Kakumbi Clinic – my final days

Yesterday, as I drove to the clinic, I saw a man at the roadside, flagging me down. Normally, I wouldn’t stop (the medical association discourages picking up hitchhikers), but this man was in uniform. And he was carrying a very large rifle. I pulled over and he got into the cabin. We greeted each other… Continue reading Kakumbi Clinic – my final days

Can you hit my head some more?

“Can you hit my head some more, Dr Ian?” Last month, I diagnosed a young lady with cervical cancer. Her symptoms of lower abdominal pain, vaginal bleeding and an offensive discharge had been repeatedly treated “syndromically” – in other words, treating the common diseases which would cause these problems without making a specific diagnosis. She… Continue reading Can you hit my head some more?

Another Day, part 2

A woman was sitting on the steps of the clinic, gazing at the ground. I was told that she had mental health problems and wouldn’t speak. She was pregnant and had indicated that she had belly ache. A nurse had prescribed paracetamol and the woman had tried to take all the tablets. I sat down… Continue reading Another Day, part 2

Another day, another clinic

Friday is the second busiest day of the week at Kakumbi Rural Health Centre. I arrived early and got to work seeing those patients who spoke English. During May, about 60% of the people attending the clinic have malaria, so I have been trying to get the clerk who registers the patients to take their… Continue reading Another day, another clinic

Medical Student

Jonathan has been helping us out in Kakumbi Rural Health Centre as part of his medical training. He styles himself “Dr Jonathan” and wears a white coat, prescribes medication and makes referrals. It seemed a bit strange to me, especially when he left last week to go to Lusaka to prepare for his examinations at… Continue reading Medical Student

Today is World Malaria Day

Last week, I have mainly been seeing patients with malaria or HIV, sometimes both together. My stay in the Valley corresponds with the malaria season, at the end of the rains and the beginning of the dry season. Heavy downpours of rain flush out the mosquito larvae breeding in standing water, but if the pools… Continue reading Today is World Malaria Day


Worldwide, rates of malaria are falling. Here in Kakumbi, they are rising. In May 2014, 870 patients had a positive blood film or rapid test for malaria, twice the figure for May 2013. We did not treat anyone for malaria “on clinical grounds”. These are proven cases. The health centre serves a population of just… Continue reading Malaria

Paludism – or malaria to you and me

I don’t like to say this, but I am starting to struggle a bit during consultations. Being here for just three months means that it is not worth trying to learn the language well enough to be able to speak to patients with ease and accuracy. I usually have an interpreter, Daillies, who will chatter… Continue reading Paludism – or malaria to you and me