I spent 4 weeks at St Martin's Hospital in Malinidi, Malawi. St Martin's is a rural mission hospital with approximately 50 beds: male and female wards, paediatric ward, and maternity. The outpatient department runs all day, five days a week, and a large volume and variety of patients are seen. There are no doctors and the hospital is run by five clinical officers, a team of nurses and patient assistants. The hospital also runs daily antiretroviral clinics, as well as regular antenatal, family planning, and vaccination clinics. There is one operating theatre, used for cases such as caesarean sections, female sterilisations, hernia repairs, and I&D.
Mondays, Wednesdays and Friday mornings are ward rounds, so I rotated around the male/female general wards, paediatric or maternity. The rest of the time I mostly split between the outpatient department and the other clinics, or labour ward, so across the five weeks I spent there there was plenty of variety and the chance to get to know the wards well. In the outpatient department in particular, there was the opportunity to run the consultations, with a clinical officer acting as translator.
We usually worked 0730-1600, with a 1½ hour lunch break. The hospital has a lovely guest house available for elective students on the hospital site (where all the staff also live). It is well equipped with a bathroom, living and dining room, simple kitchen, and three bedrooms sleeping six overall. The house is only 30m from the shore of Lake Malawi, so the views are just spectacular. A wonderful lady called Priscilla acts as cook and housekeeper, making three meals a day for the elective students.
There were lots of positives about St Martins. It was a great experience of a small, rural mission hospital, covering medical, surgical, paediatrics and maternity. There was very good email communication about accommodation/costs/transport and an exceptionally friendly and helpful chief clinical officer. Malindi was a good location to travel to other parts of Malawi including Liwonde, Zomba, Cape Maclear and Blantyre. There were a few downsides – the afternoons could sometimes be very quiet and I didn't get much exposure to surgery.
This elective would be ideal for somebody who wants to experience a rural mission hospital, where you won't come across any ex-pats, but would not be suitable for anybody wanting a lot of exposure to surgery. I wish I had known before I went that women should cover their legs in public, and to expect to wear long skirts or baggy harem pants. Also, especially in rural areas, most patients speak very little or no English, so it's very useful to learn even a small amount of Chichewa before or whilst you're there.