son.

St. Gabriel’s Hospital celebrated their 50th anniversary this May. They are supported by the Carmelite Sisters from Luxemburg. In the foyer of the private ward there is an amazing photo display tracing their history. Their progress has taken an amazing amount of commitment and dedication. They are to be congratulated!

I am grateful for the Malawian hospitality. Elizabeth, Daniel, Yiwen and I are sharing a house and have settled in well. We have been welcomed warmly. Malawians will say when they know you have just arrived – “You are most welcome” – a phrase that catches you wondering if you had just said “thank you” – and then realizing that you are indeed most welcome here in Malawi.

After work, there was plenty of action on the soccer field, and we visited a friend in the village of Namintondo to welcome his new baby, Christopher. It is winter here, and dark about 6 pm. In years past we have carried flashlights – which earned us much attention. This year, we are trying to learn to let our eyes adjust and walk the paths like the people around us. At least we are not trying to also carry things on our heads!

Elizabeth, Yiwen, Daniel and friends

Elizabeth, Yiwen, Daniel and friends

Growing new roots

June 28, 2009

The Walking Tree is actually the Banyan (Ficus bengalhensis) tree. It has the ability to move by growing long aerial roots from the branches to the ground. Depending upon the conditions, these new roots can become strong trunks. The Walking Tree is an inspiration for moving in a new direction, from a stable base. It is a model for adaptation, change and problem solving in resource limited circumstances.

St. Gabriel's Hospital

I am travelling back to Malawi to continue my work as a physical therapist at St. Gabriel’s Hospital. I have spent my past three summers there in Namitete, working with the committed doctors, nurses and Community Health Workers. The hospital serves a catchment population of a quarter of a million people, spread throughout a 100 mile radius.

Malawi is a land-locked country in southern Africa, and has one of the lowest Gross Domestic Products in the world. The majority of the 13 million people are subsistence farmers, and many are burdened by health concerns related to nutrition, HIV, TB and malaria. Namitete is located 75 km west of the capital city of Lilongwe.

Malawi is called “The Warm Heart of Africa” and the people are welcoming, resilient and patient with their struggles and triumphs. They work hard, value their communities and enjoy a competitive game of soccer. English and Chichewa are both national languages. Those who have gone to school speak English, however, many in the villages speak only Chichewa. There are several other languages spoken in other regions of Malawi.

This year I will be working with Dr. Heim to develop a rehabilitation program at the hospital for patients who have had orthopedic and trauma surgery. I will also be providing physical therapy for the acute and chronic care patients in the hospital, and doing home visits to patients in the outlying villages. I look forward to collaborating with Sylvia Kambalametore, PT and Cathy Peterson, PT regarding planning for the possibility of a physical therapy degree program in Malawi.

I am travelling this year with my younger son, Daniel. It will be his first trip out of the United States. My daughter, Elizabeth, will also be at St. Gabriel’s as an intern with the Beyond Traditional Boarders program with Rice University. She will be building incubators for the hospital, and continuing field testing of the diagnostic lab-in-a-backpack.  My older son will also be in Malawi, in Neno, implementing the FrontlineSMS:Medic program at the Partners in Health hospital.