4th of October 2017, by Peter de Rijke
When Medpacker asked me to write a story about my experiences in Africa, at first I had a hard time thinking what I wanted to tell the present and future Medpacker members. I could give a summary of traveling through South Africa and other countries. I could continue with life and culture in Malawi, including our internship in Nkhoma Mission Hospital, but that just seemed not right. Instead, I want to tell you the story of David Tsumba.
In general there are two types of ‘doctors’ working in Nkhoma Mission Hospital. The first group is the minority, this consists of real Malawian doctors who’ve had a 6-year and expensive study. Since at average people in Malawi live on less than 2 US dollars per day per person, it’s not hard to grasp that most people cannot afford this. Most people cannot become a doctor. There were four Malawian doctors and two settled American doctors.
The second group consists of the big majority of ‘doctors’: the clinical officers. This is a 2 or 3 year study, fixed on quickly preparing the Malawian for clinical practice. They were in charge of the different wards, performed surgery, saw patients in the outpatient clinic and went for outreach: they did everything.
It seemed like there was a big difference between clinical officers. There were officers who were experienced and liked to share medical knowledge. There were also officers who seemed careless, not eager to learn. They would listen to patients but not really hear them. They definitely didn’t follow communication & attitude lessons like we do in Holland. One time there was a female clinical officer who had been working in the hospital for 4 months. She wrote in every health passport (small medical history book that belongs to one patient) that the lungs were clear, while she had not even listened with the stethoscope! When I asked her why she did not listen to the lungs, she told me she had so much clinical experience that she could ‘see’ that the patient had clear lungs. I told her straightforward that did not make any sense. She saw I was serious about this so she started listening anyway, by putting the buttons of her stethoscope in her ear the other way around!! She also didn’t do vaginal nor rectal examination because she thought it was dirty.
David Tsumba was not like that. He was a clinical officer I immediately liked for his serious and gentle approach of the patient. He was not only a friendly officer, he also had brains: everything he did, he did it with a thoughtful purpose. He finished his study cum laude (very high marks!!). He taught me a lot about tropical practice, but was also open for discussion and liked to learn about what I had to tell him. In my opinion, that is a real medical professional: intelligent, curious, skillful but also conscious about the boundaries of his medical knowledge.
Aside from working together in the hospital, we also liked to hang out together. He lived in a house he rented from the hospital. With his salary, he paid for the living of his wife Valys and his two lovely daughters. He was besides from that also a man who liked to party! Together with my Dutch intern-colleagues, we organized an awesome party for the hospital personnel at his house. Everything from the braai to the booze was at our cost: reason for everyone present to eat as much and drink as much as possible.
A fun thing to tell: in Nkhoma, most people live with a Mission (hence Nkhoma Mission Hospital). This is a Christian mission. Some people severely disapprove of drinking, even see it as blasphemy. We also invited the pastors of the hospital chapel to the party. At first, drinking alcohol happened secretly, like under-age school boys doing alcohol or weed without their parents knowing. You can imagine that the party really escalated quickly when the pastors left…
Back to David. As I told you, he had to take care of his family and spend his money wisely. A good stethoscope is a very expensive instrument for the above average Malawian (someone who earns 200 USD per month). He had a very cheap one. Around his neck hung a plastic disposable stethoscope. This is why I decided to donate the stethoscope I got from Medpacker to David Tsumba. Medpacker makes this possible. We donated a lot of supplies to the hospital, which they need very much, but this gift to David was special. He was so thankful. I was also very thankful. In my opinion, there was not a single person who deserved this stethoscope more than he did. I also have a picture of me giving the stethoscope to him. It’s a funny picture because I am so tall and David is so small. The photographer had trouble getting us both in the picture.
I am still in contact with David. He’s enjoying the stethoscope very much. I know for sure that this will make him an even better clinical officer. I’m so grateful for meeting him and thanks to Medpacker I was able to add something to his medical career. Zikomo kwambiri Medpacker!