First World Third World

I am finding it difficult to write about my African experiences. The multiple images and experiences are almost too overwhelming. Recently, while working on a US project the difference and similarities between the projects were drawn into focus.

I had tried to write previously about my visit to the Salima District Hospital. Even now, a month later I am still very upset by the images and memories from that visit. Visions of multiple people in one bed, family on the floors, no screens on windows, body parts waiting for disposal, facilites in disrepair, charts showing maternal and infant deaths, numbers of babies born with malaria, are still fresh in my mind. Infants typically are not named until 6 months of age, they are not considered human beings until then because the mortaility rate is too high, it takes too much energy and resources to constantly have public funerals for these precious babies. A staggering 40% of children born here do not reach their 5th birthday. These conditions, while horrible by our standards are quite good in the countryside in Malawi. People walk for days to get to this hospital.

The new birthing center and hospital that we are beginning to construct has the potential to reduce the infant and maternal mortality rate by at least 50%! We are literally saving lives.

Contrast this to the projects currently underway in the States; State of the art centers and hospitals with the best care, and outcomes. BUT we assume that quality care is a given. We rarely, on the facility side, discuss mortality rates. While what we do as healthcare facility engineers relates directly to quality patient care, infection rates, patient satisfaction, etc., it is so transparent in the States, or at least is supposed to be that the patient rarely gives a second thought about all the work done on their behalf by the staff regarding life safety. What we do discuss on a daily basis is cost. Cost of construction, cost of systems, ROI’s, etc. Now, a caveat, my political leanings are pretty simple, I am a capitalist. I have an entrepreneurial heart and mindset and while I am a gadget guy, I want those new gadgets we install to be cost effective, operationally sound, and fiscally profitable.

To be very pragmatic, our focus in the States is financial, while in Africa our focus is lives. I spend most of my time in the States dealing with issues that relate to the bottom line of the project or facility.

I was very surprised that one of the outcomes of my trips to Africa was the realization that lives are also the focus of what we do in the States, it just gets covered up by all the other first world issues. It has been an excellent reminder that in healthcare we save lives and improve the quality of life for our patients no matter what continent we are on!

Proud to be of service.


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