Malaria

The emergency department is a ZOO. At any moment it is not uncommon to have a patient be carried into the ED completely collapsed and be really, really sick, or alternatively may not be sick at all. In the midst of this the ED physician is also seeing overflow patients from the outpatient clinic or patients that are referred from the clinical officers (essentially US equivelant of a PA) because they have a question. Fortunately the documentation is on paper and not the extensive dissertation that is required in the US EHR’s and for my friends in the military there are no AHLTA tier I errors.

I have seen over twenty cases of malaria this week alone, the majority of which are sent home on oral antimalarials, a practice pretty much unheard of in the US, where likely all patients with malaria are admitted to hospitals for treatment and observation. While that seems like a lot to me, those who have been here long-term state that malaria season is actually slowing down.

According to the CDC, in Zambia HIV/AIDS is the leading cause of death (20%) and Malaria is #2 (12%). Both of these illnesses are entirely preventable. Many of these deaths from malaria result from either absence of access or limited access to health resources. There are on average 6-7 physicians for every 100,000 Zambians (if memory serves there are >100 for every 100,000 in the US). Most of these physicians are concentrated in Lusaka, the capital city, which is a 10 hours by road from here.

Zambia tries to push health resources out into the community, with nurse aid workers, however with limited financial resources they are limited to some degree by international aid.