Malawi update

Money in Malawi is bizarre. A street vendor sells what would cost $3.00 in the US for $.60. In a completely natural, kneejerk fashion, I declare that too much for 5 pounds of bananas and talk him down to $.20.

The old guy who makes $30.00 a month to sit on our porch holding a machete from 5pm to 5am, Sunday to Sunday just came up to me and asked me to give him $2.00 so that he could buy some food for his wife who has recently been hospitalized at the large (largest in Malawi) facility near the house I’m in. I was going to tip him anyway as he’s a really kind man and gave him the equivalent of $10.00, which is, of course, a full third of his monthly wage. He was holding a large bottle of water and I asked him what he was going to do with it. He proceeded to tell me that he was going to take it to his wife. Apparently, hospitals don’t give water to their patients. You have to bottle and bring your own.

These people do amazing things with very little. The health system is entirely rudimentary and care is, by our standards, medieval, but given that beds are filled to 200% capacity and the small staff is criminally underpaid and overworked, they do a fantastic job with very little. Some facilities don’t have running water. Some don’t have power. They teeter under the load of a sick population, providing treatment to who they can, however they can and don’t utter (to my ears) a word of complaint. I went to one facility and there was a nurse there who was in her 80’s. She had tried to retire but was immediately called back since there was noone to fill her position. The lines fill at close to 5 am, and the facility sees about 300 patients on a slow day with a staff I counted to be 6: One doctor, three nurses and two pharmacists. During peak malaria season, they can easily double or triple that.

The monthly wage of a nurse in Malawi is pretty good: $270 per month. A doctor gets about $400. No one appears to get a day off. Some doctors have research responsibilities that I’m sure provide a respite from seeing a million patients all day. I would wonder what these people could do with American resources. I have met some of the brightest and hardest working people that I’ve ever seen in my lifetime here in Malawi, all working under conditions that would make the average American drop.

And here I go, haggling some kid with bananas down to less than a quarter.

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About Pete Larson

Assistant Professor of Epidemiology at the Nagasaki University Institute for Tropical Medicine

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