To some, going to a health clinic/hospital in a foreign country would be their worst nightmare. Reused needles and a lack of training are just two of the horror stories we hear about in hospitals within developing countries. However, the UK volunteers plus Thom (a national volunteer) braved this exact thing and were pleasantly surprised. At St John of God - Mzuzu, we found that not only were the staff knowledgeable but the whole centre was spotless.
I knew before commencing my trip to Malawi that whilst here I would love to get a taste of a Malawian hospital, and what better way of doing this than encouraging everyone to come for HIV testing and counselling (HTC)! Much better than injuring myself. I went in with the preconception that we would be greeted by an older woman who wouldn’t want to waste their time testing so many volunteers; wasting resources was the first thing that came to mind. Again I was completely wrong, the middle aged man was more than willing to test all eight of us. His kindness only reinforced what we had already experienced in Malawi.
To start, we had a counselling session where we were asked why we had come for HTC. We told him we were there only to see what the process was, yet he still didn’t give any signs that we were wasting his time, answering all of our questions and treating us just like anyone else.
Testing commenced similarly to UK protocol with new needles being used; all be it more simple but it worked in exactly the same way, and provided enough blood to be tested. The nursing student side of me then came into action as I noticed the bins that were being used in the room. I saw two yellow bins with signs above saying clinical waste and general waste, exactly like the ones we have dotted around all health care settings in the UK. However, when going to put waste in them, the pedals were not working. I’m sure that when buying the bins there were good intentions, but I couldn’t help but wonder how long these were like this and how easy it could have been to fix them. I noticed that what had just been used to prick my finger was being put in what I could just about see was a cardboard box. I thought that perhaps they ran out of money after buying expensive bins and all the yellow clinical waste bags that they had decide to use a cereal box as a sharps bin. So I went to investigate. On the outside of this cardboard box was the printing DANGER - SHARPS DISPOSAL. This is what they had actually spent money buying. It even said close lid when full, as if you couldn’t get in any other way!
HIV testing area - with clinical bins
The kindness extended to post-test counselling, where we each took it in turns to get our results and post counselling. Confidentiality was kept throughout to the extent that the man removed all the other test results whilst we went in. Post counselling included how we are going to stay HIV negative. This again including everything that is included in our sessions to the community.
The main differences UK volunteers found with testing here in Malawi, compared to in the UK, were that the results were given in a quicker time of just 15 minutes whereas in the UK you would wait up to a week. One of us also asked if we could be sent the result via text message. We were told that this was not possible and I can only think this could be due to confidentiality as it wouldn’t be kept as high if the result was sent via text. Whereas in the UK, we lock our phones so no one else can access private information.
Overall we were all really impressed with the whole process of HTC and how it matched exactly with how we were taught it should be done the week before. This whole process made me realise that to him it wasn’t a waste of resources at all. HIV and AIDS is a global problem and everyone should be more cautious of it and get tested in the UK, just like we would with any other sexually transmitted infection (STI).
Written by ICS volunteers Abbigail Rossiter and Thom Mpumulo