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400 inpatients, 256 beds, and one doctor

BMJ 2003; 327 doi: (Published 01 December 2003) Cite this as: BMJ 2003;327:0312468
  1. Rebecca Hodgkinson, medical student1
  1. 1University of Birmingham

Malawi, in southern Africa, is ranked among the poorest countries in the world, and many of its hospitals have only basic facilities. Rebecca Hodgkinson shares her elective experience, which she spent in a district general hospital to the south of Lake Malawi

Malawi is a country of contrasts. On one hand it is a country of awesome beauty with tropical beaches and a huge freshwater lake set against the background of the Mozambican mountains. On the other hand, it is a country burdened with malnutrition, HIV, and infectious diseases. It is also ranked among the 10 poorest in the world. I decided to spend my elective working in the district general hospital in Mangochi, at the southern tip of Lake Malawi, close to the Mozambique border.

Key facts

  • Population--11 million

  • Languages--Chewa and English

  • Capital--Lilongwe

  • Currency--Malawian kwacha

  • International code--+265

Tuesday 23 April

*Cups of coffee: 0; weight lost: 2 kg (mostly water); women at clinic: 200; times I have pinched myself to prove I am actually here: 54

Today we went to Mangochi and met the people we will be working with. It is a different world. Cows and goats wander around the dirt drive of the hospital. Some women queue at the hospital's sole water pump. Two hundred other women wait patiently outside the shack that houses the under fives clinic for immunisations; there are children everywhere and people are breast feeding …

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