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Christmas in Malawi

Christmas in Malawi

In August, Karolina Siwicka – an orthopaedic doctor – went to Malawi with her husband, Piotr, and children. She works as a volunteer in the orthopaedic Beit Cure hospital in Blantyre. PMM is the patron of this project. Here is another account from Malawi:

In Malawi, there is not many places like our hospital – where a child that comes with one imperfection is perceived integrally, as a patient with multiple diseases, and not only as a deformation to be 'straightened'.

The young patients with defects manifesting themselves in the form of bone deformities often have severe diseases of heart, spine and other key internal organs, which have never been diagnosed or treated. We try to be very vigilant so that nothing can escape our attention. It often happens that a mother brings already a few years old, very sick child, e.g. with cerebral palsy, "because the child has deformed feet," and at the very end of the interview, she admits that "the child is different and still can't walk," just like it is not important – after all, she was referred to us because of the feet. We cannot blame or resent mothers or local medical officers. The first lack of knowledge. Both the access to knowledge and ability to use it even if it was available, because they often cannot read or write. The latter are simply not enough to manage to thoroughly examine all the patients. Throughout Malawi with the population of almost 18 million people, there are only a few orthopaedic surgeons and 180 paramedics. With the enormous amount of work, they have no way and time to educate. For us, there is no excuse that it is too late, that it is impossible ... There is so little time left for us to stop deformities in patients, reduce contractures and give a chance for rehabilitation, provision of orthoses and standing on their own feet. Sometimes it is too late to start learning to walk, and then we can help, at least, with care. Here is one example, and we face such situations every day.

So far, we had had no time even for a brief account of our activities. Finally, the holiday season was there. In theory, it was supposed to be a period of slowdown in our work.

In theory. Most doctors went to their home countries to spend time with their families. With significantly limited resources, the pace of others had to increase significantly. Many young patients had to be prepared to be sent to their homes for Christmas. Not only surgically prepared – it basically was the smallest problem when there is an open operating room, generator and several pairs of hands willing to work.  However, for the patient, there must be arranged drugs, consultations, changes of dressings and further rehabilitation close to home, money to take a minibus (usually it is the biggest barrier to the continuation of treatment), and care of the out-of-town coordinator, who ensures that the child comes back for a follow-up visit. This is not easy when a parent has to carry a child in a hip cast for two days before he or she comes to the nearest gravel road, where he or she can catch a minibus to the capital, and there are another 5-6 hours to reach our hospital ...

It was a success. While many families spend long weeks and months in the hospital and it is difficult to schedule a specific date of discharge, logistically, we were successful. The department was partially emptied, and we have a moment for a family visit and a photo story.

 

At the department, there were only a dozen of smiling faces. These are mainly children with frames slowly correcting lower limb deformities or exacerbation of chronic osteitis. In both cases, we have little influence on the pace and predictability of the treatment. They have stayed with us for Christmas, but they also receive spiritual help.

Most parents were very pleased at the prospect of a break at home, although we know that many of them will not be celebrating. After the last year's drought, in the villages, there is a huge hunger, and it is difficult to create a unique atmosphere. However, our wonderful physiotherapists, before the discharges, organized a Christmas party with treats, and gifted the children with little somethings from donors.  Although this was just a second best of holidays in the European meaning, the joy knew no end. 

The hospital staff also celebrated. It was a day of Christmas carols, which we were singing along with the patients and their parents (also in the local language of Chichewa), dances, and nativity plays.

The hospital staff received Christmas gifts including sugar, margarine, oil, flour, soap for washing, candles, and many, many other most needed things – in total, several kilograms of joy.

It was difficult for us to look outside the window for the aura of Christmas. Fortunately, a few days ago it rained severely, it became grey, grim, and – if it were not for the outside temperature – almost pre-holiday. Thanks to this year's showers of rain, which has not been devastating, the corn grows well, maybe the next crop will be more abundant, and the next year more favourable for the residents.

The sea of needs. Money does not bring happiness, but even a missionary hospital has to pay for medications, dressings and implants with a hard currency, struggling with soaring food prices and is affected by the system defects (lack of water, electricity, and favour of the authorities).

The needs are endless; as endless as the joy of a child who, after several years of suffering of walking with dorsal regions of the deformed feet, for the first time, stands on his or her own soles and heels!  Even the hope itself brings happiness, though waiting for new feet can be very painful and long-lasting. 

We are trying to get funding to connect the hospital to priority power line, which provides a continuous access to electricity and will save millions of Kwacha spent on fuel for the generator. It happens that the generator is working for 20 hours a day, but the local authorities do not help in our efforts. We try to get a solar heater for water, to save on bills in the laundry and operating room. We need to drill a well, because the hospital cut off from the municipal water for a few days becomes dangerous and the reserves of water from water carts also burden the annual budget. The roof leaks, threatening to collapse, and the seasonal watercourse undermines our physiotherapy building. Each unscheduled expense means less operated young patients and smaller grants for feeding. Feeding the child and the parent with antimalarial treatment is on the list of priorities of the hospital.

We strive to provide a container with orthotic supply from Poland. Once again, costs have devastated us. We also need an orthopaedist for adults who would help once/several times a year to take care of traumatology, replacements and arthroscopy. Apart from the purely charitable activities, several percent of the needs of the children department are covered by 'private operations'. Few adult residents of Malawi have health insurance and are able to pay for the treatment, according to the following motto: "Adults pay fee so children can walk free." The smallest commercial activities bring relief to the hospital in the struggle with implacable economy outside the hospital.

If, doing the tax settlements for the year, you have to pass the tax threshold, or simply realize that sometimes, by a slight self-sacrifice, you are able to give someone newer, better legs or hands – you can support our work through Polska Misja Medyczna.

Regardless of the shortcomings of the hospital, we work; more and more children are sent home with a chance to live closer to normality. Interholiday greetings Karolina, Piotr Emiko and Roman.