Saturday, March 21, 2015

Sunday 22 March 2015


Chisomo Community Health Organisation makes its presence felt


Yesterday, 6 Vanier College nursing students, a like number of American nursing students, 6 Canadian and American nurses, two American doctors, 4 Malawian clinicians, a Malawian nurse from Chilanga, a group of HIV counsellors / animators from St Andrews and Kenny and Lonjezo from Makupo who translated for the medical staff and animated about 30 men and mostly women Volunteer Health Workers who altogether met, counselled, treated and handed out meds to almost 700 people form the area around Chilanga. Kenneth the reverend at Chilanga called it a health camp.
About 200 metres to the south beside a lovely old growth of indigenous trees the roof was being put on the Chilanga Community Clinic as bricklayers and carpenters were installing door frames, plastering walls and making it a real hive of activity. It now looks like the plan that Carl Mulvey from Montreal drew up for us after long consultation with Melodie and myself and intensive research and support from the interns at his firm.
As would be expected for a first effort, there were problems at the health camp - a late start, overwhelming numbers, crowd control, shortages, a respiratory arrest and CPR rescue with a minibus ride into Kasungu District Hospital. There were incurable and terminal illnesses and at the other end of the spectrum, the regular sniffles, arthritis and more minor complaints that clog doctors' offices and emergency rooms everywhere.
It was a first clinic of its sort in the area and a massive effort. Despite the shortcomings, it was a significant learning experience and the start of changing health delivery around here.
The real heroes were Kenny Manda and Lonjezo Kathawa who have laboured for more than a year working with the local group village heads and village heads to get across the concept of the Village Health Workers. They animated yesterday's event and as the numbers attest, reached out to over 60 smaller villages to get the message out and mobilise the Village Health Workers. These latter will become a permanent feature of village life. They will continue to monitor and act on the information gained from the camp about the kind of health issues and extent of the problems. They will be the action people to promote health and sanitation issues in their own communities and form a support network that will also receive basic training around health promotion and prevention. They will also form the nucleus of a democratic body charged with acting on health in the larger community, setting priorities and seeking support that should be forthcoming by right from an under-resourced state infrastructure.
Kenny and Lonjezo for their part are supposed to begin advanced training to better support the network of Village Heath Workers. They will eventually become Health Surveillance Assistants and integrated into the District Environmental Health Offices network providing front line health service.
They were well supported by the K2 Taso HIV/AIDS support group at St Andrews, the District Environmental Health Officers and the Vanier nursing team, as well as the K2 Foundation in British Columbia that gave the seed money to get all this started. OPSEU support sponsored this event as a kick off to the activities of Chisomo Community Health Organisation. Bert and Hannah Clark who head the K2 Foundation were present and ably assisted the process yesterday and shared with us their experience in other parts of Malawi and in the Himalayas. I was able to show them our plans for the clinic and brief them on what we have been doing in the area. Bert is impressive for his detailed knowledge of health programming, initiatives as well as drugs and treatments and his grassroots approach and networking skills.
Melodie challenged the Makupoites to feed all the major participants an end of the day meal and they rose to new culinary heights. Forty-seven people were regaled with everything from two kinds of chicken, beef and vegetarian main courses and salads and a simple banana dessert. The women dressed with their Vanier nursing T shirts and the presentation was smooth and professional. Afterwards and a couple of the standard speeches, the women began singing and dragged the Canadians in. The K2 staff from St. Andrews joined in and added some flourishes and soon the guest house was filled with singing and dancing. I was astounded that after such a hard day of work they still had so much energy to burn, and sweat they all did. Lots of hugs and goodbyes and congratulations and it was all over. People went to bath and bed without any stop in between.
Bert knew I was collaborating on a book about the history of Malawi, so I introduced Hannah and him to Kapote earlier in the day on our walkabout tour. Later Kapote was a bit reticent to join the party and was going to stay at the house, but Sautso convinced him that it would be best if he were to join us. As soon as we arrived at the guesthouse, Bert and Hannah sat on either side of him and stayed glued there all evening querying, discussing, exploring and sharing with a greet deal of mutual respect. As one party wag said, the big men (and women) know how to find each other. They only stood up when the party ended to say goodbye and promise a more social session later in the week when some of the dust settles.
Makupo Development Group was set up in 2004 by Nellie and I and our children to help put a well in our village to help that small community. In these 10 or so years it has grown to this and is entirely organic - a response to and movement forward of the larger community here. Everyone who has helped make this happen from the Canadian end has played their part with their solidarity. Everyone here recognises that support and is committed to using it wisely to break the cycle of underdevelopment.
I will organise some pictures and hopefully a clip of the Malawian / Canadian post work celebration and I am sure the nurse will be blogging so I will try to make the links for you to share their impressions.
Early arrivals

Vanier nurses arrive

Planning the day

Crowds waiting to enter

Greeting K2 TASO

Village Health Workers

Makupo prepares supper for 47

Vanier celeberating


Sunday, February 22, 2015

February 2015
Friday evening, Kapote and I were sitting on the front khonde (verandah) chatting over our sundown drinks as the light was fading. A well dressed young girl came around the corner and with a big toothy smile she called out “Uncle Doug”. It was Rhoda, Frazer's daughter, just back from the dental clinic in Lilongwe with her new front plate. She was so happy she couldn't stop smiling and giggling about her new look. She and her cousin, Gloria, the primary school teacher have not smiled in public for many years because of the big empty space where they lost many of their teeth including the conspicuous front ones. When their immune systems were weakened by HIV tooth decay set in on them, so they lost several teeth each.
That evening, they were so happy to sit in the dim evening lights and smile for us. Gloria had developed such a habit of covering her mouth when she laughed that it took her some time to restrain that reaction and allow here face to shine with the new teeth. Both of them were very happy to appear normal again.
It may not figure on many people's development priority list, but Nellie and I decided to put some money aside to help them get their smiles back in 2013. Something that would have been a simple series of visits to a denturist in Canada is however, an epic tale in a poor country like Malawi. We found a dental technician at the local mission hospital who removed the remaining rotted stumps so their gums could heal into place. He did not have the facilities to make replacement teeth. We were sent to the main regional hospital in Lilongwe where there is a very well furnished clinic and well trained dental people. But with the currency crisis caused by the corruption scandal known as Cashgate, there were none of the materials needed for moulds and plates available at the government service. The private clinics and mission hospitals could provide excellent service but it was at Canadian prices which were way beyond our means. We couldn't finish the work last year.
I really wanted an end to this tale and when we picked up the strands in January we found out that there were materials now available at the regional hospital clinic. We got there a couple of days after they had run out, but they proposed a very reasonable alternative. We could buy the materials from the local supplier rather than waiting for the hospital bureaucracy to replenish the stock and they would do the rest of the work there at the hospital. I was tight for finances, but before she had left, Karen Tennehouse had left me some cash for just this purpose. She had overheard my conversation with the women and offered to help. The dental technician was as good as her word. The materials arrived, the moulds were taken and we were told to come back in ten days. That was Friday when the two women came to show us their smiles.
I am quite sure dentures don't fit into the World Bank's development paradigm, but you can be sure these ladies lives will change greatly because of their new smiles.