April 2007

Dear Friends,

Barbara Nagy speaks with a volunteer outside of Nkhoma Hospital.

Greetings from Malawi. We are still having major problems with phones, mail, and computers. Perhaps we will soon be back in the age where the missionary’s letter took a year or so to arrive! I had an opportunity to read some of David Livingston’s correspondence to his family recently—nearly translucent pages preserved between glass plates—and was impressed by what a wonderful writer he was. As he described arriving on the east coast of Africa in a terrific storm you could all but feel wet and taste salt. So, I have inspiration for improvement.

We want to give heartfelt thanks, hugs, and many words of appreciation to all who sent us greetings and gifts at Christmas. Your financial gifts have kept Nkhoma Hospital going through a very difficult time, with few interrupted services. Because I invited people to “support Nkhoma Hospital for a day,” I am sending the following summary of a typical day to give you an idea of our activities:

Morning report starts at 7:00 a.m. as the night team of three nurses signs out admissions and problems for patients in 220 beds. There are 27 patients on the female ward, 19 patients on the male ward, 93 patients on the children’s ward, 28 on the maternity ward (including eight deliveries from the previous night, three referred from health centers due to complicated labor and one emergency cesarean section), 7 patients on the tuberculosis ward, 6 patients on the private ward, and 23 patients on the surgical ward. A smattering of outpatients stay overnight in the hospital because they are waiting for tests or treatments and live too far from the hospital to travel back and forth.

They have done eight blood transfusions and prepared eleven patients for surgery, including six tubal ligations, surgeries for breast cancer and cervical cancer, a hernia repair, a laryngoscopy, and a prostatectomy. The eye department has done 35 procedures including 16 cataracts. We will see 102 outpatients, do 14 regular x-rays and 12 ultrasounds, send 86 patients for lab tests and 13 for HIV testing. The HIV clinic will see 15 patients on antiretroviral therapy, including three new patients.

There are six kids throughout the hospital on oxygen, courtesy of lifesaving gifts from Presbytery of Western North Carolina and others.

The orphan project will distribute soy porridge bags to 235 orphans in two village centers. The nutrition center has 11 children resident for supervised feeding and education of their parents to prevent recurrences. This and the children’s ward census are much lower than normal due to the good harvest last year. Medicines and surgical supplies are collected for two health centers, which will be visited the following day for supervision and support.

There are four visiting medical students from abroad, and five visiting nursing students. One of the medical students has brought individual handscrub containers as part of our collaborative project to reduce maternal and neonatal mortality, and everyone involved in direct patient care will get a bottle plus instructions about handwashing. We will give the hospital a weekly score for handwashing while hopefully seeing our puerperal and neonatal sepsis statistics decline. (Scores for the first three weeks: 2 percent, 48 percent, 76 percent, and nearly 100 percent of staff showing up in the morning with their waterless handwash.)

Antenatal clinic will see 70 patients, screening for high risk pregnancies to refer to the hospital for delivery, doing preventive care like malaria prophylaxis, and offering free HIV testing with follow-up medications for moms testing positive, to prevent mother-to-child transmission of HIV at childbirth.

Health surveillance officers will conduct outreach clinics to give children under 5 vaccinations, health talks, and do screening for malnutrition. Mosquito nets will be purchased for free distribution to children admitted with malaria.

A strategic planning group is meeting to facilitate doubling the size of the nursing school to address the severe nursing shortages throughout the country.

Two visitors from Scotland are doing a field study of the impact of mission hospitals in Malawi to assist with a joint capacity building grant. I hope this gives you an idea of what happens on a day-to-day basis. We are so grateful for the gifts you have sent that allow these services to go on.

Blessings to you all, and tsalani bwino! (Stay well)

Barbara and girls

The 2007 Mission Yearbook for Prayer & Study, p. 337

Donations for Nkhoma Hospital in 2007

• Volutrols for pediatrics
• Small gauge IV catheters (20-24 gauge) and plugs for them (to convert into heplocks)
• Surgical handles for the sinks (lazy L-shaped faucets that can be turned on using the elbow—the size doesn’t matter; they will be adapted to fit in Malawi)
• Reusable IV armboards for newborns or infants
• Oxygen tubing, particularly sized for smaller children
• Full sets of high quality (Tyco) blood pressure cuffs, including sizes for children
• Any type of burn dressings
• Electronic thermometers (centigrade, not Fahrenheit)
• Gauze and bandages
• Spinal needles
• Hand held inhalers for asthma meds

Medicines

• Any antibiotic, especially Rocephin and the fluoroquinolones
• Any antibiotics suitable for children, particularly powdered so that they can be mixed into liquid, especially zithromax, biaxin, and any diflucan; erythromycin; doxycycline)
• Inhaled asthma medicine
• Children’s chewable Tylenol and pediatric formulations of ibuprofen
• Silvadine type ointment to put on burns 

General

• Any children’s physical therapy equipment
• Inexpensive calculators
• Heavy-duty household gloves

We cannot take anything except what is on the list. If you have something else that you think might be useful, please email me at banagy@malawi.net and copy Ginnie Stevens at vestevens2@aol.com. Please give the Presbytery of Western North Carolina office an inventory of the contributions you have. (Malawi Meds, Presbytery of Western North Carolina, 114 Silver Creek Rd., Morganton, NC 28655.)