A Day in the Life of a Malawi Medical Clinic

What a Day! We saw 193 patients today due to a miscommunication.  The numbered tickets weren't confiscated so those thinking they were doing good added over 80 patients without the proper channels.
A lunch I heard we were up 150 patients, thinking we were almost finished triaging I found out we were up to 188.
To add to the already bludgeoning number a small boy with a temp of 104 showed up at the gate.  Then the clinic coordinator asked me to check a women sitting at the gate. She had  walked for 3 1/2 hours with a friend, stopping along the way to rest. She had a temperature of 102.5. The unfortunate diagnoses was that she was HIV positive, with a urinary tract infection, and malaria.  There was no way we could ask those to return on Monday, nor was there any way we could change what  already had been done.
It is not unusual  to add people to the initial number of given tickets, some are reserved for the sick that show up at the gate.  The late comers are to be screened instead of just being let in.  We operate on a first come first served basis, many are at the gate by 6 am and already have waited a long time to be seen. We have a long line of people waiting for us to open the gate and give them that precious number.

This is a day I will not forget.  It marks the highest number of patients see in one day. Interestingly, the number of patients seen in the Rafiki Medical clinics since about 2003 tops 44,000.  We have already seen over 600 here and we have 4 more days to go.  We start at 7:00 and try to end by 4:30 so our volunteers do not have to walk home in the dark.  There is a bus that gets them to the clinic from Mzuzu, but they walk to the bus. Today, we managed to finish about 5:30.

 The day was filled with sick individuals. Right before lunch a women came in carrying an 8 years old girl on her back. At first I thought it was a mentally disabled child.  The child had a temperature of 103 .  She had a ruptured appendix.  She was rushed to a nearby hospital.   Another  acutely ill women with Aids was sent to the hospital. There were 3 near term pregnant women that showed up, one was immediately send on to the hospital. We are not in the business of delivering babies.   There was an 5 year old orphan that was brought by his 8 year old brother  who was carrying a 3 year old sibling. The grandmother was also with them.  They are being screened for possible children for Rafiki.

What is really hard here is screening the really sick from those who are not so sick. They all look sick.
The eyes are sad, the children fearful.  It is hard to get them to smile. They just watch you with those big sad eyes.  So many of the people have vision problems.   We fortunately came with a lot of reading glasses.

The reality of the day hit when we sat down for dinner.  We were all very tired.  We can only believe that what we saw as a mistake was God's providence for many of the people.  Always faithful,  God carried us through a tough day.

 And ....... the moon was full!!!