Malawi Clinics

For the past ten weeks Blantyre has registered an increase of out-patients as well as inpatient in the health  facilities of the district. One would wonder why the increase since the rainy season is over where we have a lot of malaria cases but the increase is there because of the outbreak of measles. Again the other thing is that the first symptoms and signs of measles are the same of that of malaria i.e. high fever, headache, general body pain e.t.c. so the increase has been there because patients with measles come to the hospital more than once (first they may come with the first symptoms before the real rash appears then come after appearing of rash followed with third time when there are complications or non response to treatment.

But the good news is that treatment for measles complications  is available in all the facilities of Blantyre and the measles campaign to under five children will start on Wednesday 5th May 2010 (thanks to the Blantyre DHO and MSF for the help).

In a nut shell, measles present with rash (general symptom) with either the following cough, runny nose, conjunctivitis or red eyes, sore throat, high fever, headache or general body pain.

For those of you who have never seen a case of measles, come to Mpemba health centre, you will learn a lot about measles.If I had an opportunity, I would have taken some pictures of measles for you to see but my camera is missing (the real fact is that I don’t have any, sorry to myself).

Promise to give you more updates on measles in near future.

(Christopher Mlozowa, Mpemba H/Centre, Blantyre, Malawi)

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In April 2006 the World Health Organisation (WHO) published a new growth standard for children aged under 5. The charts are based on data from the US, Norway, Oman, Brazil, India and Ghana derived from measurements on children born at term to non smoking relatively affluent mothers, and predominatly breast fed for the first 6 months. Data from each country was remarkably similar.  Several countries, including Scotland, are now adopting the new charts. The charts include a premature birth section and ‘look up’ tools for assessing body mass index.  New charts can be downloaded (on a non commercial basis) via this link. Are the new WHO charts available in Malawi?

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Guidelines on Adult Cardio Pulmonary Resusitation (CPR) have been simplified once again.  The Adult Basic Life Support Algorithm is now as follow:

Unresponsive?

Shout for Help

Open airway

Not breathing normally?

Dial 911/999 or summon help with access to a defibrillator

30 chest compressions

2 rescue breaths

30 chest compressions

Is CPR training available for clinical officers, nurses and midwives in Malawi? Let’s discuss….

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The World Health Organisation (WHO) has recently published an update on the management of malaria. Click this link for more details. The key feature is the recommendation to test and confirm the presence of the malaria parasite before commencing treatment. New methods of detecting the parasite quickly now make this a realistic prospect in remote and rural clinics without access to laboratories. Shall we compare notes on access to testing in our clinics?

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The Centre for African Studies at the University of Edinburgh, Scotland is hosting an international conference on Information and Comunication Technologies (ICT) and the revolutionary effect this is having. A call for papers has been issued for the event on 22-23rd April 2010 .

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Ignacio Ponseti, the orthopaedic surgeon who championed modern methods for treating infantile club foot, has passed away, aged 95. The ‘Ponseti method’, widely used in Malawi, consists of applying a series casts to allow the developing infant foot to straighten as it grows and avoid the need for surgery. The technique was used in Malawi long before it gained acceptance in the more afluent west.

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In May 2010 Pam Wilson, Sam Riddell and Marion Foster from Scotland are visiting Malawi College of Health Sciences, Zomba Campus, to cement the collaboration between Scottish Practices and Malawian Clinics. During thier stay they hope to make goodwill visits to several clinics including Matawale, Zingwangwa and Ndirande.

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Vaccinating children in Africa and Mexico against one of the most common causes of diarrhoea – a germ called rotavirus – has been shown to cut cases of diarrhoea and reduce deaths from diarrhoea-related illness in children. Recent research has confirmed the potential of the new rotavirus vaccine.

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Men being principle decision makers in our society have very important roles to play in efforts to reduce maternal and neonatal mortality rate. However, our hospital setting seems to be unfriendly evidenced by very few men who attend antenatal clinic with their wives. This leaves them out of safe motherhood education.

To narrate the whole story, men are expected  to shoulder the responsibility to make sure that before a woman gets pregnant, the family should be ready with the following to mention but a few:

The decision maker to the wife’s family and the man as a father will not go away up to the time when the woman will deliver, offering support and care. This is to evade the situation whereby a woman delivers at home or on the way delayed by waiting for the husband to come and okay her going to the hospital. They should decide where the woman will deliver, prepare transport save enough money in case of emergency. He should also see that there is enough food to cater for the family’s nutritional needs; since the woman will need nutritious food for successful gestation period and puerperium.

They then should decide where they can get blood in case need be and prepare to go for HIV, VDRL, Hb tests beforehand. They should also discuss the family planning method they will use after delivery and their reproductive goals.

For this to materialize let us find men where they are and teach them. In this regard I call upon Policy Makers and all of us to make policies that ensure men are empowered to be in the forefront in this matter, and we all take pregnancy issues our issues too respectively.

To find men, we can forget their attending the clinics but use HAS’s, Peer Educators, Marriage Counselors, teachers, print and electronic media to teach the community about safe motherhood and reproductive goals. Emphasis should be if the family is unable to meet the above conditions to wait when they will be ready.

By D. Kalimbira

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Post partum haemorrhage is a leading cause of maternal death in Malawi. If available, Oxytocin can be injected after delivery of the baby to reduce the risk of haemorrhage. Oxytocin is injected intravenously, and thus requires venous access and skilled birth attendants. Misoprosol can be administered sublingually and thus could be given by birth attendants ina variety of environments. A recent trial published in the Lancet, based on work from Burkina Faso, Egypt, Turkey and Vietnam showed the two treatments to be equally effective. Has anyone experience of using sublingual Misoprostol in Malawi?

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