Until the early 1990s, Malawi had been under the dictatorship of Hastings Banda, a general practitioner, who practised in the United Kingdom and then went back to his own country and proclaimed himself president for life. It was a harsh time for the people: imprisonment without trial and other human rights abuses were common. Since 1994, however, democratic elections have been held. The country itself is beautiful. Its most prominent feature, Lake Malawi, supports a sizeable fishing industry.

British passport holders do not need a visa to visit Malawi for stays of up to three months. The rainy season is in the winter (December to March), and this is also when it is hottest. Malawi is a pretty safe country to travel in. Hitchhiking is usually fine if you are with someone else.

Vaccinations for polio, hepatitis A and B, and typhoid are all essential if you are working clinically. You will also need malaria prophylaxis. Ask your occupational health department for up to date advice.

Medicine

Malawi has a poor record with one of the lowest life expectancies (42 years) and highest infant mortalities. More than half of children under 5 are short for their age, but a massive vaccination campaign and a programme to combat malnutrition is beginning to work. Infectious diseases are common. Prevalence of HIV in some areas is thought to be more than 30% (population average is 16%). Estimates suggest that there may be only one doctor for every 50 000 people. Before the change in government, Malawi had no medical schools. One has now been set up in Blantyre. The Christian Health Association of Malawi (PO Box 30 378, Lilongwe, Malawi; tel +265 775 404; fax +265 776 492; email nympha@malawi.net) operates 20 hospitals in Malawi.

For more information on the above hospitals (such as details on what they are like to work in, accommodation, and things to do near by) take a look at The Medic's Guide to Work and Electives Around the World.

Mark Wilson author of The Medic's Guide to Work and Electives around the World Mark@medicstravel.com,

Mark Wilson gives the basic facts about Malawi

Useful addresses

Ministry of Health, PO Box 30 377, Capital City, Lilongwe (tel +265 783 044; fax +265 744 943)

National AIDS Control Programme, PO Box 30 622, Lilongwe 3 (tel +265 781 344; fax +265 784 227)

Lilongwe

Lilongwe School for Health Sciences, PO Box 30 368, Capital City, Lilongwe 3 (tel +265 720 911)

Lilongwe Central Hospital, PO Box 149, Lilongwe (tel +265 721 555)

Blantyre

University of Malawi College of Medicine, Private Bag 360, Chichiri, Blantyre 3 (tel +265 677 291; fax 674 700; www.unima.mw)

Founded in 1994 this uses the Queen Elizabeth Central Hospital (PO Box 95, Blantyre). The hospital is the main referral centre for southern Malawi and the largest hospital in the country. Despite being the main teaching hospital, it is run down. Another hospital in the area is Adventist Health Services, PO Box 951, Blantyre.

Ekwendeni

Ekwendeni Hospital is a 205 bed mission run hospital in northern Malawi which caters for most large specialties.

Embangweni

The hospital has 120 beds with general medical, surgical, paediatric, and maternity wards.

Livingstonia

The David Gordon Memorial Hospital in Livingstonia has 65 beds with a number of outreach posts.

Mulanje

Mulanje Mission Hospital (PO Box 45, Mulanje) is a small hospital with 146 beds (set up in the early 1900s by Scottish ministers) in a Presbyterian mission at the foot of 3000 metres high Mulanje Massif. There are four doctors (recently all Dutch, but hospital work is done in English). This place gets fairly booked with elective students so apply well in advance.

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