LilongweAway: Hospital Week 2

Hello all,

Internet has been problematic here for the past few days but seems to be working now so I'm taking advantage of the opportunity to update.

We've been busy in the hospital this week- our groups has spent time in the operating theatre, on ward rounds and in clinic, and Dr. Charles has also been holding some teaching sessions with the residents to prep them for their boards- apparently they take some variant of oral boards after their 1st, 2nd, and 5th years of General Surgery Residency.

prep for oral boards.

A couple stories from this week:
Laura, Jared's wife, has been involved with an orphanage in Malawi at least peripherally for the past several years. There was a boy there with a large congenital (since birth) ventral hernia that had gone unrepaired his entire life. Healthcare in Malawi is free but it can be difficult to get posted for an elective operative given the huge volume of emergency cases that come into the hospital. I'm happy to report that thanks to some maneuvering from Laura we were able to bring the child into the hospital. He underwent an operation earlier this week and is doing well.

Jared, Dr. Charles, a patient who received surgery this week, and his family.

There was a really strange and terrible smell in my and Jenny's bedroom earlier this week. We searched and searched for a dead mouse and couldn't find anything. The smell was very strong close to our door, which is where my bed is located in our room. The smell went away in about a day and we didnt think anything more of it. Fast forward to last night when I came in and sat on my bed, noticed a pile of white dust, and attempted to brush it off the bed. Then, I noticed the dust was in fact moving and looked like larvae. I was immediately terrified it was mango fly larvae (African cousin of the botfly) and started a terrifying google image search which I don't recommend to others. Mango flies are relatively common here. They lay eggs on wet things like clothing line drying outside and thus everyone irons all laundry after bringing it inside to kill the larvae. If they're not killed, the larvae can hatch and burrow into skin, which causes a painful blister which a semi mature larvae will then hatch from. Anyway, our too kind housekeeper stripped my bed and washed everything including my large mosquito net. When we returned from dinner there were more of the tiny larvae on the bed so I moved to one of the other beds in our room (there are 4 full sized beds in our room, feels like summer camp).

Jenny's dad has been rounding with the medicine services and attending in Cardiology clinical this week. He received a call from the OB/GYN service here requesting a Cardiology consult for a woman 5 days post-partum with likely peri-partum cardiomyopathy. Jenny is going into OB/GYN so she and her dad went to see the consult together. Watching them tag-team examining the woman and coming up with a management plan (mental picture: the two of them, sitting together, dueling iPads in hand with reference materials- Jenny on LactMed looking for lactation safe drugs and her dad on UpToDate) was great.