Malawi: Dr. Michelle Kiser

September 24, 2011: "Patient guardians here are amazing - I am hoping to do a study, interviewing them, to find out more how they cope with the experience of caring for their loved ones with such severe burns. They have to search for ingredients to buy for food, prepare meals, feed the patients, hold them while their dressings are changed, sleep on the floor beside the beds, comfort and support them - and they do this for the weeks and weeks that the patient is in the hospital.  They can never leave. All patients must have a guardian.  Sometimes mothers and fathers will switch out, or an aunt will come..."

William Kalua, a clinical officer in the burn unit, improvising one day in the operating theater when we had no facemasks.  The image on the right features him with pieces of tape, stuck to his face.

August 5, 2011: "I took call at the hospital Wednesday for the first time since I have been here.  It was an experience. I got called to come see a patient in the women's hospital, and as I walked through the hospital, which is all open air - outdoor walkways, window openings in all the hallways, nothing enclosed - I realized what a different place the hospital is at night.  There are no lights in the corridors.  It was so dimly lit that I was worried I might stumble over anything that was in my path.  I would hardly know I was passing someone until I would hear "Good evening, Madam".  Yet you know that there are probably around a thousand people hunkered down for the night in the wards.  The guardians come in at night and sleep on the floor under the patient's bed.  So as I went to examine this woman with abdominal pains, I had to tiptoe around the sleeping, nursing guardians.  But it felt oddly cozy in the wards.  They are all so quiet."

The Burn Power Team

June 30, 2011: "I began operating this week. It is very different from the U.S.. It will take me a few days to figure out everything works. And everyone in the OR speaks to each other in chichewa! But people are generally helpful. I am really just observing how the burn operations are done right now--getting a feel for what they do. It barely resembles what we do at UNC. Our oldest patient is 6 years old. Children are by far the majority of the burn victims, and it is almost exclusively due to open fire cooking in the home. The nurses work hard with so very very little.  They rely on parents to help with dressing changes too, as they have little help, and they state that it is very hard on parents, who sometimes are even scared to touch their burned child."