Motor Neuron Disease (MND) is a condition rarely seen by our team
It is a disease that affects the nerve supply to the muscles starting initially with weakness of the arms, legs tongue and neck.

Sandram and myself made a home visit to this 24 year old gentleman on the motorbike through rough terrain. [...]

a few examples from clinic today:

patient 1 : discussion about use of condoms for him and his wife who are both on antiretroviral therapy – ARV – (condoms are still necessary to prevent spread of resistant strains of virus)

patient 2 : known to us for some time. previous poor social support is now better as [...]

http://www.biomedcentral.com/1472-684X/10/12

A review of six months of our in-patient work.

Robert is a 20 year old man we met  on the medical wards about six weeks ago. He is severely physically disabled which has resulted in recurrent chest problems, now leaving him with bronchietasis (a chronic lung disease).  Both his parents have died and his siblings  left him at a church supported orphanage some [...]

on our way to the community

Grief and preparation for death is a complicated process .  All families have their history – feuds, reconciliations etc. perhaps complicated by second, third, ‘official’, or ‘unofficial’ wives and a variety of resulting offspring.
Malawi has a well recognised practise of property grabbing which may render a bereaved husband , [...]

After walking, riding on a bicycle and catching several minibuses our 62 year old patient with oesophageal cancer looked exhausted. She could barely walk due to weakness and oedema of her legs and the money used to attend clinic meant that acquiring food would be even more difficult over the coming weeks. It was fairly [...]

Every week, on Monday and Thursday morning at Tiyanjane clinic, the staff are busy with patients and families affected by Kaposi’s sarcoma – an HIV related cancer, the commonest malignancy in Malawi. Those who have very extensive or aggressive disease maybe treated with single agent chemotherapy – vincristine (in accordance with the Malawi Ministry of [...]

The patient, a quadriplegic 14 year old girl, lies still in bed, the heaving of her chest evident below her hard neck collar. Flies drift around her semi-naked body. The main problem? For the patient -they have taken my catheter out and now my sheets are wet. For the doctors – the mother [...]

At the heart of palliative care is the patient and their families… without them we wouldn’t be here. On today’s ward round we saw a 16 year old boy with pressure sores, paraplegia and HIV. TB treatment hasn’t made any difference over the last 3 months. We helped his mother put a nappy on him [...]