1. The Burden of Malaria at the Pothawira Clinic Malawi, Africa
Devin Kennedy
International Health Rotation
University of Kansas Medical Center

2. Malawi, Africa Nickname: Warm Heart of Africa Population: 17,250,000
Gross National Income Per Capita: $750
Third Poorest Country in the World
Highest Mortality Causes:
HIV/AIDS
Malaria
Other Infectious diseases
Maternal/Neonatal complications

3. Pothawira
Pothawira means “safe haven” in Chichewa, the indigenous Bantu language of Malawi
Consists of a school, orphanage, and outpatient clinic
123 orphans housed on the property with 10 mothers and 3 cooks living there to take care of them
Clinic sees between patients every day, with two prescribing clinical officers, 4 nurses for med dispensing, and a small procedure room
Coming soon: birthing center has been built on the property and will be open in Summer 2017

4. Pothawira Orphans
Pictured are a few of the 123 orphans of all ages that live at Pothawira

5. Burden of Malaria on Pothawira Clinic
Malaria is one of the highest causes of mortality in Malawi, and especially in children 5 years old and younger.
The amount of time, testing supplies, medications, and staffing needed to treat Malaria on a daily basis places a large burden on the Pothawira clinic, and other clinics and hospitals throughout Malawi
Malaria is treated for free at government hospitals or for a small fee at private clinics like Pothawira, which also includes medication
1000 Kwatcha per adult ($1.35)
500 Kwatcha per child ($0.68)
EXAM ROom at pothawira

6. Representation of the Top 5 clinical diagnosis at Pothawira Clinic

7. Burden of Malaria at Pothawira- (Data collected from Jan. 3- Feb
In the first two months of 2017, the clinic saw 8,517 patients
4,064 (48%) of those patients were children 5 years old or younger
That’s an average of 177 patients per day
62% of patients were tested for Malaria using MRDT
That’s 5,239 MRDT tests used in two months
49% of patients tested were 5yo or younger
50% of the tests were positive
3130 patients were treated for Malaria in Jan and Feb of 2017
Meaning that 37% of all patients that came into the clinic in those months were treated for Malaria.

8. Malaria in Malawi Record keeping at Pothawira
Specifically at Pothawira, one of the largest issues with the burden of malaria is funding for all of the testing and medical supplies needed on a monthly basis to keep treating the disease.
An estimated 627,000 died from Malaria in 2012 with the largest number of deaths being in children under the age of 5 in sub-Saharan Africa
Further efforts and foreign aid are being put towards prevention. Bed nets are still the most widely used source of prevention, but many families use those nets for other purposes such as fishing, as eating is a more immediate need than preventing malaria
Although progress is being made in reducing the prevalence of Malaria, it is still one of the leading causes of morbidity and mortality with an estimated 6 millions cases of Malaria treated each year in the country
Record keeping at Pothawira

9. Clinical Experience Clinical Case:
A middle age woman presented with fatigue to the clinic and was found positive for Malaria. We also tested her hemoglobin which was found to be 1.7! She then picked up her medication, put her child on her back, and walked to the local government hospital for a blood transfusion. She walked about 2 miles, with a hemoglobin of 1.7 for that blood, and was told to come back the next day because they were out of blood for that day
Most important things learned included more experience with low resource medicine, and solidifying my knowledge in detection and treatment of Malaria

10. “You do not have the sun in the US?”
Cultural Experience
Story Time!
- I was sun burnt badly one day working outside in Malawi. A few days later some of the orphans asked me what had happened to my skin because it was peeling. I explained that I was burned from the sun. This was followed by puzzled faces, and finally someone asked the question
“You do not have the sun in the US?”
While it seemed off, if you had never seen a sun burn before in your life, wouldn’t that seem like a perfectly logical question?

11. A few younger girls that life at the orphanage as well as the newest family member, Chikambutso

12. Pothawira staff and Maseko Family
They are pictured here in front of the shipping containers that arrived holding the new equipment for the soon to open birthing center

13. Pictured: In the center is Peter Maseko, the director of Pothawira and primary clinical officer On his left is Dr. Jonathan Philippe, a family physician and graduate of the KU family medicine residency

14. References
"Global Health-Malawi." Centers for Disease Control and Prevention. CDC, n.d. Web. 15 Mar
"Malawi." World Health Organization. WHO, n.d. Web. 15 Mar