Kamuzu Central Hospital

"Pray as though everything depended on God. Work as though everything depended on you." 

-St. Augustine

Kamuzu Central Hospital and the Service Requirement

During the middle of my time here in Nkhoma, I was called to serve for 6 weeks at the Kamuzu Central Hospital (“KCH”) in Malawi’s capital city, Lilongwe. Working there is a requirement for Malawian licensure for all expatriate physicians.

KCH is one of Malawi’s largest free-of-charge public hospitals. It has specialists that most other district hospitals do not have. It is an important training and referral hospital. And KCH is HUGE: over 1000 beds! However, one of the side-effects of being a ‘free hospital’ is the extreme over-crowding, and the waiting and delays. People often wait for weeks in their beds for their needed operations. If one is poor and has no other means, then it’s either waiting at KCH or going back home.

When there are no more beds, people will place their own cushions on the floors in the hallways.

People here put up with a lot. They often will forge on and live with their ailments for as long as they can. They come in for treatment late and their diseases are often in advanced stages when it’s harder to help them. Why is that? Is it poverty? Is it mistrust? Is it the fear of contracting Covid in coming to the hospital? Are they scared to death of coming to the hospital? I really don’t know.

Despite the conditions, I had a great time there. I loved teaching their surgery residents-in-training. Like back home, the African residents are smart, eager to learn and excited to have us teaching them.

I enjoyed the challenges doing my best to help take care of people with big problems in a resource poor hospital. One of my patients even survived an attack by a hippopotamus!

As people, we can do the best we can with our hands and what we know. Beyond that, we’re only as good as the system and the machinery that surrounds us. If the pharmacy doesn’t have the medicines, then we can’t give them. If the Operating room and its team of anesthesiologists, nurses, scrub techs and don’t share a common mission, then people are neglected. If there’s no scanners or if the laboratory can’t do tests, then it’s harder to know what is wrong.

Any act of kindness goes a long way. When people’s needs are great, it feels like the kindness goes further. The same is true back home. When we are sick, we are all poor. And it’s Jesus who is hurting, lying in those beds. We can all be extensions of God’s love in the world by making that love real.

The early AM ride into Lilongwe: fog and smoke

Since Nkhoma and Lilongwe are about 40 miles apart, I had to hire a hospital driver to take me back and forth each day. We left each morning at 06:00. Each trip took an hour each way. Those rides were a great chance to see the local county side. I saw open land with rocky and rolling hills with dotted with scattered rural brick farm houses.

Entering the capital in the early am, the air was not clear. It was a combination of morning fog and smoke from the many small fires that people huddle around for warmth and socializing before the day begins. This was their winter. Temperatures fall down to the 40’s at night and early morning. It doesn’t sound that cold, but it is a bit chilly without central heating.

The daily bicycle parade

Every morning there is a parade of men on bicycles riding along the road to the capital. All the bicycles are weighed down with things to sell. Bicycles are used to move charcoal, potatoes, firewood, goats and whatever else that can be sold. Each bundle of charcoal will fetch ~$8.00 each. That a lot of pedaling for very little.

 

Malawi’s capital: Lilongwe’s skyline and profile

From a distance, Lilongwe is a long expanse of low-lying buildings, mostly 3 stories or less, over rolling hills. The city builds outward rather than upward. There are numerous cellphone towers spread across the entire city. Internet access is surprisingly good!

On Blending in to new places: Bits and Pieces

A medical missionary once advised me about coming to a new place.

“Don’t make any suggestions for 6 months. And don’t try to change anything for at least a year.”

I definitely agree with the spirit of waiting and listening when arriving in new places.

Measuring one’s words carefully. Picking one’s spots. Watching and learning about the local context. Making small daily discoveries: ‘bits and pieces’.

No one can tell you everything there is to know about anywhere during your first few days or weeks.

It takes time to learn why things are as they are. Egotistically blundering into a new situation and trying to force one’s views on everyone, while singing that tune of “this is how we do things back home where I come from” never goes well. Living in the spirit of service and love to God, our patients, and the people I’m working with is the way to go.