A big part of what we did was hang out with the Drs. Fabulous. They both worked in Lilongwe with nonprofit organizations – Dr. Papa with an HIV nonprofit, and Dr. Mama with both a pediatric HIV clinic and a public hospital. I was lucky enough to work with each of them and get a glimpse of their work.
Scene inside (L) and outside the public hospital
The hospital was very different from anything people in the US would expect for themselves and their loved ones. It was sweltering, malodorous, packed with people, and by US standards, unsanitary. It consisted of large rooms with numerous metal-frame beds, packed with up to 6 children per bed in the pediatric unit. There were a few fans, but no air conditioning and the air was dank. Outside were courtyards where family members waited, did laundry, talked with each other. Medications and supplies were scarce and technologies such as CT scan and MRI nonexistent. Radiology workers were on strike at that time so they were not doing x-rays that were needed, for example, to remove chest tubes on several toddlers. It was very sad to see the malnourished babies and children, many with TB and/or HIV, and the mothers looking so tired and often sick themselves.
Work being done by hand (L) and a map of hospital
It was a shock when Fiercely and I first went to the hospital. We had left a cold East Coast winter, but here it was warm, humid, crowded, and smelled strongly of humanity and disease. I had been in similar places, but my daughter, a privileged American 12-year-old had not. She began to turn pale, sweat, and to stagger a little so we sat her down and eventually left. Dr. Mama worked a 16-hour shift there every week. Malawians travel days to get their medical care here. The inequities of the world are stark. I wanted Fiercely to see how most of the world lives; I would like for all first-world denizens to experience this, work for a more equitable sharing of the world’s resources among the world’s people, and be truly grateful for our lucky circumstance of a materially privileged life.
Posters at a rural clinic (L), clinic building and crops
After working at the public hospital, I was able to go with Dr. Papa and crew (driver, translator, and community liaison) to several rural clinics. They were collecting data and doing some education on HIV prevention among pregnant women and newborns. Malawi actually has a progressive and successful program on reducing mother-infant HIV transmission, though the challenges are formidable. The clinics I saw were rudimentary cement buildings, one with a startling and very pungent-smelling bat colony in the ceiling! In one of these little clinics, 1 nurse – a man who was assigned there and basically on call at all times – aided the delivery of 1000 babies in a year including, in one especially busy recent month, a hundred births!
Typical rural home (top), children’s coffins at a roadside store (bottom)
A third experience I had, and Fiercely joined me for an afternoon here, was at an orphanage. It was for very young children, about 3 and under, mostly infants. It may sound cliche to be in an African orphanage but it was lovely to hold the little bundles, help to feed them and play with them in a simple building run by a religious organization. There is a great need for such facilities in an area where so many mothers have died from HIV. As I read about the lives of these babies in a photo book at the orphanage, the same stories repeated themselves – mother died of HIV, no family members, child found on street or left at hospital or orphanage door. Mama and Papa Fabulous’s twins had stayed at this orphanage at one time, and Dr Mama had brought at least one other child here from a difficult family situation. It was a sweet place, full of breezes, clean, many flowers in the garden outside, and drooling babies rolling around or napping on a brightly colored padded floor. If only there were enough places like this for all of the children in need, if only we didn’t even need such places! But I did feel hope for these youngest Malawians and I wished them the best.