Category: Malawi Experience

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Simple Changes towards a Low Salt Lifestyle

Has your doctor recommended that you should start a low-sodium diet? You might find it to be a challenge, as it seems that sodium is in everything we eat. The typical American eats a fair amount of fast food and an equally dangerous amount of comfort foods at home. These foods, such as canned soups, crackers, salsas, and of course potato chips tend to be high in sodium. It is typically recommended that your dietary intake of sodium remains between 2,000 and 3,000 milligrams per day. Remember, your goal is not to eliminate all the salt entering your system; after all, the human body needs some sodium to survive. The goal is to get your sodium levels to a healthy range. Here are some helpful tips to get you started.

  1. Stop adding salt to the food you eat. Put your salt shaker away in a hard to reach place. Old habits are harder to break if you feel like you are depriving yourself. So instead, start to experiment. Fill the shaker with salt-free herbs and spices such as basil, oregano, lemon pepper, garlic, onion, or parsley. Try different combinations until you find one that you enjoy.
  2. Buy a pepper mill and try grinding your own fresh pepper from an array of peppercorns, such as: tellicherry, lampong, white, green, sichuan, or pink peppercorns. If you haven’t tried freshly ground whole peppercorns on your food before, you are in for an amazing experience.
  3. Learn to read food labels. By comparing product labels side-by-side, you will see some notable differences between products that seem identical. Generally speaking, packaged foods will have higher levels of sodium than fresh foods, but you can learn to make healthier choices when choosing canned or frozen foods if you know what to look for.
  4. Eat more fresh food. Fresh fruits and vegetables are naturally low in sodium. You can eat as much as you’d like and not have to worry about clogging your arteries. Fresh, lean meat, fish, and chicken also tend to be low in sodium.
  5. Start fully experiencing the use of herbs in your cooking. Herbs are a great substitute for salt. Find recipes and experiment with fresh herbs to expand your cooking repertoire.

Changing your eating habits will not be easy at first, so start with small changes. Start by targeting just one meal a day. After you have established that habit, then do the same for a second meal. It will take some weeks before you build a good understanding of which foods are low in sodium, but you will with time. Eventually, as your taste buds adjust to your new diet, you will crave salt less as you have been exposed to a world of new tastes and flavors.

Dr. Barbara Edwards, a Princeton M.D. internist practices at Penn Medicine Princeton Health in the Penn Medicine Princeton Medical Center and also serves as Medical Director of the Bristol-Myers Squibb Community Health Center.

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Dr. Barbara R Edwards July 2019 Malawi Volunteer Experience – Final Thoughts

Dr. Barbara Edwards, Princeton internist, standing with other volunteers on the Malawi mission trip

This past July I went with Villages in Partnership (VIP) for another medical mission trip to the Zomba region of Malawi, Africa.  Once again, what a fabulous experience! During our trip we set up 3 pop-up clinics in remote villages with no electricity or running water.  A group of 26 American physicians, nurse practitioners, nurses, and nursing students worked side by side with around 50 Malawian physicians, medics, nurses and community workers.  We treated over 5000 patients in 3 days and saw patients of all ages from newborns to the very elderly.  People arrived before daylight to wait for us and we worked until after sunset using the light of our headlamps to see.

Dr. Barbara Edwards, Princeton internist, standing with a group of doctors in Malawi

 

 

 

 

 

 

 

We treated a variety of illnesses including upper respiratory infections, back and joint pains, malaria, gastrointestinal and urinary tract infections, and rashes such as eczema, ringworm and scabies.  At each site there were 3 to 4 American providers and 3 to 4 Malawian providers working side by side in pairs.  This was extremely helpful to the Americans as the Malawian providers could help us to recognize conditions that we don’t often see in the States.  Moreover, we had to learn how those conditions are treated in Malawi, often using antibiotics and other medications that we don’t use in the USA.

Dr. Edwards, Princeton Internist, sitting with the doctors of Malawi

 

 

 

 

 

 

 

 

Except for the medications for malaria which were supplied by the Malawian government, we prescribed medications that we brought with us or purchased in Malawi.  All care and medications were given free of charge and dispensed from a pharmacy that we created at each site. We also dispensed non-medical items such as shoes, soap and wash clothes which can be just as important when treating a medical problem.

A group of volunteers in Malawi in the back of a truck with Dr. Barbara R Edwards

 

 

 

 

 

 

 

On-site testing was an important part of the clinics and was limited to blood counts, blood glucose, VDRL, malaria and HIV testing.  The HIV testing was run by the Malawian government which has used a “test and treat” protocol since 2016 which has successfully increased the percentage of patients in Malawi maintained on suppressive HIV therapy. (1,2) Of the 164 patients tested only 4 or 2.4% tested positive.  Each of the four patients was then assigned to a community worker and brought within 48 hours into a government run clinic to be started on HIV medication.

the doctors of Malawi working with medications

 

 

 

 

 

 

 

In addition to medical care, we provided dental care.  Two years ago, a dentist with VIP raised the money to buy and bring over portable dental equipment.  At our pop-up clinic in Kalupe an American and a Malawian dentist worked together to treat 283 patients and were delighted that they could clean teeth and do fillings in addition to pulling teeth.  We also brought a large supply of amalgam so that the Malawian dentist could continue to fill teeth even after we returned home.

Dr. Barbara Edwards, Princeton internist, standing with other volunteers on the Malawi mission trip

 

 

 

 

 

 

 

 

During this trip we offered a new program to dispense glasses to patients through a partnership with Global Vision 2020. (3,4) A retired American businessman was trained in the use of a hand-held device which measures eye prescriptions and then uses a set of precut lenses which are inserted into simple empty frames.  These glasses were sold for $1 per pair and were the only thing we charged for during the trip. Prior to this program, the only glasses that were available were used glasses which were at best a gross approximation of a person’s actual prescription. The new glasses were extremely popular amongst the villagers and were considered so stylish that some people bought glasses with plain lenses as a fashion statement!  After we left, a local Malawian who worked with us took this over and will run it as a small business.

One of the best things about VIP is that the organization continues to work in the area all year round.  They have started several weekly clinics to provide year-round care staffed by medical personal whose training and salaries are paid for by VIP.  In addition, VIP is partnering with the Malawian government and the village of Khanda to build a permanent clinic in this most remote area.  This clinic will operate daily year-round to provide care to this needy area of Malawi.  VIP’s recent 10th anniversary Gala helped to raise needed funds to build this clinic.  We are all so excited to know that work can begin on this project! If you are interested in learning more about VIP, please check out their website at villagesinpartnership.org.

To learn more about the Dr. Edwards, Princeton internist, and her volunteer trips in Malawi, visit her Facebook page.

References:

  1. https://www.indexmundi.com/malawi/demographics_profile.html
  2. https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25239
  3. https://gv2020.org/
  4. https://villagesinpartnership.org/a-new-vision-by-timothy-golden/#
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Dr. Barbara R Edwards July 2019 Malawi Volunteer Experience – Culture

Dr. Barbara Edwards, Princeton internist, speaking to her volunteer group in Malawi

During this past July I was lucky enough to return to Malawi in the south-central part of Africa for another medical mission trip. I went as part of a team of 26 Americans;  a combination of physicians, dentists, nurse practitioners, nurses and nursing students who worked hand in hand with more than 50 Malawian physicians, medics, nurses and community workers to set up 3 pop up clinics in remote rural villages without electricity or running water.  People are often struck by what they think of as a sacrifice on my part to go on these trips.  What they don’t realize is that I receive as much from these trips as I give.

Dr. Barbara R Edwards in the village of Malawi on her volunteer trip

 

 

 

 

 

 

 

The people of Malawi are a warm and loving people and I felt like I had been given a gift when they welcomed us with such open arms.  They have a very communal culture spending most of their waking hours with others in the community.  I met several Peace Corps workers while I was in Malawi and they said that for an American this could sometimes become overwhelming.  They were living imbedded in a small village and if they needed “alone time” they would try to go into their hut for some quiet.  However, the Malawian villagers would follow them into their huts, concerned that they were sick if they were going off to be on their own.

The people of Malawi sitting in a circle with Dr. Barbara R Edwards

 

 

 

 

 

 

 

 

During my short stay this was not a problem for us.  We enjoyed learning about the Malawian language and culture.  We stayed in a Presbyterian conference center that was a working farm.  The conference center employees came every day at dawn to prepare our food which was mostly traditional Malawian food prepared over an open fire.  We learned to appreciate nsima, a cooked corn meal porridge, with various toppings made of greens, chicken or goat. Nsima is the basis for most Malawian meals although in the regions closer to water, rice is also frequently eaten. 

the people of Malawi standing with Dr. Edwards, Princeton internist

 

 

 

 

 

 

 

We learned that Malawians are very religious; 78% are Christian and 14% Muslim. We worked in both Christian and Muslim villages. On Sunday during our stay we attended the Presbyterian Church in the nearby village of Liti.  This was a rich cultural experience for everyone in our group, even those who were not Christian.  There were several choirs of different ages who sang and danced during the service.  We joined in forming an ad hoc American choir.  We were able to learn and sing two songs in the local language of Chichewa. Luckily there were a few local Malawians who joined us and kept us on key!

We had an opportunity to visit Malawians in their homes during home visits to several needy families who could not get to our clinics.  We brought gifts to the families as is the tradition in Malawi.  These included clothes and shoes as well as soap and other toiletries.  We had an opportunity to ask questions about the villagers’ lives and to see inside their homes.  One family was in the process of rethatching their roof and the most important gift we gave them was the large plastic trash bags which carried our other gifts.  The family planned to use these to waterproof their roof!

Most villagers raise their own food via subsistence farming raising corn or rice during the rainy season and hoping it lasts through the dry season.  They also raise goats and chickens who often sleep inside the huts with the families. During the day the animals wander outside, but they always find their way home at night.  I found it interesting that the villagers could always tell the chickens and goats apart!  During our stay we helped vaccinate the chickens in one village against Newcastle Disease, a viral illness that was ravaging the chicken population until the vaccine was introduced.  VIP helps the villagers to pay for the vaccine by supplying it to them at a reduced cost.

Dr. Barbara Edwards, Princeton internist, speaking to her volunteer group in Malawi

Villages in Partnership (VIP) also works with the villages to increase sustainable food sources.  They have a program that offers needy families a goat or chickens to increase protein supplies.  In addition, the goats supply needed fertilizer for the families to improve crop output.  VIP works directly with farmers to improve cultivation techniques, too, including using improved seeds and fertilizers.  It has also started a solar irrigation program to irrigate and grow crops during the dry season or when rain does not come as expected.  I am so glad to be able to work with an organization that offers so much to the community.

To read more experiences from Dr. Barbara Edwards, Princeton internist, visit her Facebook page.

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Dr. Barbara R Edwards July 2019 Malawi Volunteer Experience – Children

the children of Malawi walking down a dirt road towards Dr. Barbara Edwards Princeton

This past July I volunteered with Villages in Partnership (VIP) on a second medical mission trip to Malawi, Africa. I went as part of a team of 26 Americans and over 50 Malawians; a combination of physicians, dentists, nurse practitioners, nurses, nursing students and community workers who set up 3 pop up clinics in remote rural villages without electricity or running water.  I was a bit nervous before I left on the trip but once I arrived, I was so delighted to be there!  The people of Malawi are incredibly warm and inviting and we were greeted with enthusiasm and open arms.

Dr. Barbara R Edwards, Princeton internist, taking care of a sick child in Malawi

One of the best parts of the trip was being surrounded by children.  Over 45% of Malawians are under the age of 15 so there were children everywhere. (1) During the clinics many of the patients were children too.  We saw children with malaria, upper respiratory infections, gastrointestinal infections and rashes.  I learned that worms were a common cause of persistent vomiting in children and that any child with malaria was also at risk for getting a bacterial bronchitis. We saw children with burns from falling into cooking fires while playing, children with epilepsy who struggled to get medications to keep from having seizures and children born with HIV who were maintained on HIV medications.

Dr. Edwards, Princeton internist, sitting with the children of Malawi

I saw one child who had developed a partial paralysis after a viral infection.  She was 2 but had never learned to walk or crawl because she was weak from the waist down.  With the help of the VIP community workers I arranged to have her seen in the nearest hospital in the city of Zomba by a neurologist.  She needed physical therapy and a walker. This was not easy as it required transportation and the money for the consultation and any further treatment.  In September I learned that she had been to see the neurologist, was getting the needed physical therapy and was learning to walk with the walker.  How amazing that we were able to help this child!

Dr. Barbara Edwards, Princeton internist, greeting the Malawi children

In addition to the children who were patients, we were surrounded by children who wanted to play.  Luckily, the nursing students had enough energy to keep up with them.  We brought inflatable balls and frisbees with us, but the favorite game was Duck, Duck, Goose! This game went on for hours. Even some of the doctors played during their breaks.  Whenever we went out, the children would run up to us and hold our hands as we walked. The older children would speak with us and practice their English as we walked along.  They have learned English in school but rarely have the chance to practice in real conversations.

Dr. Barbara R Edwards, Princeton internist, surrounded by the children of Malawi

With so many children, it is important that they get an education, and this is one of VIP’s highest priorities. (2)  VIP has worked hard to improve the educational resources available to the children in the region.  It has helped to rebuild schools, started preschools in the area, distributed solar lamps so that the children can study at night, and sponsored students who cannot afford their school supplies.  VIP also sponsors students to go to the University.  These students then go on to become teachers, nurses, or medics who come back and work for VIP to give back to the region.  They are currently raising funds to build a middle school in the area and a permanent medical clinic.  They are doing amazing work!

 

  1. https://www.indexmundi.com/malawi/demographics_profile.html

 

  1. https://villagesinpartnership.org/six-critical-needs/education/

 

 

Dr. Barbara Edwards, Princeton internist, Shares Her Experiences in Malawi

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Malawi Trip – One Year Later

Dr. Barbara Edwards (Princeton) in Malawi May 2017

This time last year I volunteered for a medical mission trip to Malawi with Villages in Partnership, a non-profit organization dedicated to improving access to medical treatment and quality of life for those in need abroad. Over the span of the 10 days that I spent there, we created 4 clinics that served 5,000 patients.

Upon arrival there was a rumor about the government clinics running out of malaria medicine. On the second day of clinic work myself, 2 Malawi medics, and a nurse practitioner were able to help suffering patients with the appropriate treatment. At one point we ran out of malaria test strips so we had to treat empirically for the symptoms until they brought new ones from another clinic.

Spending 10 days in an unfamiliar country that is vastly different from what you are accustomed can be difficult, but I’ve learned a lot from the people of Malawi, and they’ve appreciated the work we did for them. From living in their environment with tough conditions, to eating their food, and going to their churches, it makes me so incredibly grateful to have had the opportunity to go and volunteer to help them.

Learn more about my experiences here.

Dr. Barbara Edwards, Princeton doctor internal medicine practices at Penn Medicine Princeton Health in the Penn Medicine Princeton Medical Center.