Malamulo: God's Outpost
News From Malamulo Hospital
By Adrienne James and Sandy Mattison
Malamulo Hospital was founded in 1908 by the Seventh-day Adventist Church and is located in the rural southern area of Malawi known for its many tea estates. Some patients work as tea field workers making only $1.15 for each day of labor. Because of its location and the indigent population that Malamulo Hospital serves, it is difficult for the facility to remain self-sustaining. Serving approximately 6,000 individuals per month through the 220-bed main hospital and clinics, Malamulo Hospital also provides care to surrounding rural villages by sending out health-care workers who conduct health education, satellite clinics, and childhood vaccinations. It also has an associated clinical officer school. Recently the two of us, longtime friends, made a short-term mission trip to the hospital.
Drs. James and Mattison
“Our trip was about a journey that began 12 years ago when we left our childhood homes in Nebraska and Connecticut for college at Andrews University. There we shared four memorable years as roommates in Lamson Hall, the women’s residence quarters. Later, with our biology degrees in hand, we headed off to medical schools in different regions of the country. Now, eight years later, we are reminded why we started our own journey to medical ministry many years ago.
“We could not know, however, that even as we were flying into Lilongwe, Malawi’s usually peaceful capital, the city was being battered by protests that had overrun the nation. We arrived to meet closed stores and no public transportation. There would be no bus to take us on the five-hour trip to Malamulo Hospital. But God had alternative plans for us. In His perfect timing, an Adventist man in Lilongwe on business was heading back to Malamulo the following day. Our expected five-hour bus ride introduction to the local community instead became a smooth, private ride to our destination, in company of our new Adventist friend, Elde Paladar. God is so good.”
At the Hospital With Dr. James
“The day begins with hospital morning worship. I welcome the change from work routines back home. I particularly enjoy songs in the native language of Chichewa. After our departmental meeting, our medicine rounds begin. Every room in the ward has rows of beds, each covered by mosquito nets. The floors are frequently mopped to remove the persistent red dust tracked in from the dirt roads, likely because many patients are barefoot. I am especially blessed by the inquisitive nature and excitement of my clinical officer students. They are eager to learn, which is wonderfully refreshing to me and fuels my passion for our patients.
The resilience of these patients and their families inspires me. Many of them walk for miles to seek medical care. In most cases devoted family members or guardians remain at the bedside of their loved ones and assist with basic care. With a life expectancy of only 41 years in Malawi, many patients suffer from a host of tropical illnesses, such as tuberculosis, meningitis, and malaria. My work in Washington, D.C., with one of the highest U.S. rates of HIV, makes me all too familiar with the complications of HIV that many here exhibit. Because of the challenges to health-care access, patients seem that much more grateful for the care provided at Malamulo.”
With Dr. Mattison
“I am spending most of my time on the maternity ward. While the rest of the hospital’s patient population swells with malaria season and lessens with the dry season, the maternity ward is nearly full year-round, serving 25-40 patients at any given time. The maternity ward averages four to seven births per day. Staff includes two nurse- midwives, sometimes with the help of a clinical officer (U.S. equivalent of physician’s assistant) and an on-call physician. In the maternity ward there is care for all antepartum (prior to birth), labor, delivery, and postpartum patients and their babies. The two nurse-midwives are also responsible for the care of a special room dedicated to premature infants and their mothers. In a maternity ward in the U.S. at least a half dozen nurses and an equal number of nursing assistants (in addition to midwives, residents, and physicians) would be doing this work.
“Pregnant patients who experience lower abdominal pain and backache are invited to stay in the hospital for hours, days, or weeks, awaiting labor, as many have walked great distances to reach this haven. The delivery suites are made up of three tall beds covered in black vinyl separated by cloth curtains. Wheelchairs aren’t available, and women in labor are required to climb stairs to lie down where they labor. Once they give birth, they descend the stairs, shower themselves, and shuffle down to the postpartum ward. Their strength and resilience is amazing. We lose six premature infants during our short stay. At least two in six women have HIV. Thankfully, medications to reduce mother-to-child transmission of HIV are available to the patients through a special clinic and governmental program. I learn too that all postpartum tubal ligations are done here under local anesthetic instead of using spinal anesthesia, as is done in the U.S. This lowers the price and encourages family planning.”
“At Malamulo we are blessed with wonderful weather until one day prior to our departure, when it rains for two days, with only shy appearances from the sun. On the evening of our departure the rains clear as we start our bus ride across the Malawi countryside. The sun bursts through, and I am surprised to discover vast mountains and foothills previously hidden by dust and biomass fuel smoke. Before the rains I saw a beautiful countryside with foothills here and there, but the rains unveil a crisp, expansive, mountainous landscape. It’s a memory that I never would have experienced without the prelude of rain. I think to myself: That’s how it is with our Savior, taking us through the downpours of life only to bless us with expansive landscapes we hadn’t even imagined were there, previously hidden from view.”
“Malamulo is doing great things on an incredibly small budget, caring for patients who are unable to pay for the services they receive. I praise God for the national and foreign medical personnel that give freely and sacrificially of themselves to these patients’ care.”
Dr. Adrienne James practices internal medicine in the Washington, D.C., area. Dr. Sandy Mattison is an ob/gyn in Pennsylvania, U.S.A.