Help Support Medical Officers in Training in Malawi

Project Malawi

Goal: Dealing with the problem of the lack of trained medical professionals in Malawi.

Our goal is to facilitate the training of local people within their country.  

100% of donations go to the student support program. This makes use of their:

• Command of the local languages eliminating the need for interpreters 
• Intimate knowledge of local customs and ability to deal with them positively 
• Family and social relationships to encourage them to remain in their country

About Us

Medica XXI is a non-governmental, not for profit organization formed to address healthcare challenges within culturally appropriate paradigms. It is an organization that believes in the power of what can be done on a local level to improve life for the whole.

The board consists of Chairman Georgia O. Denman; Senior Medical Advisor Dr. John W. Denman; President Dr. Britta L. Denman; and Secretary/Public Relations Manager Caitrin L. Bayard.  Elizabeth L. McGee provides design assistance and Noel Jones is the Website designer/manager.

While in Internal Medicine Residency at the University of Iowa, Britta L. Denman, D O completed a two month International Health rotation in Malawi.  There she encountered many intelligent, competent and motivated healthcare providers who wanted to further their education.  However, the financial aspect of attending school is virtually insurmountable for many people.  Therefore, Medica XXI was created to address assisting culturally native people of any nation to attend healthcare education programs within their own countries, commencing with Malawi

Chairman of the Board, Georgia Denman has always had an interest in International Relations and access to healthcare.  She has a Bachelor’s degree from Drew University in Political Science, with a minor in Economics; a Master’s Degree, plus the course work for a PhD from Temple University in International Relations and Comparative Government, with additional fields of American Politics and Public Administration; and a Master's degree in Hospital and Health Administration from the University of Iowa, with a special interest in access to healthcare and International Health.

John W. Denman, D O has practiced Internal Medicine and Emergency Medicine for many years.  He has Administrative roles in Practice Management and a keen interest in access to health care and rural healthcare delivery and design of healthcare facilities.

Caitrin L. Bayard has a degree in Sociology from The University of Massachusetts, Boston with minors in Psychology and African-American Studies.  She has practiced as a caregiver and as a Social Worker in predominantly major urban locations.  She has a special interest in Alcohol and Drug Addictions programs and access to care.

We appreciate your interest and support of our projects.  We welcome comments or suggestions to improve the projects and our website. Thank you very much.

Yewo chomene [Tumbuka].  Asante sana [Yao].

A Message from Our President

The barriers to medical care often present in developing nations were the motivation for me to begin medicine training.  Initially, I imagined full time practice of clinical medicine in different countries around the world.

As part of my third year of Internal Medicine residency, I was afforded the opportunity to travel to Nkhoma, Malawi for a two month international health elective. The experience provided both in and outpatient opportunities. Inherent in the experience was the exposure to and occasion to manage diseases not often seen in traditional training in the United States. Malaria, Tuberculosis, Schistosomiasis, and HIV were the predominate diagnoses. Learning to manage these diseases was challenging and rewarding. This was the culmination of my professional aspiration and personally satisfying to practice medicine in this setting. 

During my elective I met several young men working as clinical assistants and clinical officers. These gentlemen were bright, motivated, clinically skilled, and had an impressive intellectual approach to the diagnosis of their patients.  They were sincerely interested in the discipline of medicine and the care of their patients.  In many situations, being culturally native was integral in how they assisted me in patient care.  By translating with a proper sense of colloquialisms and an understanding of cultural norms with which I was unfamiliar, patient care was enhanced.  The success of my practice of medicine there was inextricably bound to their support. 

Further discussion revealed they would like to attend medical school.  However, the cost was prohibitive. I began to contemplate the opportunity medical education would give them individually and hopefully create a ripple effect in their community.  By educating individuals who will provide culturally native care, traditional barriers to care would be removed.  Translating and interpretation of cultural norms would no longer interfere with the practice of medicine.  In addition, from a fundamental perspective, education of individual members of a community advances the opportunities and fortunes of that community as a whole.

We agreed if they were accepted to school that I would arrange the payment.  Such is the evolution of Medica XXI and a new focus in my approach to International Health.  While practicing over seas is personally and professionally fulfilling for me, it could easily be asserted that patients derive a greater benefit in a direct sense from care provided by a member of their own community.  The foundation of Medica XXI is that through a grass roots approach to education of members of a community or citizens of a country, the public health concerns can be resolved in a manner that is in accord with the needs and practices of the community or country as a whole.

The concept of Medica XXI is to continue to fund individual people’s education with the hope of resolving the myriad of medical and public health problems frequently obstructive to care in developing nations. 

I look forward to seeing the growth of these individuals in their medical career, with the hope to sponsor several individuals each year.

Global Healthcare for the 21st Century

In an increasingly globally interconnected world, awareness of diseases and the status of healthcare in other countries are imperative for a holistic approach to the practice of medicine.  Social responsibility in such a global community necessitates understanding the healthcare needs of populations in all countries.

Medica XXI is a nongovernmental, not for profit organization formed to address healthcare challenges within culturally appropriate paradigms. It is an organization that believes in the power of what can be done on a local level to improve life for the whole.

Due to the fact that Malawi is one of the nations of the world most in need of intervention, it is where Medica XXI is first shining attention to what we as individuals can do to improve the country’s healthcare, infrastructure and its economy.

Background and Rationale

Malawi is a beautiful southern African country with one of the world’s most impoverished populations.  Despite recent global media attention, little has been achieved in measurable change in desperate situations.  With a reported population of 13,013,926 and an estimated 2005 Gross Domestic Product (GDP) per capita of $600.00, Malawi faces many difficulties. 

One of the most significant crises occurring is that of access to healthcare.  It is reported that the doctor per 1000 patients is 0.02, with 266 doctors in WHO statistics from 2002.

The lack of physicians is a critical concern as Infectious Diseases, particularly Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Malaria continue to ravage the population. 

UNAIDS estimates in 2005 940,000 people were living with HIV/AIDS with an HIV/AIDS prevalence rate of 14.1%.  The World Health Organization (WHO) number of people in Malawi with TB in 2004 was reported as 63,159 and the number of new cases 52,042.  Malaria cases in 2002 were reported at 2,853,317, with the number of attributed deaths at 6.993.

In addition, public health concerns such as a dearth of easily accessible potable water and malnutrition require attention from healthcare providers, in part due to the obvious direct impact and additionally poor water and malnutrition complicating previously mentioned disease processes.

Further challenges to Malawi’s healthcare system relate to the relatively small number of culturally native physicians and physician extenders.  Cultural nuances often significantly impact the direction to diagnosis, implementation of a treatment plan, and provider:patient rapport.  Additionally, providers who are not fluent in Chichewa (Malawi’s most prominent native language) face further obstacles to these aspects of care.  Translator facilitated conversations are often inherently convoluted, with increased opportunities to err.  Requiring a translator can inhibit the open communication between a patient and provider due to embarrassment on the part of the patient.  There is also a significant burden of an overuse of the valuable social resource of bilingual people.  These individuals are in high demand for other projects for social advancement.  Liberating them to participate in other projects will benefit many sectors of Malawian culture.



Goals and Objectives

Increased access to culturally sensitive healthcare is the primary goal of Medica XXI. 

The tuition, books, living expenses, etc. present an overwhelming obstacle to healthcare educations for most Malawians. 

Through financial support to culturally native Malawian students, the number of physicians and physician extenders could dramatically rise. 

The subsequent improvement in healthcare delivery would be difficult to measure, though has the potential for exponential impact on the population served.

Empowering culturally native Malawians with the opportunities for healthcare education will allow for self determination of the direction of healthcare delivery and public health initiatives, while keeping the funds spent in the local economy.

 

How Medica XXI Helps

Individuals interested in pursuing healthcare education, particularly clinical officer school and medical school are encouraged to apply to the programs of choice.  Letters of acceptance to the school and a request for support will be provided by the applicants.  The request for support will detail their interest in healthcare practice and their future plans.

The officers and members of Medica XXI will review the applications for legitimacy.  Upon determination of sponsorship, funds will be transferred directly to the school.  The financial officer of the school will then apply the funds to the student’s tuition and associated fees. Payment toward living expenses such as transportation, food and housing will go to either the student directly on a monthly basis or to the school for monthly dispersion to the student.

Biannual onsite visits will be conducted by Officers of Medica XXI or their designated in country representatives to assure appropriate application of funds.  Also, visits will provide an opportunity to meet with the students and school officials, and also to interview future candidates to sponsor.



Meet the Students

A profile of each candidate will be posted on the website for Medica XXI.  The students being supported will periodically submit reports of their progress in classes, cases that have shaped their education, and unique issues of healthcare delivery that they confront during their training.  Also, plans for their medical practice in Malawi will be listed in their profile.

Of four candidates identified so far, three are now in pre-medical studies.

Asani Lida will attend medical school at Mzuzu UniversityMzuzuMalawi.

Joseph Chilewani will attend medical school at Mzuzu UniversityMzuzuMalawi.

Savello Kafwafwa has joined the program and is studying at  Kilimanjaro Christian Medical Center.  Here's a recent note from Savello about some of his recent experiences.

Mzuzu is in the Northern part of Malawi.  It is often referred to as the Capital of the North. Mzuzu is a major stopping point on the North-South travel route and has the usual facilities of a larger town banks, supermarkets, restaurants, hotels, pharmacies and gas (petrol) stations.

A link to the Mzuzu University website is provided here for your interest.

The Kiliminjaro Christian Medical Center  website.

 



 

How your financial support assists the students and their country.

While the cost of tuition, books, living expenses, etc. present an overwhelming obstacle to healthcare educations for most Malawians, the investment of our dollars pooled together provide an incalculable value for the people of Malawi and other nations that Medica XXI eventually will aid. 

The course of study for these young men will run two years.  In each academic year the costs they will incur are:

Tuition fee:  K 150,000 (One Hundred and Fifty Thousand Kwacha)

Registration and administration fee:  K 5,000 (Five Thousand Kwacha)

Medical fee:  K 12,000 (Twelve Thousand Kwacha)

Student fee:  K 100 (One Hundred Kwacha)

Coation fee:  K 1,000 (One Thousand Kwacha)

At the current exchange rate ($US1.00: 140.61K) this amount is roughly $US 1,200.00 per year.  This is quite a financial difference to train Malawian physicians in their own country. This also allows them to be treating patients at home while they are in training; keeps them near their families; and contributing to their own economy.  This is a winning situation all the way around.

As non-resident students at the University, they also require support for housing, food and transportation, and also for stationary which is a very expensive item in Malawi.  We plan on equaling their lost wages as Clinical Officers of approximately $200.00 per month for support of these items.

No administrative funds are taken out of your donation.

You can donate towards the cost of a specific item for each of the young people, or as a one time donation.  Any amount is appreciated and goes 100% towards the costs of training and support for these students, and to identifying other worthy prospective physicians or towards other worthwhile ancillary projects that fit Medica XXI’'s mandate of supporting Global Healthcare for the 21st century. 

 All administrative costs are covered by The Denman Family.


 

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The Brain Drain

A note from Savello 

dear brit,
hope all is well with you there, but really i have missed you. i was a bit quite because i was at Malingunde Health Centre for the past ten weeks. i came back yesterday.
i was asked to work there temporarily to take care of some of the challanges there. i should here admit that what i saw there was really unbelievable.
i found the health center without running water, the pit latrines were filled to the brim, the toilets drainage/sewege system was completely blocked, one nurse on duty working day and night against an average delivery of 85 babies per month, the guardians using an old demolished building as their bathroom, the pharmacy had been abandoned and drugs were being stored in a large wooden box, everything just looked completely messed up, it was worthy running away from the situation but i decided to confront the task head on, i had to pray and work with determination. iam glad to tell you that during the ten of my stay water has been re-installed, the drainage system rehabilitated, three new pit latrines and three guardians bathrooms constructed e.t.c... still more work needs to be done but i could nolonger be there as i had to prepare my school departure, it was an adventure truly.

note from savelo


hope all is well with you there, but really i have missed you. i was a bit quite because i was at Malingunde Health Centre for the past ten weeks. i came back yesterday.
i was asked to work there temporarily to take care of some of the challanges there. i should here admit that what i saw there was really unbelievable.
i found the health center without running water, the pit latrines were filled to the brim, the toilets drainage/sewege system was completely blocked, one nurse on duty working day and night against an average delivery of 85 babies per month, the guardians using an old demolished building as their bathroom, the pharmacy had been abandoned and drugs were being stored in a large wooden box, everything just looked completely messed up, it was worthy running away from the situation but i decided to confront the task head on, i had to pray and work with determination. iam glad to tell you that during the ten of my stay water has been re-installed, the drainage system rehabilitated, three new pit latrines and three guardians bathrooms constructed e.t.c... still more work needs to be done but i could no longer be there as i had to prepare my school departure, it was an adventure truly.



Dear Britta,

i want to let you know that iam now into the program and fully settled now.
 
this an interesting place and is full of students much far from what i had imaginened. the college is having about 14 other allied courses. we are 40 in our programme though the other 4 have not yet reported. imagine i happen to be amongst the youngest in the whole class so far because most of my collegues have worked for more than 10 years.. other have even a 20 year working experience, this just shows how hard it is to get this oppotunities.
 
the campus is much closer to mount Kilimanjaro, the nearest mountain ranges streching to the pick are as near as 7 km from here. we are always looking at mountain with its snow capped top on every clear day. the weather is cool not much different from that of Nkhoma though i hear that its extremely cold especially during the months of June and July.

The Hospital is big and a referral centre for most cases. has departments such as Urology, with dialysis being done and has a Cardiology department with a local Cardiac Surgeon, some minor heart surgeries are done.. the construction of the more complex center still in progress.
 
they are alot of western students doing their attachments. most of the lecturers in the allied programmes are from U.S and Europe. most of the projects at the hospital are supported by the westerners, missioneries, just like in Nkhoma. The cases so far more similar to the Malawian pattern.
 
We are currently only 4 foreign students who have managed to enroll out of the expected ten. we are given our own fully furnished kitchen where it is intended that we should feel free to prepare our traditional meals. iam in a company of two Zambians and a Cameroonian. we have just followed the old trend whereby the cooking is done together since our foods are similar and their is an old cook whom the students themselves pay out of their stipend, but the Cameroonian prepares his own FUFU dishes. We are given a room each, but the indiginous students share. this is part of the accomodation charges on the tuiton fees. but the food we source on our own and that is part of  the stipend they mentioned on the admmision letter, so as they estimated it to be at 180 $US per month is really almost exact. all the other payments were settlled until next school year in october 2010 for the final tuition fee payment.
 
we will be doing the basic sciences for the next 8 weeks then we will be going to the hospital in the morning then classes in the afternoon until the end of our course in 2011.
 
Once again iam so thankful for the support and this great priviledge that you have given me that i study at this magnificent learning institution..

i wish you all the Godly Blessings in all your activities.
 
yours
   savel.

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