Ready...Set...Go!!!

Well, the packing is all done, and my room no longer looks like a closet of junk! With the final zip of the zipper on my 4th bag (!), I am both anxious and excited for the adventure that begins tomorrow. At the same time, I am trying to keep my expectations low(ish)--but how can you NOT have high expectations for this trip?! I'm about to go to Africa!!

Clinically, this trip will provide an insight into how HIV/AIDS affects a country. Malawi is one of the poorest countries in Africa, and its plight is made worse by ~20% of its 13.5M people being affected by HIV/AIDS. The illness leaves children without parents, parents without children, and men and women too weak to work or farm for their living. There will be many more illustrations of how AIDS affects individuals, and I'll write about those as they arise. But this trip will also try to teach me how to practice medicine with limited (none?) resources. I'm leaving the comfortable, indeed luxurious, Ronald Regan UCLA Hospital, with its multiple CT scanners and MRIs, its fully-loaded pharmacy, and daily organ and bone marrow transplants. And I'll be practicing in the clinics of Partners in Malawi (http://www.partnersinmalawi.org), located in Lilongwe, Malawi. The contrasts are starkly obvious already--Malawi has 1 CT scanner for the whole country, performs no organ or bone marrow transplants, and uses anti-retroviral medications that are often suboptimal at treating the various HIV genotypes seen in Malawi. In addition, these anti-retrovirals often interact with other medications used to treat illnesses like malaria, rendering the anti-retrovirals less effective against HIV. This experience surely will stretch my comfort zones of the practice of medicine. But more about these issues later...

Personally, I'll be out of my comfort zone as well. Perhaps the most exciting and anxiety-provoking aspect about this trip is just how far out of my comfort zone I'll be. Gone will be the flat screen TV with HD cable and DVR, my car, the iPhone, and my airconditioning! In its place will be dirt roads, malaria nets, and spotty internet service. This experience surely will be a welcomed shock to my system, which has grone accustomed to seeing BMWs as the "entry level" car in west LA, hearing about fancy restaurants and clubs, and the strong drive many resident-physicians feel to start "making a living." I hope to become much more comfortable at "living without" than I am currently.

I leave tomorrow morning at 730am west coast time. Thank you for all the well-wishes/emails/phone calls. I'll try to write/post as often as possible to share more thoughts and experiences. Until then, be well, and remember to vote!!
chase

Picture: Street Artist--NOLA, 2008