It takes a village

August 16, 2012

I am home now – but have woken up several mornings ready to go to the morning clinical meetings and begin a busy day with the patients at St. Gabriel’s. It is good to be starting back to work here – meeting new teachers, preparing for new students and facing new challenges for the therapists I work with.

A friend shared some pictures of one of my patients at St. Gabriel’s – a little two-year-old girl with a broken elbow. She was also just learning to stand, walk with help, raise her arms over her head, comb her hair, and play while on her stomach. The pictures tell the story of everyone’s important part in her learning new things.



If a patient in the next room needed blood right now….how long would it take you decide to give blood? When faced with that question this week, I found it a simple, quick decision. Yes I will, now-now.

Giving blood in Malawi is also a simple, quick process. Your blood is screened, and they take a unit of blood in just a few minutes. Families of patients having surgery are required to give blood prior to the surgery, but “volunteers” like me are thanked with a soda. I was even asked if I wanted to take the blood directly to the patient. Every time I have given blood here at St. Gabriel’s, it has never been stored – it is always out the door as quickly as I am. By the way, no time for resting, either. You can drink the soda on your way out.

I encourage all of you, if you are able, to give blood – even if there is not a patient in the next room…or even if the blood spends some time in storage…it will be needed by someone at some time.

The blood donation room at St. Gabriel’s

Come on in…you are most welcome.

In the community

August 7, 2012

Everything we work towards in the Family Centered Care Unit and in the Home-Based Palliative Care program at St. Gabriel’s is aimed at the patient and his/her family returning to the community. Hopefully, they will return to their homes, families, and villages with improved function…the ability to walk, to use their hands to work, to care for their children, to care for themselves. If they have an illness that needs palliative care, hopefully, they are returning home with their pain managed, their diagnosis well understood, and their family prepared to care for them in their end of life journey.

I spent the day with Alex on the back of the motorcycle visiting patients…watching out for low trees, low roofs, large holes dug by people making mud bricks, and various animals (pigs are the slowest!). I always learn a lot when I see the real context of life here, and get a glimpse of how health care is provided in the villages by families, neighbors and community volunteers.

And, yesterday, I “shadowed” a patient going to the village for the first time since February when he sustained an injury to his spinal cord resulting in paraplegia. He wanted to buy some chips (fried potatoes), and was successful. They were served in a plastic bag that was hot, so the chip man helped him put it in his jacket pocket to carry back to the hospital.

A patient in the village with her family – and curious children!

Buying lunch in the village…yes, it was accessible.

Dzalanyama Forest

August 6, 2012

Sunday, I found trails in Malawi! I hiked with two others from St. Gabriels in the Dzalanyama “place of animals” forest. This is a large reserve just south of were I am, along the border with Mozambique. We didn’t see any large animals (although we heard the calls of baboons), but we did see lots of interesting birds. The views from the Dzanlanyma Hills were beautiful – as were the waterfalls.

View of the Dzalanyama Hills

On the way to Dzalanyama Forest Reserve

The sound of these waterfalls was amazing

Singing, dancing…

August 5, 2012

Smiling, running, finding friends, playing soccer, digging, helping with chores, taking a bath, carrying a little brother or sister, fixing something, and chasing goats – just some of the “busy-ness” of active, happy children in Malawi. And children are outside everywhere. No TV, no computers, no portable devices and lots of buddies. There is not much room in a typical house or hut, so they are all out in the courtyards, markets, footpaths and gardens.

Here are several video clips of some children playing/dancing, and a church choir competition.


Christopher and his cousin…smiles, ready to dance

Rice Owls!

August 1, 2012

Every year Rice University sends students to St. Gabriel’s with the Beyond Traditional Borders program. Elizabeth (my daughter) was in the first group of students to come here, and I have had the pleasure of meeting most of the other students over the past four years.

They come with technologies to put in the field and gather feedback so that they can be further modified. The home-based care backpack was one of the first design projects to come to St. Gabriel’s. Since then, they have brought a hand washing system for the mobile clinic, a salad spinner centrifuge, community health worker backpacks, SAPHE pads to monitor blood loss after delivery, dose right clips for accurate measurement of liquid medicines…..and many more.

This year, Kamal, Teresa and Tara were also busy developing an electronic record system for the palliative care unit. They did a great job of developing a useful system, training, and helping the staff put it all into use. Their blog is

I also met Bridgit and Kathleen – two other Rice students – when I was in Blantyre. They are working on a study using a low cost breathing assistance device for babies. I loved they way they worked so closely with the nurses in the special care nursery. A link to that project is

I really enjoyed working with the Rice students this year. They developed great relationships with the people in the hospital, and were very respected for their thoughtful approach. They were also excellent cooks! Because we cook for each other at the guest house…rotating cooking “teams” – we always looked forward to their sweets and spicy flavorings.

I hope they have had a good trip back to Houston, and I wish all of them well in the future!

The Rice cooking “team”

The palliative care staff learning about the electronic record system

Electronic records training

Tara with Alex, the home-based palliative care nurse – preparing for home visits

Planning visits with Alex and Father William

Alex ready for home visits – using the backpack deigned by Rice students – including Elizabeth!

Kamal demonstrating the syringe with a clip for accurate medicine measurement

Using the bottle adapted for the syringe

Teresa teaching Comfort how to type

The door of the special care nursery at Queen Elizabeth Central Hospital in Blantyre