Reserapport - utresande lärare
Lärosäte: University of Malawi
Utbildningsprogram: Läkare
Utbytesprogram: INK
Termin: Vårtermin 16/17
Antal dagar: 21
Namn: peter Berg
E-postadress: peter.berg@karolinska.se

Boende

I booked trough Booking.com my Lodge stay in Blantyre and that was good it was the offer of the day. I payed 30-40 dollars/day but got nice breakfast, you could dine there and there was a pool. One can find much cheaper places but in Blantyre lodging for visitors can be expensive if you don´t look up.They have modern fast eating places and nice beer for cheap prices from our Point of wiev and if you eat in local places it is real cheap. You get bored on chicken and the meet is chewy.

 I stay there all the different times in Malawi without getting stomach problems. When you travel in other parts of the country you don´t have to prebook but in the National parks it is expensive. one can stay outside. At Lake Malawi you can stay cheaper and they have an Irish driven hospital there Cape Maclear clinic, which you can visit. You can travel around by bike or local buses which are cheap in the country. It is all up to you how much you spend my 20 years old daughter was there for 3 months and spent around 8000 Sv kr.

Språk och kultur

English. The students English were excellent. It is a peaceful country but with great differences in economic situation, which even was obvious among the students and doctors. The salery is low for doctors but around 3 -4 times over medium income. There was a privat hospital in Blantyre where the rich people Went and payed for treatment.  I visited that clinic but many patients also Went to South Africa and bought the medicin they could not get in Malawi. Many drugs was also imported from India.  I also went to a small private clinic with wealthy patients with problems sometime of partly cosmetic caracter. The Health care is free but drugs can be expensive and many lacks the money.

Fritid

I had my doctor as a free guest most of the late dinners as well as all the lunches. Otherwise we worked. During weekends you can go to bars and make trips in the country. One can just look for Malawi on the net. One Swedish travel Agency have just started exclusive safaris in Malawi which is very expensive. You can just go around to the Zomba Mountains. Hiking in teeplantations and the Mulanje Mountains. Lake Malawi and the islands are extreamly beatiful and go bathing and the National parks have great amounts of animals, like baby rhinoceros, elephants, hippottamus and so on.

Övrigt

I have the privilige to travel a lot. Still I will go back to Malawi in a combination with my promise to come back to the hospital as well as staying there a litle bit longer to go around in the country with my family and maybe friend and doctors. This country have a lot of alternatives and opertunities.

Annan verksamhet

There is a specialist in dermatology who is very engaged in the education and clinics. He has been collaborating with others concerning other small Projects. He has a great amount of albinism patients in need for support and the patients are very willing to be engaged in Projects. There is of course a lack of Money and sometines the working situation is hard. I have looked at other studies and presented posters from the hospital on epidermal questions which are option to look further on. There is a need for looking at the awareness of HIV, infection and related skin diseases. Queen Elisabeth hospital is spilt into four departments: surgery, medicine, pediatrics and gynecology so many different oppurtunities are possible and the interest is high for theese type of Contacts.

Förberedelser

Malawi is a Beautiful and a very friendly country. First time I was there, some years ago I visited childcareunits, schools and hospitals in Southern parts of Malawi. They have fantastic areas with National parks with few Tourists even though they now try to attract visitors who want to have a special experience. The Malawi lake is big and worldknown for the ciclids in aquariums from all over the World.


 Through other doctors who have organized trips to different countries I got a Contact with the administration on Karolinska Institut. Therefore I was happy when the Karolinska Institut was interested and invited doctors from Malawi to Stockholm.  The flight is reasonable 8000 Sv kr and the living is cheap. Car rental is quite expensive but you can drive yourself, without worries.

 I Went there this May 17,to hold the undergraduate course in skin diseases for doctors in Malawi together with the only dermatologist in Malawi. Due to that I knew the country it was easy to plan the trip but I had to start to get all my lectures in English, in all the different dermatologic conditions that they wanted a lecture in. One of the big problems was to get nice and educating photos on dark skin. On the net and textbooks most Pictures are on White skin. I was happy to have some photos from patients in Sweden, Sudan and Etiopia. The fantastic thing is that now after the visit I have a lot of fine patient pictures because the patients were very ok with me taking a photo, as well as Beautiful Pictures on the landscapes and the happy people that live here.You feel very comfortable with the kindness of the people but one must be aware of that this is one of the ten poorest countries in the World.

 I bought a new excellent small camera Before going there to get good photos, as well as my computor with all prepared lectures and photos on skin diseases. In the Queen Elisabeth Hospital in central Malawi, Blantyre city where they have the only Medical college, it was of great use to have hospital clothes although other Doctors had private cloths. As well as having alcogel for the hands felt nice. I brought an old mobile and got a chip with a local number that I could use during the visiting time. After a lot of mail Contact with the dermatologist there I had a full suitcase with different dressings and other Medical material which I got mostly from Sophiahemmets skin clinic.

 May is a nice weather period with rare rains but it´s the Winter there so the nights can be a Little Cold around 16  C. You don´t need much of clothes or other things but some drugs if you eat something less proper is good and antimalarias because that´s not a nice disease. Another good thing is that you Always can find someone who speeks English because the local languge Chichewa is difficult to understand. So hopefully this makes you curious because there is a lot to learn and experience in Malawi.

Reflektioner

Due to this trip I have been asked to lecture for specialists about dark skin diseases at Karolinska, the Leo symposia 1/9 in Stockholm for specialists as well as in Copenhagen the 25/8 for specialists so far. I hope I can spread an interest and knowledge about the difficulties in treating and diagnosing dark skin diseases. Trips like this makes you develop and learn new things as well as understanding different people and their Life situation. I have planned to go back soon again and I gladly help those that will go there and hopefully I can come and visit them during their stay. I gladly give any of my knowledge from Malawi to fellow doctors and students at any possible time.

Undervisning

The course in dermatology was around 35 students in Queen Elisabeth hospital. I lectured around 90 % of all the different subjects but there was an English Dr also having a lecture and the dermatologist from Malawi hold the Venerology and HIV.

 A day could look like starting lectures at 08.30-10. with 60 min on exzema of diffrent types with lot of photos. Thereafter outpatient clinic with patients and students like many albinism patients malignant melanomas psoriasis and HIV related diseases.The students discussed the cases together and choose those that will be presented later. Prescriptions and drug get distributed. A short lunch in some fast food Place. Then often a walk to some wards , pediatric or internal medicine for patients with other problems like bullous diseases or SLE. After this new outpatient clinic with students and new cases. The end of the day case presentation with Powerpoint presentations and question to students in the whole Group. The sessions were quite tough for the students because if they hadn´t read on the subject it was like an exam. The way of expecting Quick and good knowledge from the students really differ but still it was a very personal and familiar relation.

 The relation to the patient differs a lot because the Healthcare is free but not the drugs. Many of the patients were low educated and had great respsct for the doctors even the Young ones.

 The day ended around 16.30 but then I Went to other hospital or clinics untill 19,30. Dinner and then work with lectures and photos.  The day after in the morning a repetition on unclear facts from the day Before.

The teaching methods are maybe a Little bit more conservative and the expectations on the sudents knowledge higher. But ofcourse the was diffrent levels on the students and the exam some weeks later was difficult.

 If you come there on a special Project or just want to learn more about other types of diseases especially in dark skin I am sure you will find it fantastic and that you will be very well treated form these nice people. It is overvelming all that you can expirience in a site like this.

 


Undervisningstimmar

The traditional lectures: 8 hours/ week. Bedside education/ patient Contact: 25 hours/week. Group discussions and PP presentations/ seminars: 7 hours/week. Same type of scedule as here during the day but more hours. The seminars more like a preexam.