Resilience in the Face of Hardship: Pediatrics in Malawi

Kerry OBrienBlog, Featured, Malawi, Medicine

Surrounding this year’s American Academy of Family Physicians Global Health Summit, Seed Global Health spoke with Joshua Grahe, MD, former GHSP Volunteer, about how his experience teaching in Malawi has continued to impact his outlook as a Pediatrician in the US.

  • Could you tell me a little bit about yourself? How did you initially become involved in GHSP?

During my residency at St. Christopher’s Hospital for Children, I began to see how being a Pediatrician meant that I have a responsibility for treating children in a multifaceted way. There was and continues to be a big push for understanding not only traditional medicine, but the social determinants of health and how they influence the lives of our patients. Be it physical, sexual, verbal or emotional abuse, neglect, loss of a parent, poverty, or exposure to violence, these events impact those who experience trauma at a young age and can lead to both physical and mental manifestations later in life.

From this foundation, my wife and fellow Pediatrician, Yasmin Bahora, DO, and I sought out opportunities to improve the lives of our patients. One of our advisors at St. Christopher’s sent us a link to the GHSP program, and the more we read, the more we realized that this was the right program for us.  The most attractive part of GHSP was the ability to work and teach with medical students for an entire year– which felt like the perfect amount of time in order to have the greatest impact.

  • What were some major takeaways that you found working with the youth in Malawi?

The resilience that these children show is astonishing.  Children in Malawi want what most children all around the world want: to feel safe around family and friends that love them, to eat when they are hungry, and most of all they want to play.

The children’s ward is over-saturated with children suffering from illnesses that are common in sub-Saharan Africa such as Malaria, HIV, TB, and malnutrition as well as other diseases that are common among children worldwide such as asthma, acute respiratory illness, and diarrheal illnesses.  However, the suffering is amplified when resources are limited. There are often 2-3 children sharing a cot, and their mothers sleep on the floor.  The list of tragedies from family members dying of communicable diseases, natural disasters, and malnutrition seemed never ending.  But if you only focused on the tragedies, you would never witness the smiles and laughter coming from a group of children at play outside of the ward.

  • Are there any lessons that you learned in Malawi that you’ve been able to apply to your current role?

It can be difficult to explain to trainees in the US who have never traveled or worked in  sub-Saharan Africa what it is like practicing medicine there.  Even now, trying to write about my experience and thinking back on that time is tough.  The mortality rate in Malawi is much higher than it is here. The sound of a mother crying for a lost child is heard every day.  I can never forget that. As a physician, you have the ability to treat patients all over the world. You have the ability to teach medical students all over the world. If you look at the shortage of physicians, and the number of patients in need in places like Malawi, you see just how stark the situation is.  

  • How can we empower youth in the healthcare community?

This is a tough question.  I think the premise of the question is the answer.  We first have to remember that youth have the ability to learn and can be empowered to control their own lives and their own health.  Too often parents underestimate how smart and capable their children are.  We have to educate both parents and children that their health is in their hands.  We as clinicians are available to help when things go awry and when there is an acute illness to get them back on track, but the daily preventative health maintenance should be a constant conversation in their homes.  We as clinicians must help guide families through the minefields of misinformation about vaccines, diet, exercise, and mental health, in order to empower youth to take control of their own health.