Ten years in Malawi: was it worth it?

Many people ask why my wife and I gave up our safe NHS jobs 10 years ago to go to Malawi. We could give a spiritual answer about going where God guides—and that would be true—but the simplest answer is that we were needed. The 12 million people in the greater London area had more than 200 consultant orthopaedic surgeons; Malawi, with the same population, had none. One of the poorest countries in the world, it had few doctors and annual spending on health care of about £2 per person.

My colleagues and the chief executive of our NHS trust allowed me to keep honorary consultant status while I went to work for a local charity and a new medical school, supported by Christian Blind Mission International. We planned to stay for four years, but by the end of three I was deeply involved in setting up national and regional surgical training and had to extend our stay. After six years we were building Malawi's first orthopaedic hospital. I had to stay to see this through, so before we knew it …