Dr Ilona Hale, doctor, Nitcheu District Hospital, Malawi
Dr Hale found herself the only doctor at a hospital that served a population of over half-a-million. In addition to emergencies and the anything-but-routine life of a volunteer doctor, she was able to introduce new life-saving preventative medicine measures.
“You will work for many years in your career – make two of them memorable.”
The career advice in the ad by the volunteer agency CUSO-VSO struck a chord with Dr. Ilona Hale, a family doctor from Kimberley, British Columbia. “I remember that ad convincing me. Just put that in perspective - when you think you are going to work for thirty or forty, what’s two years?”
In 2007, along with her husband and two small children, she transplanted herself from a routine family practice in Canada to the busy Ntcheu District Hospital, two hours south of Lilongwe, Malawi’s capital. Following a “very steep learning curve in tropical medicine,” Dr. Hale found herself the only doctor at the 250 bed hospital (with 300 - 400 patients) that served a population of over half a million.
The routine became anything but, ranging from delivering a breeched baby to rushing to an accident scene to treat several trauma victims from the tragedy. “Every day could move from exhilarating to exasperating to exciting to exhausting,” says Hale.
Confronting an urgent need
She came face to face with heartbreaking statistics. “The number of children dying in Africa from malaria each day amounts to the equivalent of seven Boeing 747s packed with children crashing - every day,” emphasizes Hale, her voice conveying a sense of responsibility and urgency. “Every single day that goes by that we sit here and don’t do anything, that’s a whole lot of kids that are lost.”
Hale despairs that completely treatable conditions such as diarrhea and malnutrition have wiped out so many young lives. One million children die from malaria a year in Africa. According to the World Health Organization, acute diarrhea caused 16 percent of the deaths of children under the age of five in Africa between 2000 and 2003 and pneumonia was responsible for 21 per cent.
These staggering statistics just made her work harder.
“It just made me want to work more and encourage more people to learn about how these things… are really preventable in a lot of cases. There is a lot of good work happening in Malawi in the area of prevention and education, but it’s just not enough and it’s just not fast enough,” says Hale.
Preventative medicine saves lives
Besides working as a clinician, Hale focused on a number of prevention measures at the hospital that have resulted in saved lives. She worked with hospital staff to ensure all patients in the hospital were tested for HIV.
“If you know a pregnant woman is HIV positive, you can do something for her child,” says Hale. Her hunch was right: five to ten percent of patients tested positive.
She focused on improving newborn care, having witnessed a number of preventable deaths. She realized that babies who were born not breathing were assumed to be already dead. She taught staff gentle resuscitation methods using gentle pumping and heart massage.
Ilona conducted workshops on “kangaroo care” - a method of keeping newborns warm and healthy in the absence of incubators.“ The nurses were all really keen, they all heard of it, but they didn’t know how to do it and they didn’t have access to the more up-to-date literature on how to implement it,” says Hale.
She collaborated with an American gynecologist working in Malawi to develop a cervical cancer clinic, an initiative the hospital had wanted to set up for many years. The screening program has detected a shocking a 10 percent occurrence rate and as a result, women are getting the early treatment they need to beat the odds.
She saw firsthand how sharing knowledge and encouraging access to information could make all the difference. She secured a number of books to start a resource library at the hospital, and encouraged clinical officers to use the reference guides.“ They have never had access to texts where they can look up questions or diagnosis or dosages.”
Just one volunteer can have an impact
VSO’s International Programs Director Richard Hawkes, visited Ntcheu Hospital during Hale’s work term and saw how her efforts created sustainable change.
“Ilona was without doubt one of the best volunteers I have ever met. She was passionate about her work and really thoughtful about what she could achieve and how she had been able to pass on skills and information.”
Hale has returned to Canada, and in retrospect, she says the ad promising a memorable two years summed up perfectly.
“You can plod along in your life in one place for so long,” says Hale. “But doing something different with your career brings so much richness and depth and meaning to your life. I often wonder why everybody isn’t doing it.”
You can also listen to a podcast interview with Dr. Hale.
