Reflections on My Last Day in Lilongwe

Greetings from Lilongwe!

I have really enjoyed getting to know the UNC Project and the team that leads it.

Francis Martinson is the country director for the project, meaning he is overall in charge. He is Ghanaian, and he received his PhD in epidemiology from UNC School of Public Health. Mina Hosseinipour, MD, is the clinical director. She is from Kentucky originally, and is an internist who trained in infectious diseases at UNC. She is based here in Malawi. David Chilongozi, is the manager of research operations. He is a clinical officer (a physician’s assistant), who now oversees the various research projects here. Innocent Mofolo is in charge of operations, and makes the trains run on time. Arthur Sungitsa is the finance manager, and plays a key role in making sure everything gets done in a proper fashion.

Last evening we went to a wonderful dinner party at David and Rita Chilongozi’s home. They have a large house, which has served them well, as they have provided care for nine nieces and nephews who were orphaned due to AIDS. There were at least 40 UNC Project staff there, and we had a “covered dish” dinner, with everyone bringing a favorite Malawian dish. They grilled beef and chicken outside on the grill, and everything was very tasty.

One of the big parts of the evening was cooking the nsima, which is made from corn flour, and is rather like grits. They cook it in a pot on top of the stove, and it has to be stirred often in order not to be lumpy. They showed me how to do it, and I joined in the stirring — everyone got a kick out of that.

The whole menu was overseen by Godfrey, the manager and cook at the UNC Project’s guesthouse. He wore a chef’s jacket and hat, and really got into the role. He and I really had fun together.

We had many dishes with peanuts (they call them ground nuts) or peanut butter or peanut flour, plus chicken, fish, etc.

We also had a dish with little fish, like sardines, and even roasted termites!!

For dessert there was lots of fruit, including bananas, papayas, pineapple, etc.

Will and Jessica seemed to really get into it, and we all had a good time. It was a real team-building function.

This morning, we went to Bwaila Hospital, a local community hospital, where the UNC Project has major efforts.

We observed the ante-natal clinic education, with a large number, perhaps 100, women seated outside the clinic. We had a translator for us, so we could follow what was being said in Chichewa, the Malawian language. The talk was about pregnancy, HIV, family planning, etc. At the end they sang a song — using the call and response style, about HIV prevention. It was beautiful!

Then we toured Bwaila Hospital, much of which is 70 years old. We saw the work of the BAN Study, which the UNC Project operates. It is looking at the interrelationships of breastfeeding, anti-retrovirals and nutrition.

We also saw the labor and delivery area and the newborn nursery. For this pediatrician, this was one of the highlights of the entire trip! Some of the bassinets had two or even three newborns in them, due to the crowding of the facility.

The Kangaroo Care Unit was particularly interesting — where the mothers have the babies (less than 1500 grams or about 3.3 pounds) wrapped directly on their chest/abdomen continuously — thus the name.

I met Lisa Hyde, MD, an Australian-born physician who was trained in pediatrics at Johns Hopkins. She works on the BAN study at Bwaila Hospital, and provides major care for the children there.

In the lab, we saw malaria parasites under the microscope. We also walked by the TB ward and the psych ward.

Back at Kamuzu Central Hospital, we went to the former leprosarium, where the UNC Project has a state-of-the-art PCR (polymerase chain reaction) facility for detecting HIV DNA and RNA in patients blood. It is really impressive to see what dedicated staff can do out here under what must be trying conditions.

This afternoon I got a tour of KCH with Dr. Hadge Juma, the hospital director. I saw the children’s ward, which has, for example, one unit with ~40 beds in one open room.

We saw the surgery suite, the recovery room, the step-down unit and their four-chair dialysis center.

Then we went to the adult medical wards — and saw directly what the UNC Project is doing to improve care there, especially helping Malawian doctors get trained in internal medicine in South Africa, so that care can be improved — thus boosting the work of the UNC Project, and also benefiting the people here.

I am sure I will have more reflections soon — but this is enough for now. This has been an amazing experience.

Tomorrow we are off to Zambia for a couple of days in a game park — then home to Chapel Hill.


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