Back to work!

We’ve been back to work this week, despite all the safari info I’ve been posting!  Things have definitely been different without Hans, the primary attending we worked with the first half of the trip, around.  On the one hand we have been able to see some different areas of the hospital which has been nice, but on the other hand it was kind of nice at times to have someone “in charge” of us.  All that being said, we’ve had some good experiences. 

Meghan and I each spent time with the oncologist here and got a better picture of oncology in Africa.  Like most everything, it’s a whole different world.  Compared to the detailed diagnostic testing and the complex protocols we have at home, things are much more simplistic.  Diagnosis is based on clinical presentation, HIV status, FNA, and maybe biopsy with relatively limited pathology analysis.  Treatment is some combination of the around 5 drugs they have to chose from.  All things considered, the oncologist from the US who is here currently has made great strides in treatment of kiddos with cancer in this area.  He is heading back to the US this summer and is training a pair of local clinical officers (like a PA) to run the show once he’s gone.  It’s really incredible the volume of children these guys are managing with so few staff, especially when you compare it to home.

The last few days we have been at the Baylor Clinic next door to KCH, part of Baylor’s International Pediatric AIDS Initiative.  The clinic may be directly next door to KCH, even connected by a covered walkway, but it’s like you’re in a different country.  The clinic is clean and modern.  There’s very organized, structured patient flow.  There aren’t any bugs (that I saw at least).  There’s (supposedly) air conditioning, though it’s broken at the moment.  It’s just amazing that the two places exist side by side.  The Baylor clinic follows a huge number of the HIV infected or exposed children in Lilongwe and the surrounding area and provides all of their HIV related care as well as “sick visits.” Even in just two days I learned a lot about HIV care in resource-limited settings and saw first hand some of the challenges that these areas face.  It was also just really nice to get back into a clinic environment for a few days and to be in a setting that’s a little more open for longer conversations, more questions, and more in depth patient interactions.  While I definitely enjoy inpatient medicine and have definitely learned a ton at KCH, I like clinic as well at times. It was good to add this experience into our Malawian mix.

We’re back at KCH tomorrow, but only for the day – we’re heading to Lake Malawi this weekend for some sun and relaxation!  My photo burden may not be as large after this trip as it was after safari, but I fully expect to have a few new things to post.  We’ll be heading back to Lilongwe on Sunday, so no more posts until then at the earliest… and then just a few days until we’re US bound once again!  Thanks again for reading and for all the lovely comments from home. 🙂