I read this book prior to working in Malawi for a summer. It's a great preview into the medical system as well as the sociopolitical dynamics affecting health in the country. It's a must read for anyone doing healthcare work in Malawi, but it's also an eye opening book for any medical student. Sep 17, Liralen rated it really liked it Shelves: africa , doctors , nonfiction , z , reviewed. In the United States, I have often heard students, residents, and practicing physicians say of a colleague, "He may be an asshole, but he's a really good doc.
I never heard anything similar in Malawi and have come to believe that it would be heard as nonsensical there. The work itself, for these students, required heart. Wendland walks through t In the United States, I have often heard students, residents, and practicing physicians say of a colleague, "He may be an asshole, but he's a really good doc.
I'm just a curious layperson, but I highly, highly recommend reading the endnotes ; they add a great deal.
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They learned about neuroimaging and fluoroscopy and care of the extremely premature neonate, but had access to none of the equipment necessary. Disposable latex gloves are among the things in relatively short supply, and they're consequently washed, dried, and reused 91 -- have any manufacturers aimed for reusable gloves, which might stand up better to multiple washings, etc.? Much higher risk of physician exposure to diseases than in Northern medical settings; interesting calculation of occupational exposure Not just a matter of higher numbers of patients with e.
Common theme of Northern med-school memoirs is coming to terms with the reality that some patients will die; students in Malawian med schools are much more likely to see high levels of death both in med school and after.
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Jan 15, Manasvi rated it it was ok. A Heart for the Work I read this book for my Medical Anthropology class. I am not really a big fan of this subject. So I delayed reading the book a week before the review was due. I wish I hadn't because I liked the books. Although a little boring in the beginning, it picks up its momentum from the second chapter. Claire Wendland asserts that despite the material and technological strain if you have A Heart for the Work then you A Heart for the Work Claire Wendland asserts that despite the material and technological strain if you have A Heart for the Work then you can always find a silver lining and help your patients.
Medicine is considered to be neutral and beyond any cultural influence. Wendland says, "If anything lends itself to globalization, medicine does 7. The book fascinated and depressed me at the same time. The things I learnt were very unsettling.
A Heart for the Work: Journeys through an African Medical School (Book Review)
For instance, the medical books used in Malawi are the same as used in North America and Europe but many of the medical techniques showed in the books remain only theoretical concepts for the medical doctors in Malawi. Even if they prescribe a drug or a test, they lack the resources to provide the patients with the help they need. With students transitioning into clinical years, they experience anger and resentment against their government.
They are demoralized by the workload and the lack of resources in the hospital and forced to compromise with their own ethics. Facts like doctors earn a lot and patient privacy is of highest concern are not true in Malawi. Also, a lack of protective equipments such as gloves and masks puts the doctors at risk of infection from blood and other body fluids. The students are frustrated because they are "charged to heal yet unable to do so ".
The word resource is just a verb for them. I think Wendland did a commendable job describing the situations that affect the personal values of medical students in Malawi. Her manner of ending each chapter with a subject story kept me intrigued throughout the book. At last, I agree with Wendland that biomedicine is influenced by culture and the studies done in the North does not represent the situations worldwide. Aug 01, Lady Jaye rated it liked it Shelves: food-for-thought , liked-it , non-fiction , read-in , stars-3 , owned-dtb.
I just finished this book, with mixed feelings.
A Heart for the Work: Journeys through an African Medical School
I am African and hoping to be in an African medical school soon. I have hung out with frican medical students, African house officers I call them baby doctors, lol , African residents, and African specialists. I have been a patron of public hospitals in Africa, and I have observed the public health system at work. Wendland did her research. Our situation is rather different from theirs, I just finished this book, with mixed feelings.
Our situation is rather different from theirs, but similar enough that I know exactly what Ms. I might not agree with the spin she put on all of it, but I think it is a solid effort to represent the journey to becoming a health worker in Africa as well as the challenges of working in the public health sector in Africa.
Apr 15, fleetofhorses rated it it was amazing Shelves: field-guide. We are supposed to accept that the destruction of idealism begins only when one becomes a doctor, forgetting that in most countries medical students spend the last three years on clinical attachment beforehand.
If Western medical training has barely been given due attention,  then it is little surprise that African medical education has been equally neglected. Claire Wendland, however, has begun bringing light to a seeming uncharted arena. Her book, A Heart for the Work , traces the path of medical students in Malawi and paints a contrasting picture with accounts of Western training. One of the earliest studies of medical school was undertaken by four sociologists at Kansas Medical School in the s Becker et al, In both accounts, those that enter medicine are privileged; for Becker and his colleges this usually meant white Caucasians Becker et al, , p Medical students in Malawi, on the other hand, can come from a more varied background.
These students had often completed some basic medical training and would have often spent several years being exposed to the realities of clinical medicine in Malawi. Despite their clinical experience, there is a snobbery between the students, with the clinical officers being from less privileged backgrounds than the other medical students. If a student shows any aptitude towards scientific work, only teaching and medicine appear as practical options. Teaching, with its poor working conditions and pay, is seen as an unattractive option and medicine is therefore seen as the natural resting place for those with an inclination toward scientific subjects.
Despite recognising the inevitability of medicine as a career, Wendland goes on to describe the quasi-religious reasons that students give for entering medical school. Their entry into medicine was driven by nationalist impulses. Some had witnessed suffering of those they knew personally; others, like Mirriam Kamanga, talk of how delivering food to those affected by famine forced her to confront the suffering of ordinary Malawians:.
Medicine, and the metaphor of healing bodies as a proxy for healing the country, is brought up repeatedly by the interviewees whom she speaks to. Whether these would be the reasons they give when students apply to medical schools, or whether these are thoughts they simply express to Wendland goes unsaid. We have no account of the admission process, and whether the motives of students are examined.
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To the outsider it perhaps seems strange that British medical students are advised not to take an idealistic approach and that professing to want to heal the sick can be construed as negative. Cynicism is admittedly seen as a national trait by many observers of the British Mazella, , p , and Malawians may not hold self-mockery in such high regard.
Nevertheless, whilst medicine undoubtedly makes a difference, the ability of an individual doctor to heal a nation is somewhat fanciful. Whilst British medical students are derided for even dreaming about saving their patients, Wendland lauds the Malawians for dreaming of saving their nation.
Instead, we are left only with the notion that medicine is the new salvation, and that the medical students are the evangelical novitiates of this healing religion. Admittedly, for Malawians medicine is a career not without its dangers.
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Wendland recounts how she was often told of clinicians who had died from HIV and other infections, caught from patients on the ward. Whilst not unknown in the developed world, the incidence is much lower Wendland, , p77 ; universal precautions are easily available as post-exposure prophylaxis medication. Such fatalistic working conditions no doubt grant a genuine edge to prostrations of wanting to heal. In London, whilst medical students are occasionally given special prominence amongst other students, within the medical hierarchy they are firmly on the lowest rung.
As Sinclair writes:. In Malawi, where there is a great paucity of doctors, medical students are often elevated, especially when on their community placements. Even pre-clinical students who have yet to experience life on the medical wads find themselves cast into the role of doctor, as Joe Phoya recounts of his community placement:. From the day of their entrance to medical school, the mantle of doctor has to be assumed. As first year student, Mkuma Lifa, describes:.