Lua Samimi
Lua Samimi
MSc. in Global Health Student at McMaster University
September 1, 2018

Lessons Learned in Lilongwe (and a bit of science too)

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Throughout my four years at UNB, I have had the opportunity to gain incredible cross-cultural experiences both on campus and abroad. Upon entering my first year, I joined the UNB Global Medical Brigades and traveled to Honduras, delivering accessible healthcare to rural communities. Ever since that first encounter with global health, I’ve been hooked.

I wanted to broaden my international experiences—so in my third year, I applied for (and received!) the Queen Elizabeth II Diamond Jubilee Scholarship. This program offers university students a unique opportunity to complete a paid internship in any Commonwealth country. Although UNB has a number of partnerships around the world, their strongest connection for the scholarship is in Malawi. I was offered a placement at the Africa University of Diplomacy, Counselling and International Relations, to help lead the development and setup of a campus clinic. I also had an opportunity to shadow local physicians in various clinics and hospitals.

Without hesitation, I packed my bags, bid my family farewell and off I went. I boarded the plane to Lilongwe, Malawi with a million expectations in my mind. As a self-proclaimed perfectionist who over-thinks, over-plans and over-exaggerates, I spent countless hours watching videos about Malawi, reading about the dangerous wildlife I could encounter, coming up with my work plan and making lists of places I wanted to visit. I thought I had it all figured out. Spoiler alert: I did not.

If you’ve gone on exchange or have lived abroad, you might recognize the feeling I’m about to describe: it’s the initial feeling after two plus days of travel when your feet finally land on soil and you look up at your new home for the next (approximately) three months. It’s a mixture of excitement, curiosity, joy, fear and “oh-this-isn’t-what-I-expected.”

Little did I know, my summer would be full of those “this-isn’t-what-I-expected” moments. But looking back, those were the moments that really shaped my internship—and my life. What’s that cheesy quote again? “Life begins at the end of your comfort zone.” Well, cheesy as it may be, it’s true. So here are some “this-isn’t-what-I-expected” moments from my three months in Malawi:

I can truthfully say that I never expected to meet both the Malawian king and Olusegun Obasanjo, the former president of Nigeria, all in one week (or ever, for that matter). I didn’t expect fancy hotels with casinos and huge swimming pools—nor a vast array of restaurants serving Indian, Asian and Italian foods. I didn’t expect being able to buy just about anything on the side of the road (and that includes phone plans, shoes, puppies and cooked field mice). And I definitely didn’t expect to be standing a few feet away from a wild African elephant.

That being said, I also learned a lot of lessons while living in Lilongwe (try saying that five times fast). First and foremost, I learned that every country has its strengths and weaknesses. It’s easy to come back to the everyday luxuries we have in Canada and think of how fortunate we are compared to the people of Malawi. And it’s true: we are very fortunate to live in such a beautiful, safe and welcoming country—but it’s important to realize that developing countries have just as much wealth as we do. Their wealth may not necessarily be financial, but Malawians are some of the happiest, most intelligent and most creative people I have ever met.

On that note, although there are many developed regions in Lilongwe, the economic challenges that many people face cannot be ignored. During my internship, I was lucky enough to collaborate with a number of local physicians, patients and students. The number one concern that was brought up throughout the summer was the Malawian healthcare system.

Just like Canada, Malawi’s healthcare is free and government-funded. From an outsider’s perspective, this sounds great, right? Not quite… Although the hospitals and clinics are equipped with plenty of well-trained healthcare professionals, the shelves are often bare and necessary resources are scarce.

Poor sanitation is also a major concern and causes a large number of avoidable deaths in Malawi. I remember walking down the halls of Kamuzu Central Hospital with one of the local physicians, Dr. McNeil, when he began telling me the story of a teenage boy living with HIV. With recent advances in HIV care, the patient was on a long-term treatment plan and had the potential to live a long, relatively healthy life—until he contracted a hospital-borne infection and sadly passed away as a result. Hearing this story was definitely one of the most eye-opening moments of the summer.  

During my internship, I also had a unique opportunity to explore my interest in medicine by participating in rounds on the pediatrics unit. As we were moving from patient to patient, I asked the physician what he believed was the most serious illness in Malawi. We had seen a number of patients with tuberculosis and pneumonia, so I was expecting one of the two—but to my surprise, he said it was malaria.

Up until that point, all I knew about malaria was that it was a mosquito-borne illness and affected a large portion of Sub-Saharan Africa, as well as some countries in South America and Asia. I also knew that I was taking daily antimalarial drugs while living in Malawi…but why? What exactly is malaria? I’m a Biology student, so let’s jump into the science for a bit!

Malaria is caused by parasites from the genus Plasmodium and is transmitted to humans through the bite of female Anopheles mosquitoes. The mosquito first becomes infected by feeding on a host that already has malaria; then, it continues transferring the parasite from one human to another. Once in our bloodstream, the parasites can travel to our liver—where they multiply and cause some not-so-pleasant symptoms: chills, headache, fever, sweating and nausea. After they have multiplied, Plasmodium parasites can also destroy our red blood cells or stay in the blood and infect the next uninfected mosquito that comes along.

Interestingly, the majority of healthy adults that become infected usually only show minor and flu-like symptoms, so they are treated with basic antimalarial drugs. Even my boss during the internship had malaria while I was there. However, the symptoms can become far more severe and life-threatening for children under five, pregnant women and patients with illnesses that weaken the immune system. In these cases, that same parasite that caused mild flu-like symptoms in a 40 year-old male can now cause convulsions, kidney failure and death in high-risk patients.

So why is malaria such a big problem in Sub-Saharan Africa? Part of the reason has to do with the climate, of course—but economic challenges also play a huge role. While we were fortunate enough to sleep under mosquito nets every night, the majority of Malawians living in rural villages don’t have access to protective nets or insecticides. Malaria is also so normalized (just like the common cold here in Canada) that they don’t see a need to sleep under “annoying” mosquito nets. And trust me—they can get quite annoying.

Overall, the biggest lesson I learned while living in Malawi was that every problem is multi-dimensional. Whether it’s struggles that lead to personal growth or a healthcare problem such as malaria, there’s always several factors that play into both the root of the issue and the potential solution. I initially traveled to Malawi in the hopes of learning more about global health; I left with a greater sense of independence, a new outlook on developing countries and health disparities, and a new-found ability to be comfortable in those dreadfully uncomfortable “this-isn’t-what-I-expected” moments.

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