Zomba

Today we traveled to Zomba district hospital, located a hour and a half north of Blantyre. It is a bit difficult trying to find these places as the directions we're always given are very non-specific and there are no street signs. Zomba hospital has been around since colonial times and part of the buildings are over a hundred years old and quite amazing. We met Dzimbiri, the orthopaedic clinical officer and Robert Ayalla - a Ugandan orthopaedic surgeon that comes to the hospital once a week to operate. We advised on one surgery then had lunch and then went to see the patients on the wards. You think you've seen the worst of it and then you see more. This hospital is crowded with people and since there is a big push to teach the mothers how to properly breastfeed, there are breasts out everywhere!

I saw a few patients in clinic - one of which I admitted - a 5 month old girl that was brought in because her mother fell while carrying her and the baby hit her head. Her head is now swollen and she is crying alot. We got the xray and found she has a skull fracture. Her mother was checking her in when we eventually entered the peds wards. There are so many difficult problems that it's hard to know where to begin or what to do. Victoria (another OCO) took us to see a 9yr old boy that has an infection that has destoyed his entire femur and subsequently he has sustained two fractures in this femur such that the middle of the bone is just floating free. His leg is shortened and very swollen and draining pus. He's malnourished and of course he's in pain and scared. It's very hard to know what to do - he'll probably need an amputation in these conditions but it's hard to take off a little boys leg. We decided to do our best to get him over to the children's hospital in Blantyre and go from there. I covered him back up and was about to leave and Victoria asked us to see another boy just a few beds down. His leg is swolllen and shortened and when I looked at the xray I couldn't believe it. He has the same problem only he also has HIV. I just couldn't believe it.

We left the ward and walked to the car where we realized our battery was dead. I began pushing while Dr. Witschi steered. Quickly a few men joined in and we built up speed and Dr. Witschi threw it into gear and got it going. Some bystanders laughed at us which made me laugh too. I thanked the men and jumped into the car and off we went.

Zomba plateau is located high in the mountains and is reached via a winding road made for the transporting lumber. The top of the mountain is covered by a heavy mist. We drove past a few rockslides, a small waterfall, and a damn then slipped off into the mist. We just now found our lodge and I am anxious to get some sleep.

Tomorrow we head further north to Manchini distict hospital in Liwonde, Hippo country.