Day 8, The surreal life

We gathered at 9 AM with the head of the dental department to head over to KCH’s pediatric oncology ward. She’s a dentist who is pursuing public health training through a school in South Africa, and as part of her research she’s performing work with Burkitt’s lymphoma patients. Burkitt’s lymphoma is a cancer associated with the combination of Epstein-Barr virus (the virus associated with mono) and malaria (amongst other things). It affects the oral and abdominal cavities in particular. You can see what it looks like with a quick google search, but I’ll warn you that it’s not pretty.

The cancer ward itself is probably a lot like you’d expect. Eight beds are in each “ward” of a four-ward open air room. The rooms are painted hospital green, and the only privacy available is a two-panel portable screen. A playground in the adjacent quad is painted with images of African animals, many of which are extinct in Malawi due to deforestation. A school is present for those who have extended stays. Many have been referred to KCH from distant locations, and some will stay at KCH during the months and weeks treatment is provided.

We began rounding with Dr. Mlotha, who was checking up on some previous patients and screening some new ones. We started with a little boy of no more than five years, who had a recurrent lesion on the skin below his jaw. After we left, he played with his infant sister, who his mother held in her arms. It was all downhill from there. A two year old with liver cancer. A seven year old with lymphoma spread to the eye socket and lymph nodes of the neck. Another liver. I won’t go on and on about it, but it was a challenging experience.

After making the rounds, we returned to the regular hospital dental clinic, where we set up shop in the extraction area. I did a few anesthetizations, extracted a few teeth, and got to talk with the dentists in the operatories. We broke for lunch, and then returned and did a few more rounds in the clinic. The pace in the hospital clinic in the afternoon is less hectic, but we got to see some more interesting cases in the surgery clinic: a child with trauma to the front teeth, complete with broken jaw; a man with a mandible broken vertically down the ramus; a woman who would be seen for an excisional biopsy of a probable fibroma. The variations seen in the surgery clinic are really remarkable.

The hours that followed will remain, I hope, the most surreal since my arrival in Africa. The former manager of the guest house, who I’ll call Steve for the sake of anonymity, is a currently serving member of the Malawi Parliament. He took us to dinner at a private club in town. I simply can’t recant the particulars here, but the next time you see me ask me to describe it for you. Steve was very nice to take us out, and I’ll leave it at that.

Tomorrow’s day will be spent at Baylor University’s HIV/AIDS clinic, so I’m sure I’ll have more to write about tomorrow.

PS – No pictures today, as I can’t get my SD card to read on my computer. Tomorrow I’ll borrow a cable and get them in, and edit the blog. The sunset tonight was particularly spectacular, as was the tiny gecko which lives in one of the rooms of the guest house.