Update: Family Medicine in Malawi

John Parks MD is head of the Department of Family Medicine at University of Malawi College of Medicine in Malawi. Here he writes an update on Family Medicine in Malawi.

The Department of Family Medicine, at the University of Malawi College of Medicine was founded in 2011. A founding Faculty member for the department, Dr Luckson Dullie, was profiled on the WONCA website in 2013. In a prescient quote Dr Dullie reported the Department was “looking at the possibility of developing a model site at which the integration of family medicine into the health system as well as its benefits can be demonstrated.”

Since its founding, the Department has deepened its roots and grown the number of partnerships to deliver Family Medicine education and service in Malawi. The undergraduate rotation in Family Medicine, during MBBS (medical school) year 4, has been in continuous operation since 2011. In 2016, postgraduate training in Family Medicine was officially launched in our partner district hospital, Mangochi District Hospital, we subsequently have expanded to include a second postgraduate site at Nkhoma Mission Hospital. In 2017 the Department of Family Medicine was formally granted WONCA Academic Membership.

Experiences of Medical Students During Family Medicine Rotation

Medical students at the University of Malawi College of Medicine rotate through a 6-week course in Family Medicine during year 4 of training. This rotation is the only time during five-years of medical school that students do hands-on clinical work at a district hospital before graduating to become medical officers and serve in the districts.

Photo: An MBBS Student in Nkhoma, sharing notes with Dr Hodge

Below are some quotes from medical students at the end of their Family Medicine rotation at Mangochi District Hospital:

“Encouraged to probe more into patient problems so that you can manage all of their conditions so that they leave satisfied – this allows us to help the patients as much as possible, helped us to develop broader differentials (expand biological assessment)”, MBBS 4 Student.

Photo: MBBS students in Mangochi

“Teamwork, encouraged to handover patients to each other, this allowed us to have follow-up, if things were missed our colleagues would let us know”, MBBS 4 Student.

“I enjoyed it in a way that for once during my training I have seen someone that is educated in the medical field who can actually listen to a student and teach them without trying to embarrass them, even if we are way off” MBBS 4 Student.

“I didn’t want to come to Mangochi – but it has taught me a lot, especially about the setting of the hospital”, MBBS 4 Student.

Here is a link to a video interview with an MBBS 4 Student sharing his experience of the Family Medicine medical school rotation at Mangochi District Hospital: Interview with Dalitso Chilambe

The relationship that our department has with the District hospital, run by the Malawi Ministry of Health (MOH), has led to slow and steady improvement of the care given to patients. This has been achieved because of the partnership which exists between our students and faculty with the MOH staff at the hospital, with the focus on providing quality care. We call the model in Mangochi a “multi-displicinary district teaching & learning platform”. This captures the idea that this district hospital is a place we are investing in students from different health backgrounds and institutions (for example: nursing students, clinical officer students, medical students, physiotherapy students) and invest in education for the local MOH staff at their level of need so that together we provide excellent care for patients.

Mangochi District Hospital Fire 

The morning of Sunday, the 15th April 2018, we received sad news about a fire accident that destroyed part of Mangochi District Hospital. After investigating it was found out that the fire was caused by an electrical fault. No one was severely injured during the fire.

Photo above: Under 5 Clinical on fire on the fateful day.
 
Photo below : The Under 5 on a normal day before the fire

In response we started a crowdfunding campaign (gofundme.com/mangochihospitalfire -which stopped accepting donations on 15-May-2018) The funds will be used to replace damaged equipment, assist in the rebuilding, and invest in people (trainings for skills relevant to areas affected). Consistent with our history as a College and as a Department, we are working closely with the hospital leadership to facilitate appropriate and transparent use of the funds as part of the relief response. As Dr Dullie envisioned five years ago, this response is an example of how we are integrating “family medicine into the health system” and real demonstration of the “benefits” of partnership.

If you would like to contact John Parks please email hodfamilymedicine@medcol.mw