Malawi Day 7

I’ve spent the past days with mzungu, watching soccer on big screen tvs in bars and eating far too much in a country where tons of kids don’t get enough protein to be able to develop well enough to survive past their fifth birthday. It’s a rather odd feeling. I feel no guilt; that’s a pointless venture. But although Malawi’s economy is the second fastest growing in the United States and the quality of car and buying power of many Malawians has expanded even in the twelve months that I’ve been related to this country, there is still much work that needs to be done to balance out the incredible inequality that exists here. Hanging out in places where people spend the equivalent of a months wage for an average Malawian in a minute and watch sports without power outages in an English speaking environment just strikes me as surreal. Most mzungu never pick up the local language. It’s easy to see why.

There has been an outbreak of measles in the Machinga District, north of here and toward a large nature reserve on the banks of Lake Malawi. It is likely that, despite extensive vaccination efforts, the conditions were right to facilitate spiraling measles transmission in children. In America, we have to presnt detailed and exasperated arguments to get partenst to properly vaccinate their children. In Malawi, mothers line up eagerly in the Machinga District Hospital to get their children vaccinated before the worst can occur. The Malawian government is unable to provide resources for this impoverished population. Doctors Without Borders has set up a temporary vaccination site and is furiously trying to keep pace with the incredible demand by vaccinating more than 2.5 million children throughout Malawi

Machinga district Hospital appears to be an excellent facility for reproductive health, advertising proudly that it is a hospital for healthy babies. By all appearances, they struggle to provide as quality of service as they possibly can and look to be well outfitted. However, a walk around the compound provides a look into the incredible challenges they must face there.

The TB and AIDS wards appear packed to the gills, and incredibly ill patients walk about the compound aimless and clearly exhausted from fighting the specters of disease and physical debilitation. I spot what appears to be an ancient woman who is likely not but 50, give me a glazed look before she hikes up her skirt and urinates, standing, not but 10 feet away from me. Perhaps this is common practice here in rural Malawi and my wealthy sensibilities are merely unused to what could be a full natural human behavior, but after a litany of ill children, ill parents, TB patients and human suffering that desperately collects about this overworked facility, I can’t help but think that this is the true cost of disease, poverty and poor distribution of worldwide resources, the cost of human dignity and self determination.

It does not make me feel the fake guilt that we are trained from birth to feel. It does not make me feel sadness or pity, but it does anger me that in 2010, at a point where portions of humanity are living wealthier and healthier than any other time in human history, that a combination of bad governance, lack of development and use of available resources and the surrounding spectre of an environmental climate that favors the circulation of infectious disease at the expense of human health is allowed to continue. Of course, it only strengthens my lean toward atheism. If there is a god, then he must truly hate his most faithful of sheep.

Full time residents who likely work at the facility appear to have reasonably good accommodations, ancient solar power units adorn the houses and music emanates from inside, indicating that all is not unwell. Technology is not completely unknown in this end of the world, and those who have it and the education necessary to keep it, can at least somewhat shield themselves from the worst. One has to remember, however, that the residents of these dwellings are those who fight the hardest fight every day, often at their own expense. I’ve met a number of doctors here and don’t think that I’ve met a smarter, more dedicated lot. It can be said that they have gone a route that is lucrative here in cash strapped Malawi, but I am positive that these people put in more than their allotted number of hours. In the end, they don’t make even as much as a full time convenience store worker in the US and work twice as much, under the most challenging of conditions. No wonder Malawi has an incredible problem keeping doctors and nurses in the country. The situation is improving, but this country of 15 million people still has less than 250 doctors in the entire country. One can hope that the expanding economy will encourage more physicians to stay and offer promising students the opportunity to obtain training. All is not bad.

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About Pete Larson

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

One response to “Malawi Day 7”

  1. Luis Fernando says :

    250 doctors for 15 million …. wow … wow Latin America is a paradise

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