I first agreed to the medical mission trip this spring during our Nurse Practitioner white coat ceremony at Xavier. As far as I knew at that time, we were treating Malawian patients at four remote clinics who would normally not receive any form of healthcare. In the trip information it mentioned unfathomable volumes, extremely ill patients, and needed resources that were not readily available. I had my sight on a mission trip for quite some time, and this seemed like an appropriate scenario given my background working as an ER nurse and Trauma Program Manager for a busy rural hospital.
Set up and necessary preparations felt overwhelming as myself and other healthcare providers recognized a long list of drugs that we do not typically utilize in the United States, along with ones we did not have with us. Of course, we not only had to have a crash course on prescribing these foreign medications, we had to be able to recognize diseases such as Malaria, Shistosomiasis, and my favorite, gastrointestinal “worms”! It was quickly notable that the several veteran staff working with us have been experienced who guided us through the learning process, especially Lucy Goeke who was extremely knowledgeable and just a fantastic teacher.
I was assigned as a provider (or prescriber here) to the Nkumbira clinic, and the clinic days were very busy and could almost be recognized as slightly overwhelming most of the time. Throughout the three days we evaluated, treated, and provided medications to over 4,500 patient’s. The Malawi culture is one of dignity, respect, and civil fortitude. Well over a hundred patients were patiently waiting outside for us every morning with their medical passport- the only form of their medical record in their hands to openly share with strange providers. Not at any time were the patients disrespectful, have a sense of entitlement, nor demand any form of treatments and/or medications. Even though we were working under extreme pressure with providers we never seen before, each and every person walked into the clinic with the same goal to help make a difference in complete strangers’ lives, no matter how small.
The goal of the clinics is to do the most good for the most amount of people with limited resources. It was quite evident that a simple referral to the hospital was almost impossible for most, therefore all but life threatening cases needed handled in the one room clinic which did not have electricity nor running water. I will remember many cases forever, including those with a poor prognosis- knowing the feeling that some would not survive even with our best efforts will be there. The feeling of having to cut away dead tissue, make incisions and drain wounds without lidocaine or anesthesia just knowing that it has to be done to give patients a chance at beating infections. Finding recurrent Malaria in a child who’s spleen was so large it consumed a third of her abdomen, and feeling responsible to make the appropriate decisions in their care again to give them their best chance. Providing medications and draining infection from a foot to a child who could not walk due to the infection, having him return the next two days of clinic to see him walk again the last day. Seeing the comfort, joy and shear appreciation in the patients eyes each day made everything we did as a team made me feel overwhelmingly humble.
A quick shoutout should also be sent to Liz (Executive Director of VIP), Jordan (Liz’s daughter and extremely talented leader), and Lucy (Medical Team Leader and organizer) as none of the amazing work we completed as a team would have been remotely possible without you!