The Lake

Lake Malawi is a special place. Itś home to the biggest variety of tropical fish in the world which means when you go swimming itś like being inside a giant aquarium!

Yesterday I did two dives - a deep dive and a deep night dive. The first down to 22.6m and the second to 18m... we saw lots and lots of pretty fish and some big cat fish, some cool mouth breeding fish which catch their babies in their mouths and then spit them out again (pretty cool to watch under the water!)... business is a bit slow for the dive centre in Nkhata Bay which meant it was only me diving with both the dive masters.

Back at the bar at the place I am staying I meet Ima - A british nurse currently nursing locally in Malawi. The truth about the lack of ECG machines is uncovered. Ima has an ECG machine in her office but it´s the only one in the hospital and she says she has only used it twice since she has been there. The person who had her job before she did didn´t even know how to read ECGs or to use the machine so it never got used.

Ima thought she would be using the machine every day as she has a background in ED and knows about ECG interpretation but the problem is that knowing that a person has a left bundle branch block doesn´t change much - with no cardiologist to refer people on to, very basic availability of drugs, no cardiac catheter lab, there seems little point.

Ima has also offered to teach some of the staff trauma skills... she believes a bit of basic c-spine immobilisation would go a long way. Nkhata Bay is not a trauma centre but traumatic accidents still do happen frequently (most common is drunk people getting hit by cars). If these people are lucky they get bundled into a taxi and taken straight to Mzuzu which is a bigger centre. Most just go to Nkhata Bay and sit and wait in the waiting room for hours waiting to be seen... then perhaps if they are bad they get bundled into the ambulance or private vehicle and taken to Mzuzu... more often than not these people die during transit. But getting the hospital staff to stay behind for education is a difficult mission...

I think I have discovered why the life expectancy of the average Malawian sits at a low 43 years old and I think it goes much much further than just the HIV problem.