Karonga travels!

6/11

We left for karonga today.....and I mean just left. We were scheduled to leave at 8am, but it is now 1:30pm and we are just leaving. What a mess this morning was. We were picked up on time by this massive pink bus van and the driver and manager thought we were scheduled to go to the airport, not 12 hours north to karonga. After some debate and conversation they, the manager and driver of the subcontracted company that's driving us, told us that we would need a permit to drive to karonga. They then dropped us off at the grocery store to exchange money and buy some bottled water. We then sat there for 3 hours! They literally left us to go argue with the contractor for more money! Because they thought we were going to the airport, they had arranged for the trip to be shorter and cost less money. And the only reason we know that is because we called the contractor and they explained that the driver and manager were in their office arguing with them. And then, when they came back they tried to lie to us and tell us that it took that long to get the permit. Terrible business and professionalism. Finally we got on the way and picked up the abc students. We have so much stuff and 17 people! Ridiculous. We won't get to karonga until 1am probably, which will be very late, since many of us have been going to bed at 730pm! 

6/12
We finally arrived in Karonga very late last night (1:30am) after an exciting and long trip from Lilongwe. We were all very exhausted and quickly fell asleep in our rooms with our bug bevies and sleep sacks. 

We awoke to the lovely sound of the rooster early this morning and walked with tired bodies to breakfast where we were served eggs, toast, sausage, rice porridge, and tea. It was delicious! We then left the Safari Lodge Annex and traveled to Karonga hospital where we set up shop in a couple clinic rooms. Some of our group went to the Karonga school for the Deaf and tested many adults and some children from the school, who had heard about our visit. Those who stayed at the hospital had a very busy day testing many adults and children who had arrives in need of our services. Overall, the themes of the day was drainage and bilateral conductive hearing loss. For those audiologists reading this, you know that that meant many masking dilemmas and referrals for antibiotics. We worked diligently and were able to see all the patients who had arrived today, as well as fit several hearing aids. 

Although today was our hardest day so far, we had great learning experiences with difficult patients, middle ear pathologies, and infection control. We are excited for a good nights rest and full day tomorrow! 

6/13

Today was a much better day for everyone physically, but emotionally it was a taxing day for us all. We continued our work at the Karonga Hospital and Karonga School for the Deaf, and worked efficiently as a group. Each person on the team was flexible and made changes in their plans and organization as needed. We were able to see many more patients and fit many hearing aids.

It was an emotional day for most of us because of the severity of middle ear disease and other pathologies that we saw. Almost every patient we saw had drainage, pus, fungus, perforations, chokestatoma, otosclerosis, cysts, or other outer and middle ear pathologies that are easily treated and prevented in the United States. It is very difficult to observe and test these patients knowing that the treatment available is limited and surgical intervention is often not possible. 

Although it is difficult for us to see these patients, it is a fantastic opportunity for us as clinicians to learn from each other as well as work independently to help patients through the developing medical system in Malawi. It also allows us to see first hand many of the pathologies that we learn about in textbooks and lectures. Also, it gives our students a lot of practice with masking! :) 

After working hard until after the sun had set, our group congregated by lake Malawi with some of the teachers from the school to have dinner and debrief. We had delicious chombo (fish) fresh from the lake and enjoyed sharing moments from the day. We also celebrated Tiwa's (ABC student) birthday!

Everyone was asked to share why today was different from yeaterday and what made it good or bad. Here are some highlights from the day. 

"Today was different because I enjoyed the silence. It's amazing how many things you learn in silence, while observing others and learning from them" - Mwasoni 

"Today I saw a story come full circle. I was able to see a patient who was tested yesterday come back into the testing room thrilled with his new blue hearing aids!" - McBride

"Today I had my first nonorganic hearing loss patient, ever!" - Mandy

"Today was different because there is so much middle ear disease that's preventable. And that makes me angry" - Belus (choking back tears) 

"I saw a beautiful sunrise today and started my day off well. It was just a good day." - Laura