Dr. Vivienne Malawi is in her third, and final year, of training with Save a Child's Heart as an intensivist in the pediatric ICU at Wolfson Medical Center. Dr. Malawi began her training several years ago, returning to Tanzania after two years to build her family. With one year left to her program, she returned to Israel for a final year of training in 2020. Shortly after her arrival, COVID-19 began to spread across the globe and Dr. Malawi was presented with a difficult choice to continue training or return home to care for her family as they and their country waded into unprecedented territory. Dr. Malawi chose to go home soon thereafter but has recently returned to Israel to finish her training "once and for all." Her dedication to serving the needs of Tanzanian children against all odds inspires us. Her story also highlights the very real challenges that healthcare providers everywhere are forced to reconcile with, in the face of a health crisis, unlike anything they've seen before. Read below for Dr. Malawi's honest portrayal of her choice to return to Tanzania and her choice to return once again to Israel amidst the pandemic.
How did you feel at the beginning of the outbreak? How did your feelings change as you realized the global repercussions?
In Israel, we were trained to handle the oncoming threat. Our team in the pediatric ICU performed mock trials to handle COVID patients and the entire hospital was mobilized and ready to shift focus if it were overrun with cases. Thankfully, that didn’t happen. For the first few months of this year, the pediatric ICU remained calm. We continued to treat Israeli children as well at the SACH children who were already in Israel for life-saving heart procedures prior to the spread of the virus and subsequent border closures. When COVID began to spread to Africa though, I was terrified. It kept getting worse by the day and I wasn’t sure which direction it would take back home in Tanzania. I worried about my family and for Tanzanians more generally, knowing our living conditions and understanding the limits of our health care system.
We knew very little at the beginning, but at first, I had hope that the virus wouldn’t survive in a region as hot as East Africa. But when cases started to swell and borders began to close, I felt I had to go home to my family. I felt that if I were unable to reach Tanzania and my children or husband fell ill, I wouldn’t survive so I decided to go back.
At the beginning of April, things were not good. We started seeing increasing cases and patient mortality rising. The country was on the brink of total panic, but preventive measures were kept in place that focused on mask-wearing and hand washing, without interfering with local businesses or work. Only those who could work from home were encouraged to, but all public sectors operated normally. Eventually and luckily, we started seeing a decline in cases and at the end of June, almost everything went back to normal.
After careful and intense discussions with my family, I decided to come back and finish my remaining time in Israel. It's been really nice to return to work with people that I now know well and SACH has been very supportive of the trainees. We feel like while anything can happen at least we have people who are backing us up and people who we can depend on. That’s not to say that the transition back has not been difficult. No one knows what’s really happening, and things can change at any moment.
Still, what I feel is that I have to do this, finish my training once and for all, so that I can return home and treat children who need my help.