N k h a n i Z a u l e r e
the Malawi Chatterbox February 2005
Tsunami and AIDS by Justin Malewezi
As Vice-President of Malawi, Justin led the fight against HIV/AIDS and is a
member of the UN Task force on Women, Girls & AIDS. He now chairs the
Parliamentary Committee on AIDS. He writes:
December 2004 saw two momentous events. The largest earthquake in 40 years
destroyed lives and property in eleven SE Asia countries and killed about
150,000 people. This is equivalent to 600 jumbo jets crashing and killing all
passengers and crew. It is also equivalent to the number of people that die of
AIDS every single month in Africa.
Our faith in God is greatly tested when such calamities befall us. Why does
God allow tsunamis to kill so many innocent men, women and children? Why does
God allow HIV to infect even unborn children? On Christmas Eve I saw the film
called The Passion of Christ. Jesus is beaten and whipped so much that his
body is reduced to pulp and covered with blood. If the Son of God himself
could go through such suffering, pain and humiliation, who are we to question
when suffering befalls us?
But the suffering caused by tsunami and HIV/AIDS challenges us individually
and collectively. $10 billion is required to assist the victims of tsunami to
rebuild their lives. The same amount of money is required annually to fight
HIV/AIDS through the Global Fund. $4 billion was pledged to the Tsunami Appeal
Fund during the first 10 days. The Global Fund has received just over $2
billion from contributions in one year.
Money for the tsunami victims quickly reached the affected communities in SE
Asia. Feasibility studies or project proposals were not required. For HIV/AIDS
programmes, bureaucratic process makes it nearly impossible to access the $2
billion from the Global Fund. HIV/AIDS in Africa is an emergency and it
requires an emergency approach to fight it effectively.
The faiths versus HIV/AIDS
20,000 Christians, Muslims and Buddhists came to Bangkok last year for the
international AIDS conference. For the first time they shared an interfaith
room for prayers. Dr. Peter Piot, director of UNAIDS said,
“I hope for the day when every church engages in open dialogue on sexuality;
when every temple will fully welcome people living with HIV; when every mosque
is where young people will learn the facts of AIDS.”
Dr Mercy Oduyoye of Trinity Theological Seminary in Accra, speaking at the
conference, cautioned against the desire to discover ‘who has sinned’ in an
HIV infection. “The churches are called to a ministry of healing, not a
ministry of assigning blame. The Good Samaritan didn’t ask the injured
traveller why he was walking alone. He responded with the limited resources he
had.”
The 3 x 5 initiative. The aim of WHO and the UN is that in the developing
world, 3 million of the 38 million with HIV should be receiving
anti-retroviral drugs (ARVs) by the end of 2005. It is a modest target but
many doubt if it is possible. If a clinic takes on 25 patients a month, they
will be patients for life. In two years the clinic will be caring for 600
extra patients on top of its normal workload – all needing continuous
monitoring, many with piggy-back diseases such as TB.
In Malawi, around 10,000 are currently receiving ARVs, mainly from Médécins
sans Frontières at Chiradzulu and Thyolo. The church hospitals are lined up to
start but the drugs have not yet come. MSF have the advantage of focussing
solely on AIDS. and can deploy far more trained staff for the task than any
government or church hospital.
The shortage of nurses is the biggest challenge. 80 registered nurses were
trained in Malawi last year; the UK took 100. Celia Dugger writes in the New
York Times:
“The result of the nursing crisis – the neglect of the sick – is starkly
apparent here on the dilapidated wards of Lilongwe Central Hospital, where a
single nurse often looks after 50 or more desperately ill people. In this
830-bed hospital, there are supposed to be 532 nurses. Only 183 are left. And
only 30 of those are registered nurses.
“What is equally visible is the boon to Britain, where Lilongwe Central’s
former nurses help solve the NHS crisis and minister to the elderly in the
carpeted lounges of nursing homes and to patients in hushed private hospital
rooms.”
“Young women between 15 and 25”, said Kofi Annan at Bangkok, “form a shocking
75% of the total who are living with HIV/AIDS in Sub-saharan Africa.
Empowering women and girls to protect themselves against the virus should be a
major priority.” Education, financial independence and access to
female-controlled methods of prevention were ways to achieve this. “It also
means freeing boys and men from some of the cultural expectations they may be
trapped in.”
St Anne’s Nkhotakota fights AIDS
Emmanuel Phemba, hospital accountant and Khama Mphatso, administrative
officer, tell the story:
Primary Health Care. We have eight community outreach clinics, one of which is
visited every week. Amongst many other activities we distribute Likuni phala –
a high protein flour made from soya beans and maize. This has been highly
effective with malnourished children.
Family planning is much in demand by women as a result of our continuous
education. The most demanded methods are Depo Provera and other injectibles,
condoms, spermicides and tube ligation.
Home Based Care began at Kapiri, among a community of 29,000. We have trained
80 Home Based Care providers in a programme originally funded by the National
Commission on AIDS but now by Save the Children USA. 25 carers who are
themselves living with AIDS have been registered with a programme based on
positive living and basic nursing skills. Care-givers are trained on how to
look after the sick in the household and how to combat stigma.
Counselling and testing. We have been a centre for this for over four years.
Of the 882 tested for HIV infection, 220 were positive. This rate of 24% is
much higher than the national prevalence rate of 16%.
Of the three hospitals in Nkhotakota District, St. Anne’s and the Dwangwa
Sugar Clinic have been approved as ARV treatment centres, but not the
government hospital. But the drugs themselves are not expected till April!
Violence against women. World AIDS Day was celebrated on 8 January and we will
start every new year with this day. Mr. W.A.K. Banda, our Chief Clinical
Superintendent, opened with a moving speech on ‘Women & Children against
Violence’, emphasizing that women are more affected by the AIDS pandemic than
men.
He condemned men’s behaviour in harassing and abusing women and girls. Dr. Tim
Wiggin underlined the distressing effects which often end with both mother and
child becoming infected with HIV. A multitude of men and women attended the
function from all walks of life. Two cathedral choirs sang of orphans and that
“God is love and teaches us to love one another, so why rape women and
children?”
The most moving moment of the day came when a beautiful young lady, Gertrude
Ng’oma, stood up. You could hardly realise that she is one of those people
living with AIDS. With vigour, composure and intellect, she narrated her
experience since her husband died, leaving her with the sole responsibiluity
of looking after the children.
The most moving moment of the day came when a
She told us she accepted the situation by going for Voluntary Counselling &
Testing (VCT) and how she is listed for the ARV programme, if and when the
drugs come. She is not afraid of what people say, she says it is a blessing to
her. The crowd was moved. You couldn’t imagine that even the most sceptical
would not go for VCT.
The Church Youth Group presented a thrilling play which brought the real
situation home. The man was always victimizing his daughter. It was a mixture
of sadness and laughter at the jokes that were chipped in with real
traditional vocabulary. Everyone was moved. It was indeed a marvel to watch.
Dr. Kalungwe has been appointed to St. Anne’s Hospital. This has freed Dr. Tim
Wiggin to spend the inside of each week at St. Andrew’s, the new diocesan
Health Centre at Mtunthama, close to The Academy, helping it achieve full
hospital status.
Malindi Orphan Care
Roger Flambert writes: The long-awaited tarmac road now runs right through
Malindi and beyond – a 5th gear road with lay-bys for buses. Malindi Orphan
Care is concentrating on improving irrigation for the seven demonstration
gardens. Owing to light rains early in the year, the wells have had to be made
deeper. They were designed so that this could be done but it has taken longer
than intended as some pumps were damaged when silt was ingested, and then some
parts stolen!
The Group continues to support families who have orphans dependent on them:
450 families, selected by the community leaders on the basis of need.
Typically, a grandmother supporting her own younger children with a few
orphaned relatives thrown in. So we support around 1,000 orphans as well as
other family members, all affected by the weight of orphan dependency.
Every one of the 14 villages in which the group works has three volunteers
trained to support AIDS sufferers, their carers and dependents. Helping frail
and elderly grandmothers, single mothers and orphan-headed families is the
group’s main concern. When the opportunity to earn money hardly exists, the
ability to dig, cultivate and produce a crop is critical to life itself.
With so much illness, the group provides medical expenses for orphans at St.
Martin’s Hospital, headed by Mr. Zigona and his wife. This 60-bed hospital now
boasts a nursing staff of 10. Two years ago they were down to 4! No small
wonder Mr. Zigona, in his late 60s, nearly died earlier this year from high
blood-pressure.
A Canadian doctor and his wife have just come to help Mr. Zigona for four
months – Tom and Renée Nunan from Saskatchewan. They have already worked in
Kenya, Nigeria, Ghana and Gambia and found USPG on the web.
First African Bishops’ Conference
Bishop Michael Doe, General Secretary of USPG, reports on the conference of
the bishops of Africa at Lagos last October. It was called by CAPA, the
Conference of the Anglican Provinces of Africa, which met for the first time
at Chilema in 1979:
Many resemble the Early Church in their simple clarity about the content and
urgency of the Gospel, the hardships they suffer, their commitment to
evangelism, their openness to the Holy Spirit and their understanding that you
cannot preach the Gospel without remembering the poor.
Africa is coming of age. Last week’s first-ever conference of African Anglican
bishops in Lagos was about Africa coming of age. The Church is growing faster
than in any other part of the Anglican Communion. Half of all Anglicans are
now Africans. Bishop Jo Seoka of Pretoria said that the rest of the Anglican
Communion must listen: “We keep missing each other on the journey of faith,
but even if I need to tell you that you are wrong, there is no hope of
reconciliation unless we talk to each other.”
The Conference was not about sexuality but about the issues that belong to
Africa – poverty, persecution, corruption, HIV/AIDS – and therefore the need
for a renewed commitment to evangelism and justice. But "what the Americans
have done" was never far beneath the surface. What happened in North America
is seen as part of Western imperialism which wants to exploit Africa and keep
it subordinate and poor. The invitation to ECUSA had been withdrawn; even the
Anglican Communion Office was seen as too pro-American to be present.
If African Anglicanism is to be indigenous, it cannot tolerate the official
sanction of practices that are alien to African culture. “Of course such
things go on everywhere”, one bishop said to me, “but we resent those who want
to bring them into the life of the Church.” Bishops who face daily tension
with Muslims feel particularly betrayed by recent events.
There is a sense that the centre of the world Church is returning to the
continent where it flourished in the early centuries with Augustine and others
in North Africa. There was a real sense that Africa must now reclaim its
historic rôle as the bearer of the tradition and the truth.
The “gay issue” focuses a fundamental difference over Biblical authority. A
Nigerian bishop who had been assuring me that Adam and Eve were historical
characters and evolution a heresy asked “How can the Americans do what they
did and still claim to be following Scripture?” In a way most African bishops
continue in the kind of evangelical theology which the Victorian missionaries
first gave them.
Their Primates want to establish centres of theological training untainted by
Western liberalism, believing this will make their Church more indigenous,
more able to confront the Pentecostalists and the Muslims, more able to keep
their young people. Whether or not this is the answer depends on whether a
new, technological African generation follows the more liberal model, or the
more conservative American one.
Towards the end the Conference collapsed – literally. A home-made stand for
the group photograph collapsed and they tumbled over each other on the ground.
Reaching into their cassock pockets, some produced mobile phones to call an
ambulance while others found a holy oil stock to anoint the sick. A few
erupted into high-pitched prayer that the Devil would not have his way with
the injured. Somewhere between self-help and suffering, between technology and
spiritualities of various kinds, lies the future of the Church in Africa.
Making Poverty History
From the keynote speech by Janet Ncube of Zimbabwe at the churches’ launch
in London of this campaign against world poverty which links 200 organizations
in the UK.
Over 10 countries are involved in armed conflicts. A vast amount of people are
being killed, maimed, displaced, starved and raped. Children are being forced
to join gangs led by mischievous warlords. Little boys and girls sustain the
fantasy of these warlords who think they have an army. They make sexual slaves
of these children as young as nine and make the little girls prizes for the
teens who grow up in these barbaric conditions.
All these rebel leaders get their guns and grenades from the thriving arms
industries of Britain, France and America. Sales by the USA to countries
involved in the Congo war show that 65% of total sales were sales of arms to
perpetuate the conflict.
The US policy not to act on Rwanda was based on lessons from Somalia, a
country they had dismally tried to rescue but instead lost over 50 of their
soldiers. So they immediately pulled out and refused to intervene in Rwanda.
The cost of under 100 American lives was 943,000 Rwandan lives.
In the last five years in Zimbabwe, the challenges I faced as a voice for
women sometimes left me overwhelmed. I felt as if my efforts were just drops
of water in a desert with scorching heat. One afternoon I realised I was
wrong. I was holding Mary who had fainted from hunger in my office. Mary is a
30-year old young woman just like me – only she had been raped by seven of
Mugabe’s youth militias who did it one after another. They infected her with
HIV and she had to run away from home as she was constantly followed.
I felt hopeless, drained and useless; I could not take away their fears. I was
too small for the mountain confronting Zimbabwe. Then I realised that the fact
that I was fighting, challenging the regime, gave her hope, gave her a reason
to go on. I was making a difference.
Jesus gave his followers a mandate. He told us to be the salt of the earth and
the light of the world. You and I have the power to bring healing to that
festering wound and to bring preservation to a continent being corroded by the
negative forces of unfair trade and the brain drain. That is what salt does.
You are my family and you, my family, can help Make Poverty History.
Malaria and DDT
Worldwide, about 400 million catch malaria every year and several million
die, especially small children and pregnant mothers. “Africa has the worst
form of the disease being transmitted by the two most competent mosquitoes,
Anopheles gambiae and A.funestus”, says John Clark of WHO’s Roll Back Malaria.
Malaria was a thing of the past in Swaziland in the 1950s, though the mission
where I worked had been abandoned in 1913 because of malaria. In the 1940s a
refugee doctor from the Baltic with little English was sent to the bushveld
‘to do something about malaria.’ He realised that the Central American
strategy of oiling swamps was of no use in Africa where the two species of
mosquito can breed in the hoof-prints of a cow. He then tried spraying with
DDT the walls of places where people slept. It worked like magic. Four times a
year a couple of men with knapsack sprayers visited us for 15 minutes.
Swaziland is one of the few countries where this method has gone on until
today, though now they spray only once a year. The malaria rate is minimal.
Rachel Carson’s Silent Spring came out in 1962. It envisaged a morning when
everyone would wake up and hear no chirping because all the songbirds were
dead. Jay Ambrose, a senior Washington journalist, writes:
“It was the disuse of DDT that did the silencing, not of birds, but of
children. Millions now dead would have been chasing about and laughing if DDT
had been available to protect them. Banning DDT is one of the most disgraceful
episodes in 20thcentury America. We knew better, and we let people around the
world die because we didn’t give a damn.”
The tsunami has led Greenpeace and the World Wildlife Fund to change their
minds and allow the use of DDT in Indonesia where malaria threatens many
lives. WHO supports its use on internal walls. When Silent Spring was
published, up to 80,000 tons of DDT were being sprayed on American crops every
year and South Africa was blanketing game reserves with it. Knapsack spraying
uses tiny amounts of DDT: 450,000 people can be protected with the same amount
that was used then on a single cotton farm.
We asked Professor Malcolm Molyneux, a malaria expert in Malawi, what he
thought:
DDT was the main instrument of the enormously successful campaigns in India
and SE Asia in the 50s and 60s. In the 50s it inspired the belief that malaria
would soon be eradicated from the globe. Can this be achieved in Africa? I do
believe that we have to give it a lot of thought, as there is more
international money and goodwill around these days than there has been for
decades. The size of the challenge of IRS (Indoor Residual Spraying)
nation-wide should not be underestimated however.
Graphs in Tropical Medicine of January 2004 are part of the answer to
Malcolm’s question. They show that in Mozambique, Zimbabwe and four other
African countries, malaria parasite rates in children came down from 80% to
15% and in one case to nil, after spraying campaigns. A recent programme in
Southern Mozambique has been so successful that the Global Fund is being asked
to halve its budget for the rest of the country! Success is also reported from
Zambia.
The only other malaria control strategy is that of distributing impregnated
bed-nets, but this still has many problems to be overcome, such as how to get
them all re-impregnated every year. Malawi led Africa in eradicating polio and
leprosy. Could it add malaria?
(Tropical Medicine Jan 04 p.125; Aug.04 p.846; Jan 05 p.19).
Transparency & Corruption
President Bingu wa Mutharika is launching his own political party in a
battle to win a majority in parliament. He won the presidential election in
May as nominee of former president Muluzi and was generally seen as his
puppet.
Soon, however, top officials appointed by Muluzi were being dismissed and some
were charged with corruption. This led to a wave of ‘Bingumania’, but also
doubts about how far he could survive without the backing of his party.
Recently he disbanded the National Intelligence Bureau, and accused its
officials of misappropriating K1.5 billion (£6 million).
Now the gloves are off. President Bingu wa Mutharika resigned from the UDF on
Anti-Corruption Day, 5 February, and has formed a new party, the Democratic
Progressive Party (DPP). About 20 senior members have left the UDF and 23
independent MPs have joined the DPP together with veteran politicians such as
Aleke Banda and Gwanda Chakwuamba. The constitution does not allow MPs to
cross the floor if elected on a party platform, but it does allow them to join
a new party.
The 71-year-old economist said: “I inherited a system infested with men and
women who thrived on corruption. I am not happy to see Malawi being ranked as
one of the most corrupt countries in the world. A few individuals in
government have become rich while poverty plagues millions of Malawians. My
only enemy is poverty.”
Aid to Malawi was frozen by IMF and major western donors in 2002 after
warnings about wastage and corruption. In 2004 however the UK gave US $193
million for ARVs and to reduce maternal and child deaths. The World Bank
followed with $27m in September to support the fiscal management programme and
has just added $15m for hospitals and nurses. A second tranche will be added
if financial reform continues. Denmark and Norway have also come back as
donors.
Much will depend on the churches. Outside the cities, there are few civil
society bodies and no newspapers. If the burning desire of the people for an
uncorrupt government is to take effect, the churches must lead.
News in brief
Bishop Peter Nyanja was brought to St. Luke’s Hospital in London when very ill
last August through the generosity of two London parishes. He made a
remarkable recovery and did several confirmations after his return in
September but is now again seriously ill in Lilongwe, following palliative
treatment at St. Anne’s. He has been bishop of Lake Malawi since 1978. He
needs our prayers.
Crop hopes. A drop of 1% on last year is predicted, due to shortage of hybrid
seed and the high price of fertilizer. The EU has helped Malawi buy 60,000
tons of maize to replenish the strategic grain reserve, largely from Zambia. A
food-for-work programme fed 600,000 vulnerable people last year.
Charcoal-burning provides one of the few opportunities for poor households to
make a little money. Only about 4% have access to electricity. Each year the
charcoal industry brings in $8 million but destroys 50,000 hectares of
brachystegia forests, Malawi’s miombo heritage. There is a real need for
fuel-saving kitchen fireplaces that people actually use.
“Tobacco remains far and away the country’s most important crop”, writes Bruce
Barron from Mbabzi, “and it has been a bitterly disappointing year. Half way
through the selling season prices crashed to their lowest level for many
years. One cause is a large increase in production in Zambia and Mozambique,
fostered by companies here. So much so that Limbe Leaf is building a $60
million plant in Tete, Mozambique.”
Canon Stewart Lane has left Malawi after more than 40 years service to live
near his daughters Emily and Martha in South Africa. His astonishing spectrum
of activity has included teaching at Malosa Secondary School, writing and
producing award-winning plays, lecturing at the Polytechnic, weekly columns in
seven newspapers, author of ten books, colleges chaplain, launching
charismatic renewal in the Cornelius Fellowship, ordination into the voluntary
priesthood, pastoral care of Holy Innocents, retreats for ordinands, the first
definitive list of aloes in Africa, ringing birds..... and being a stimulating
friend to all in need. Every possible good wish in your new life!
E-mail: Lane@sdnp.org.mw
Spectrum Guide to Malawi: John Douglas and Kelly White; 384pages, 250 photos.
£13.99. Camrapix International. ISBN 1 874041 55 5 £13.99. A wonderful new
guide, excellently researched over eight years with 250 new and superb photos
by the authors. Did you know that 10% of the 650 species of birds in Malawi
are not seen in other parts of southern Africa? Or that there are more than
ten different species of brachystegia on Malosa mountain?
St. Luke’s Hospital is delighted to welcome Sister Margaret Young, an Irish
nurse who has been working for eight years at Ekwendeni Hospital in the
northern region, training midwives, introducing the mother-to-child HIV
prevention programme using nevirapine, and also palliative care for the
terminally ill.
Two new real dictionaries! Chewa-English, 522 pp. ISBN 99908-16-66-2; K800/£4;
English-Chewa, 388pp; ISBN 99908-16-50-6, K650/£3.25 + p&p. Edited by Steven
Paas of Zomba Theological College with input from Stella Kachiwanda and others
in the Dept. of Linguistics at Chancellor. Published by Kachere Press, Box
1037, Zomba. kachere@globemw.net
Norman Holland came as a lay missionary to Malosa in 1957 and is copying out
his journal. If you would like to see it, phone 020 8850 9370.
R.I.P.
Margaret Woodley joined UMCA in 1938 and was posted to Nkhotakota, where
for a time she worked both at St. Anne’s and the Government Hospital. In 1941
she began the Midwives’ Training School, working with the pioneer midwife Mary
Msasu, later decorated with the Order of the Epiphany. In one month in 1951
the School delivered 50 babies and all its students passed! Margaret was given
the MBE and after handing over to Joan Knowles, moved to Malindi in 1953 and
for the next 15 years worked with the Mothers’ Union throughout Malawi. Her
last years were spent at St. Katherine’s, Wantage, under the loving care of
the CSMV Sisters, though her mind was often still at Malindi. She died on
December 28th.
Dr. Muriel Harris, wife of Michael, worked in Bavendaland in the Transvaal and
then at Kasungu Hospital and Zomba General. She died on 3 December at Witney.
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