• Mozambique, Africa – Aug 4, 2011

    Posted on by Marko Dimiskovski

  • Hello!

    I have to apologize for this very late post after my return to the United States.  I had a wonderful, but also busy last few days in Chicuque, Maxixe, and Maputo.  Below is a capture of an exciting local soccer game!

    Local Maxixe Soccer Game

    I wanted to take this last post sum up the 7 weeks I spent in Mozambique, but also absolutely must thank Drexel University and Mozambique Development In Motion (MDIM) for giving me the opportunity to be able to train, travel and serve in Mozambique.  I would like to also thank Chicuque Rural Hospital and Dr. Jeremais Fraca for letting me serve and work among them.  I have to definitely have thank Richard Duncan from MDIM for the support and guidance he has given me.  I can not forget Shirin Karsan as well!  A special thank you goes to Miguel Rungo, who was pretty much my best friend for the entire time there and taught me so much.

    For a quick summary of my time: I completed a full inventory of all medical equipment in the hospital.  I was able to restore some equipment mostly in the surgery department.  The 8 vital signs monitors were not able to be set-up due to lack of some cables it was missing, but there are efforts with the great help from Mr. Duncan to obtain the parts needed.  The anesthesia machine I was able to restore is now being used as the main machine in surgery.  The dental set and compressor was fixed last minute before leaving and figured out the problems arose from wrong pressure settings.  That is to list just the main equipment restored.

    I did manage to travel to other hospitals to connect and see their state for potential engineering or service projects.  Some hospials were: Inhambane Provincial Hospital, Cambine Hospital, Maboti Hospita, and Maputo Central Hospital.

    Maputo Central Hospital

    Introduction to electronic medical system and its possibilities and potentials have started some development conversation.  I would like to continue work with this in the future.

    Thank you to everyone who has read the blog and took interest in it.  I hope my time in Mozambique was of value to everyone and the hospital as much it was to me.  The culture, the attitude, and lifestyles were an amazing experience much different from the other places I have visited in my past.  The constant singing, daily customs, ect.  I listened to the beautiful singing of United Methodist Church Choir every night right outside my window.  I cannot forget how beautiful and different the environment was.  As Vanessa Lin mentioned seeing shooting stars, I was able to see the Milky Way (even without my glasses!).  The safari landscapes with anthills as tall as me, and the river that animals fed.  It was an experience I will always remember and will never regret!

    Signing off with warm regards,

    Marko Dimiskovski

    Posted in Mozambique | 1 Comment
  • Mozambique, Africa – July 21, 2011

    Posted on by Marko Dimiskovski

  • Sorry for the lack of updates! Past 2 weeks have been quite exciting. First topic I wanted to talk about is the parts I have been trying to obtain for the 6 anesthesia monitors. I finally been contacted by someone actually from a Mozambican company that I contacted earlier. They helped me out getting the correct part numbers since mine were outdated from an old manual I had. Turns out we don’t have the funds to get the cables needed to run the monitors. It costs about $1,300 for 1 set of cables. That is only 4 cables per monitor. That should put in perspective how hard it is to run a hospital that has a budget of a little more than that amount. They have been asking for things that I haven’t been able to provide, which makes me very sad.

    I was able to fix an anesthesia machine. The surgery department was very happy to have another machine to use as they only had one. I found manuals from a few good and generous people over the world who have been in my situation. They taught me how to use the machine and I taught them how to use the machine. It was a nice collaborative effort. So far they use only O2, but I’ve been trying to find a way to fix their NO2 delivery system for the surgery suite. It only needs connector fittings, so we’ll see how far we get. I did manage to restore the oxygen concentrator completely as well. I still have some dental tools to look at, 2 other monitors, 2 huge washing machines, 2 dryers, and a few pumps. I don’t think I will be able to get to all of them, but I’ll try my best.

    I did take a trip to Maboti. This is the city I mentioned in my earlier post about having limited power and such. First the travel there was a grueling and painful one. It took pretty much the entire day from 6am to 6pm (it gets dark here early around 4:30-5pm). The city only receives power by generator for 3 hours a day. Some people and businesses that can afford it have generators. I saw my first gas powered refrigerator and freezer. Cell phone coverage is quite new for them, and it’s pretty hard to charge your cell phone during the 2-3 hrs of electricity. The government is building a path to the city as well as power lines connecting a larger nearby city Vilanculus, which runs on massive generators all day 24/7. They will temporarily receive power from them until they get connected to the government’s hydropower like Chicuque. I visited the hospital there. The only equipment they had was a microscope and a blood tester. They said the microscope was solar powered, but I didn’t see how. They had a solar power system, but it was broken and I think they said they needed new batteries. Power is their main problem. They said many times women come to give birth and its been done under cell phone light. I see many potential engineering projects here in all fields. I also traveled even further into the wild safari to Zinave. The towns/cities out that far have no power at all and most don’t even have generators. Some had solar power, but only for a little.

    I visited Cambine once again, this time to see the hospital and city. The hospital is pretty much in the same situation as Maboti and others. They do have power though, but no doctors. Only nurses and technicians. If a severe case comes they patient is transferred to Chicuque or Inhambane, which is not far off. Many engineering designs can been placed here too. I had a chance to stop by the Carolyn Belshe Orphanage again and play with the children there and hang out with the older guys. I met all the “mammas” who worked there. Everyone there had hearts bigger than the world. I’ll miss them, and hope I’ll see them in my future.

    Currently I have been trying to download files for teaching Miguel and others who might be interested about the electronic medical record system. I’ve been using OpenMRS (http://openmrs.org). Great system and hope future students get interested in it. Although there is no infrastructure for this system currently I believe it can be done within the next few years or sooner. I wanted to introduce it to Dr. Jeremais and Miguel at least a little before I left. It’s been hard downloading past 2 weeks because the city seems to not have enough bandwidth and stable connection anywhere I go for Internet. I hope this problem deceases one day because it could open up many more possibilities, especially for the medical record system.

    Next week is my last week working at the hospital before I leave for Maputo, then back home to the US. I will try to update you before I depart!

    Boa Noite,
    Marko

    Posted in Mozambique | 1 Comment
  • Mozambique, Africa – July 10, 2011

    Posted on by Marko Dimiskovski

  • 66 out of 151 pieces of equipment needs repair or parts.  I spent most of the past week on compiling the inventory into a database.  Took longer than expected!  I’ve also been doing much ‘on-call’ work.  The dental tools broke down and started leaking water when used.  Few hoses just needed trimming and a connector fitting was broke, but we swapped it and the dentist quickly got back to work.  Its been cold and on and off rainy so not many patients at the hospital.

    I finally got in contact with someone about the parts for those vital signs monitors.  Philips South Africa.  I am currently being directed to speak to the right person.  I hope they can help. And also contacted Andy Rich as a back-up.

    I made plans to go to Cambine again to visit the clinic there.  I’ll also stop by and visit the orphanage again, they are too much fun.  At the end of this up coming week I should be going to the isolated town that I’m forgetting the name of currently.   They say I should be able to see a safari while I’m there!  Sorry this past week not so exciting, but this next week will be!

    Ciao,

    Marko

    Posted in Mozambique | 1 Comment
  • Mozambique, Africa – July 4, 2011

    Posted on by Marko Dimiskovski

  • Happy 4th of July!  Sort of… I know I’m posting this way later but its ok.  Second week flew by.  I continued work on inventory and now data gathering is completed.  Now time to compile it all to something readable.  I am still trying to find how to get parts for those monitors.  Think I’ll have to get them in the states and have Richard Duncan bring them.  Its hard finding a company with parts. Ugh!

    I’ve started working on getting all the defibrillators working.  They had 5 just sitting in the basement collecting dust!  I got 4 in working condition.   The last seems to need a whole new power supply.  I think the bigger problem is teaching all the staff how to use them.  This also goes for the vital signs monitors.  I think I might make up some sort of seminar for the doctors in the hospital at least.  As well as make some posters or a quick guide attached to the equipment.

    Sadly the infant bed warmers that Alexa and Zain restored on their last visit weren’t working.  The maternity staff said they stopped using them because they kept making too much noise and problems.  I got one working, but missing a temperature probe, which makes it useless because it alarms the whole time without it.  Also, I’ve read this particular model is recalled in the states, but I think it’s better than the space heater they currently have.

    Besides life at the hospital I’ve visited Tofo and Tofina.  Tofo is the most beautiful beach period.  Tofina means little Tofo.  I also traveled to Cambine where the Carolyn Belshe Orphanage is located.  I met everyone there, had tons of fun and got a few pictures.  I’ve also linked up with the new director of the clinic there.  We will be meeting again so I can take a look around the hospital and talk about maybe making it a site for students to be engineers and do some work there in the future.

    I’ve also been invited by Dr. Albertina to visit a clinic in a very isolated place where there is high poverty.  No electricity or anything.

    Well… The power has been out and my laptop battery is running low!

    Ciao,

    Marko

     

    Posted in Mozambique | Leave a comment
  • Mozambique, Africa – June 26, 2011

    Posted on by Marko Dimiskovski

  • Hi! My name is Marko Dimiskovski. Here I will write about my experiences during my stay in Mozambique serving as a clinical biomed engineer at Chicuque Rural Hospital.

    So, after a early 2.5 hr drive to JFK, 15.5 hr plane ride to Johannesburg, a 1.5 layover, 2 hr plane ride to Maputo, 12 hr bus ride to Maxixe, and 10 min ride to Chicuque… I finally made it to my home for the next 6 weeks. Total travel time: 33.6 hrs with no exaggeration. The bus ride was… interesting…. No other comments about that… Everything else has been great.

    My first contact I met up with was Mr. Miguel Rungo. He has been the most generous and amazing person. And has been showing me the ropes of Mozambique and helping me get around.

    I am staying at the United Methodist Church guesthouse, which is a short walk away from the hospital. My day starts out with a pleasant walk to the hospital. Along the way everyone greets with a good morning and the children all yell “bye bye!!” as I walk by the day care across the street from the hospital.  I meet with Sergio, the head of maintenance and Miguel. For this past week we have been going around the entire hospital and making a record inventory of every single piece of equipment. This is a long tedious process and is still in the works. In between creating an inventory I’ve fixed a few pieces of equipment here and there. I’ve also started begun my search for missing parts needed to get the equipment running. One of the main priorities right now is building an intensive care unit with working anesthesia vital sign monitors.

    I’ve met up with Amandio from Mozambique Motion in Development (MMID). He was introduced to me through Richard Duncan, who is on the board committee of MMID. They have provided a generous amount of money to support efforts in getting things running. So a special thanks goes out to MMID! Amandio is my main point of contact for tracking down and ordering parts (somehow). It’s very hard to get parts in a remote location like Chiqucue.

    Besides work at the hospital I’ve briefly visited Hospital Provincial de Inhambane. I had a quick tour of the labs there and was invited back by the clinical director for a more formal visit. The hospital is much larger. Usually if the patient has a certain condition that cannot be handled at CRH they are transferred to Inhambane. Inhambane is a much older and historic city. Will talk about this in a few weeks.

    This up coming week I plan to continue and hopefully finish up inventory as well as get to work on getting priority equipment up and running. And if time permits I will try to make contacts with a few of the hospitals to try to set up some sort of ‘biomedical’ meeting. I’m sure there will be many unplanned surprises as well.

    Till next time. Adios!

    Marko Dimiskovski

    Posted in Mozambique | 4 Comments
  • 15June2011

    Posted on by Vanessa Lin

  • I am more than grateful to the Drexel weServe Program and Sulayman Junkung General Hospital for giving me this enriching opportunity in The Gambia. The six weeks I spent there were filled with experiential learning as I gained valuable skills in fixing medical equipment as well as sharing my knowledge with the hospital power-supply team. Due to the fact that the hospital does not have designated biomedical engineers, I spent much of my time with the members of the power-supply department.  They are the main technicians working on and repairing any broken medical equipment. Many may think that since I was volunteering at a hospital everything I did must have been medical related.  However, I believe the tasks that I accomplished are evidence that there is plenty of variety in the areas of work available at the hospital. As I wrote in my previous blog entries, I also contributed to enhancing the hospital’s library collection and aided in fixing the medical school’s computers.

    Owen Montgomery and SJGH Librarian, Agnes, organizing books in the hospital library

    View of the computers we fixed in SJGH's medical school.

    Continue reading

    Posted in Gambia | 1 Comment
  • 07June2011

    Posted on by Vanessa Lin

  • We just got back from the Kombo area where we spent the weekend with students from Juniata College.  The students were visiting the Gambia as part of a three-week summer course with their professor Dr. Emil Nagengast.  In addition to visiting various parts of the country both near the coast and inland, part of their itinerary was to visit Sulayman Junkung General Hospital.  We met them after their tour of the hospital site and made plans to meet up the following weekend when they would be in the city area.

    I really appreciated Dr. Nagengast’s hospitality as he was very warm in welcoming us to his students as well as encouraging us to join them with their activities.  I enjoyed talking to the Juniata students and hearing about their experiences in The Gambia as well as sharing similar stories in terms of being an American in a foreign country.  I was especially excited when the other students mentioned going to Serrekunda market to buy fabric and getting clothing tailored.  I had heard from previous weServe students that there is beautiful fabric in all the markets as well as some crafts available to buy.  I can confirm that, yes, there is definitely beautiful fabric and its most certainly plenty in number!  From the crowded streets with taxis squeezing by to the bargaining tactics, I was in for an experience.  I can deal with the crowded areas with heavily flow of people walking through because I have been to a bazaar before.  However, this was the first time I had to bargain for a good price.  I was warned by my Juniata friends that every shop owner will try to tell me that I’m going to get “Good Gambian price” but it’s not quite so.  Thankfully, they prepped me on what prices to expect for certain items and some haggling techniques to really get a good price.  I have to admit, at first, I was settling for a price that was too high but eventually, I gathered more confidence and was able to bargain for lower prices.

    New friend from Juniata College shopping for fabric at Serrekunda market

    In addition to the market adventures, we joined the Juniata students in watching a football—soccer—match at Bakau Stadium where it was Bakau vs. Young Afrikans.  I was surprised to see that this decently sized stadium was filled with maybe less than 25% spectators.  Aside from the small crowd for the soccer match, there is still a strong passion for the sport.  Every Sunday, there are soccer matches going on all along the beach.  I snapped some action pictures of the Juniata students playing since I wasn’t exactly participating.  Watching the soccer matched along the beach was a sight worth seeing and was a great way to close our weekend.

    Football (Soccer) on the beach in Kombo every Sunday

     

    Posted in Gambia | 1 Comment