N k h a n i Z a u l e r e
the Malawi Chatterbox September 2006
Dr. Susannah Woodd
flies this month to work at St. Luke’s Hospital, Malosa and its five health
centres. Here is some of what she said to the people of St.Alban’s, N. Harrow,
who are helping to sponsor her through USPG:
“I’ve been working as a GP in a very deprived area of South London for
three years. But my identity isn’t only as a GP. I belong to a loving family,
to great friends from school and university, various musical activities and to
the eclectic mix of people who make up God’s Church. To work with God to
become the person God is making me, to work with God in that creation,
strengthens all those relationships – but it also calls me on to the
unfamiliar, where I cannot depend on my old belongings.
“So why Malawi? I was drawn to that region of the world, after studying
Tropical Medicine in Liverpool. When I was shown other possibilities, I had to
muster up enthusiasm for them. But when I was asked about Malawi, I
immediately felt it was right. Those who have visited or have worked there
speak with enthusiasm of its beauty and the warmth of its people. Through
those who have worked at St. Luke’s I have been given a better picture of the
medical and financial challenges they face. I feel particularly drawn to
aspects of the work such as the HIV clinics, palliative care and the rural
Health Centres. As a GP I obviously think primary health care is the most
valuable part of any health system.
I realise the reality could be very different from my expectations. There will
certainly be many challenges – such as returning to an acute hospital setting
where I’ll need lots of practical skills, some new and others very rusty. I
hope to maintain the importance of relationships with patients that I’ve
learnt in general practice, and the holistic approach to care that considers
the whole person within their family and community.
A very real challenge will be working in a foreign language – and that
certainly makes me feel weak. But it emphasizes the point that I am a visitor,
staying in their house and dependent on their welcome.
My reason for going as part of the Church, not with a medical charity, is that
I can be a missionary and a doctor as one. Not to put on two tunics, just to
wear one. But, like the disciples, I can only go in God’s strength.
Food or Hunger?
The problems of Malawi are huge:
- famines in 2002 and 2006;
- 900,000 are expected to face hunger in 2007
- 50,000 hectares of indigenous forest burned each year as charcoal .......
The good news is that crop production this past season increased by
57%. This was due to the arrival on time of rain, fertilizer and improved
seed. The ample harvest has also brought prices down.
Permaculture Network in Malawi lists perennial food trees, not subject
to drought, such as -
• Cassava Tree (chigwada): cassava family but a large tree with leaves eatable
throughout the dry season. Easy to propagate: one produced 50 new trees!
• Air Potato (chinkowe): yam family but the tuber grows on the vine instead of
underground.
• Snot Apple (mtowo):indigenous fruit after the rains, tastes like an apple,
grows easily from seed.
To learn more, contact Permaculture Network, Crossroads Post Dot Net X-124,
Lilongwe; or e-mail: nordin@eomw.net Join for MK400 p.a.; £2 from UK, and
receive their Newsletter.
Kitchen Gardens. A proven method, demonstrated dramatically at Lobi,
25km west of Dedza. In the southern half of this region where the plan,
introduced by Concern Universal, was widely followed, almost no one needed
feeding in the 2002 drought. The adjacent northern half, identical in soil,
was one of the hungriest areas in Malawi. One ‘How to do it’ suggests:
- mark out the size of a door; dig out to knee deep.
- keep topsoil separate – darker and more fertile
- line with material that will rot (grass, peelings, paper, manure
- when half-full, soak with water; then subsoil, then topsoil
- plant vegetables, tallest in the middle.
Now move on to the neighbour who helped you and start one by her kitchen!
Women who started this way converted their husbands and they developed into
real organic farmers, using many new crops such as an improved cassava that
grows 8’ tall.
Time to Talk by Bishop James Tengatenga and Revd. Dr. Anne Bayley.
ISBN 0 954 9051 8 0
The best book we’ve seen on HIV – and it’s home-grown! James is Bishop of
Southern Malawi; Anne was one of the team that diagnosed the first case of
AIDS in Africa and has worked in Zambia and Malawi for most of her life.
What makes the book unique? –
- it goes straight to the point. +James’ first sentence is, “Is sex the only
reason that people get married?”
- it grows out of the real comments of real people, in plain hard-hitting
English, not
‘NGO-speak’.
- the hilarious cartoons on every other page, in which Malawians will see the
hand of Brian Hara.
Cartoon in Time to Talk
It is brief – 13 pages of A4 in large print for the main topic: ‘Family
Life, HIV and the Church’. Then 22 pages of ‘Guidelines for a Family Life
Workshop’ – designed for any church, school or community group. Will be
published soon by Strategies for Hope and available in Malawi.
For more details contact Glen Williams at g.and.a.williams@ntlworld.com
or 95 Divinity Road, Oxford, OX4 1LN.
Gideon Byamugisha – His name is nearly as well known in Africa as that
of his fellow Ugandan Janani Luwum, the archbishop killed by Idi Amin. Gideon
is known as the first church leader to announce publicly that he was HIV
positive. His video “What Can I Do?” has the full printed text of his story,
here greatly abridged:
In 1991 Gideon was a priest in Uganda, about to leave for Britain for further
study, when his wife Eunice fell seriously ill and died. Five months later his
sister-in-law showed him the piece of paper she had been given by the clinic
at the time of her death. Gideon read it and just said, “I can’t believe
this”, and broke down and cried. In his own words:
“I was still grieving over the death of my wife. Now there was even more
gruesome news that my wife died of HIV/AIDS. My wife? You mean I could also be
positive? A born-again Christian? A priest? It was so shocking.
“But I remember the words Eunice told me after she saw the confusion in my
eyes and in my face. She said, ”Gideon, I am giving you terrible news. I am
sorry about that, but I want to assure you that you are still loved. And we
will support you, we will care for you.” Probably those could be the greatest
words people living with HIV/AIDS in your family or in your community really
need, the assurance that they are still loved. I think God used Eunice to
rebuild my life. I remember I rubbed the tears out of my eyes and got courage
to ask questions, what does that mean? And what do I next?
“I made the decision to have an HIV test. At that time we had to wait for two
weeks to get the results...They confirmed my worst fears. I was HIV-positive.
I remember this man asked me a question, somehow in a mocking way, he said,
‘Man of God, what are you going to do?’ For the first time I realized I didn’t
have a plan for how I was going to handle the HIV. But I remember telling him,
‘Counsellor, I don’t know what I am going to do, but the God who created me
will give me guidance on what to do.’
“The first challenge was: ‘Do I keep quiet? Or do I tell people.’ I had a
choice, but I said, you are a leader, you are a pastor. How do I say ‘I am
fine’ when you are not fine? So I made a decision that, however painful it
will be, I will tell people. Those I first told said, ‘Well, we will support
you, but don’t talk about it.’
Brothers and sisters, if you could be positive here, or you have a friend who
is positive, don’t let society box you in because they want to be happy at
your expense. If you feel it is the right thing to do, to tell people, to be
open – do it. They said to me, ‘Thank you for being honest; we will give you
the support you need.’ ”
Gideon continued lecturing at the theological college, and in 1995 met and
married Pamela, a widow whose husband had died of AIDS. Relatives and friends
knew about his HIV status, but it was not publicly known. Now he had to tell
his bishop.
Bishop Ssekkadde takes up the story. “I had told him he was going to Namugongo
seminary to teach. After he had left me he came back and said, ‘Bishop, you
want me to go to Namugongo, but you don’t know my status.’ And then Gideon
explained his health position.”
Gideon says: “After a long silence, the bishop left his chair and came and
prayed for me where I was seated and then said: ‘Gideon, you have a calling,
you have a ministry. This job I’ve given you, of being a lecturer, why don’t
you leave it and start an AIDS programme here? Because we also have this
problem in the diocese.’ ”
Gideon became the first pastor in Africa to declare publicly that he was
living with AIDS. He has founded ANERELA – the African Network of Religious
Leaders Living with AIDS – with 1500 members in 14 countries. The Coordinator
for Southern Africa lives in Blantyre - the Revd. Ephraim Disi:
edisi@anerela.org
Medical work in Upper Shire
Anthony Chilembwe, the new Principal Administrator, was born at St.
Luke’s when his father was teaching at Mposa, near Lake Chirwa. So was his
wife whose father was teaching at Malosa SS. Both are Anglicans.
Dr. Hans de Graaf has just left, having completed magnificently his two
VSO years as Senior MO. Before leaving, Hans worked on an excellent and
comprehensive series of reports covering the 2 hospitals and 8 health centres
in the Diocese of Upper Shire. The final copy will shortly be available – ask
Nkhani’s editor if you would like a copy. Hans is succeeded by Dr. Hanna
Jellema, assisted by VSO Dr Daniel Dyamukama from Uganda. Dr. Jellema leaves
at the end of the year. Excerpts from the report:
• The background: Malawi averages 1 doctor for 62,5000 people but most are in
the cities.
• CHAM – (Christian Health Assoc. of Malawi) links 155 church
institutions which provide 37% of hospital beds and two-thirds of healthcare
in rural areas.
• St. Luke’s College of Nursing has been enlarged to take 113 students.
• Surgical training for clinical officers: a surgeon comes each month from
Blantyre to train COs.
• Shortage of funds has forced painful decisions e.g.
- follow-up of TB patients from St. Luke’s axed;
- supervision of 72 outlying dental units axed;
- lab staff endangered through no sputum hoods;
- no X-ray at St. Martin’s to combat TB.
St. Martin’s, Malindi is a 100-bed hospital with 3 Health Centres and
many mobile clinics. Mr. Mark Zigona, trained in Austria, has just retired for
the second time after 12 years as MO; his wife Ethel was matron for much of
the time. Its establishment should be 2 MOs but now only Dr. Marieka Vos; 8
Senior Clinical Officers -1 in place; 35 nurse-midwives - 8 in place.
• Staff is the biggest challenge at St. Martin’s. The target is to
recruit 16 new staff this year. There is an urgent need for houses for which
the sites are ready.
• Cholera broke out as usual last wet season and, as a makeshift, a
large tent was borrowed.
• The low death-rate in the women’s ward is because they are coming to
hospital earlier.
• Children: most deaths are from malaria + anaemia and chest problems +
malnutrition.
• Blood transfusions: the lab has no fridge for blood, so blood is
taken from family members, often too late.
These quotes all come from the first 14 pages: there are 23 more to follow! In
the next issue we hope to have reports covering St Anne’s Hospital and its 4
health centres in the Diocese of Lake Malawi, and St Peter’s Hospital and the
2 health centres in the Diocese of Northern Malawi.
R.I.P.
Dr. Colin Bullough and Mary met at the College of the Ascension,
Birmingham, when preparing to be missionaries. Colin worked at St. Luke’s from
1967-70 and Mary as the bishop’s secretary. Both were concerned about the many
women who died at childbirth: even today one woman in 7 will die in this way
at some point in her life. Colin continued with government until 1979,
developing a programme for training traditional birth attendants at national
level which still continues. He received a doctorate for this work. After 13
years as a consultant on Tyneside, he took a master’s degree in medical
education and worked in Bangladesh for 5 years. The rest of his working life
he spent researching his passion - women’s health in developing countries.
Nearly £4000 has been given in his memory and will be used to complete a new
unit for Voluntary Counselling and Testing for HIV at St. Anne’s Maternity
Hospital, Nkhotakota. This will carry Colin’s name.
Sir Martin Reid died on 20 June at 77 and was Acting High Commissioner
in Malawi 1970-74. His special contribution to the church in Malawi was
tactfully helping the Chewa and English medium congregations at St. Paul’s
Blantyre to see themselves as one in Christ. He went on to play a major role
in negotiating the independence of Namibia in 1990 and ended his career as
High Commissioner in Jamaica. For over 30 years he battled his parkinsonism
with huge courage. He continued to paint his exquisite landscapes until the
day he left for hospital. Our deepest sympathy to Jane and their children.
Margaret Fiddes died in her sleep in April, aged 86. Stewart Lane
writes: “We gave her a proper send-off, though the heavens opened and the
burial was delayed by the water in her grave. Margaret with her keen eye for
the absurd would have enjoyed it.” Margaret lived all her life on Mpingwe
Hill, opposite Limbe Cathedral, and has left her land to the church.
In brief
The cancellation of £1½ billion of Malawi debt has just been
announced by the World Bank and IMF. Malawi’s Finance Minister Goodall Gondwe,
a former World Bank director, said it would wipe out 90% of Malawi’s debt and
boost economic growth from 2% p.a. to 6%. The IMF’s country director said,
“The corner-stone is to continue fighting corruption.” This was followed 3
days later by a $40 million grant from the World Bank for electricity,
telecommunications, roads, water and sanitation. In August, Malawi received
$32m. from the World Bank to improve primary education. This is reaching
schools in the form of a monthly grant to buy equipment. Since free primary
education was introduced ten years ago, literacy levels have risen from 30% to
above 60%.
Anti-retrovirals (ARVs) still reach only 24% of those with HIV, said
the Toronto AIDS Conference, despite the ‘3x5’ target (3m. by 2005) but this
had changed the landscape. The G8 has now set a new target of universal
treatment by 2010 – but it will be hard going. The proportion of women
receiving ARVs in Africa now equals that of men – but only 6% of children
receive ARVs, although they represent 14% of AIDS deaths. Pregnant women are
also being failed: only 10% of infected women in poor countries get the drugs
they need.
Diocese of Lake Malawi. Archbishop Bernard Malango has told the diocese
that he recognizes “that some of his actions, words and attitudes may
unintentionally have contributed to a spirit of disagreement and confusion in
the Diocese which he regrets. He readily offers this acknowledgment to all
interested parties to smooth the progress of reconciliation and to help bring
a way forward.” There are unlikely to be further developments for several
months, until a panel of enquiry submits a report.
Malaria. There has been a very wide take-up of the ‘permanets’
described in our last issue, but few seem to be reaching Malawi. They do not
require the 6-monthly dipping that other impregnated nets need but are a
little more expensive.
MACS. Margaret Parr, the Project Officer for MACS, is currently in
Malawi. During the year there have been many urgent and worthwhile requests
but there have been funds to support only a few of these.
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