A letter from Sue Makin in Malawi

January 27, 2007

This Saturday morning

Friends,

Can you imagine a 33-year-old American woman who by the light of a kerosene lamp gives birth at home to her seventh baby, assisted only by her mother, and then walks the next morning seven miles to the hospital carrying her newborn baby and asks for a bilateral tubal ligation so she can stop having any more babies?

Not in America, you might say. But this is what happened this Saturday morning in Mulanje. I was making rounds in our maternity ward when I met this remarkable woman. We were happy to comply with her request. I escorted her to the operating room. We had no nurse, but we had two ward attendants who are experienced and capable. One assisted me with the surgery under local anesthesia. The other one talked to the patient to help her feel relaxed during the procedure. The small operation took about 20 minutes. Then she walked back to the ward to rest a while before walking back home later in the day.

This procedure is offered for free to any mother who requests it. The suture for the surgery was donated by Global Links, a non-profit organization in Pittsburgh, which supplies free suture to charity hospitals. The money to run the sterilizer to have sterile supplies and the local anesthesia comes from well wishers all over the world that support Mulanje Mission Hospital.

Just as I was writing the previous paragraphs, a small truck pulled up in my yard with a 33-year-old woman with severe pain in the right upper leg for six weeks. She is deaf and works at a school for the deaf 30 miles from here. Her headmaster brought her. She has been to three health facilities on five different occasions since the first of December with lower abdominal pain and leg pain. No one examined her properly or made the correct diagnosis. She has advanced cervical cancer, which is inoperable. I will be trying to arrange for her to go with government funds to South Africa for radiation therapy. If that cannot be arranged, we will offer her palliative care to try to relieve the severe pain she is experiencing as this terrible tumor invades the nerves in her right leg.

As many of you already know, we are engaged in promoting and disseminating a cervical cancer-prevention program in Malawi that involves visual inspection of the cervix with vinegar and offering cryotherapy to women who are found to have small areas on the cervix that could become cancer in ten to twenty years. The program is five years old and going strong. Very little money needs to be spent to keep the screening going, once the providers of the service are trained. The training is expensive and time consuming.

Next week I will be traveling to Roi Et, Thailand, to participate in a five-day program to train trainers to provide this lifesaving screening procedure for women in Malawi.

Grace and peace to all of you,

Sue Makin