Some visits

It is interesting to note how different is each volunteer's experience of Malawi, depending upon their interests, what is happening at the time that they are here, and how dynamic and determined they are! I have really benefitted in recent weeks in this regard from having Joan here working on the project as Room Leader in the Baby Room. She is here for three and a half months only and is determined to pack in as much experience as possible. She has arranged a number of trips to various provisions for children and I have been able to tag along and see lots of things that are new to me despite the fact that I have been here so much longer. We began some weeks ago with a trip to a small orphanage called Yamikani which currently houses 16 children aged between 3 and about 14 years. We had trouble finding it and drove up and down the first part of the Zomba road for a while following impossibly vague instructions. Eventually we phoned one of the two gap-year volunteers who are living there at the moment and helping with the education and care of the children. There are Malawian house-mothers who live with the children and they go to the local schools. Accommodation was basic. The children share rooms with about six children in each room. There is one wardrobe in each room which seems to be plenty of space to house all the possessions of the children. We saw the communal dining/living room/kitchen, but while we were there all the children who were at home were out the back on the concrete khonde making and decorating bean-filled balls from a kit that had been sent by the mother of one of the volunteers. The project runs a nursery school for local children. The profits from this contribute towards the food bills for the orphanage children. The older children grow some maize and vegetables in the back garden and I understand the project also has a farm, some distance away where more crops are grown to feed the children. The nursery school had a few basic puzzles and bits of equipment, but very little by our standards.

Our next visit was to a well-established orphanage project in Blantyre for young orphans. This has been running for about 20 years and I was thrilled and encouraged to see a project which has been sustained over such a long period. On arrival we were ushered into an empty living room and through a door onto a khonde where there were between 20 and 30 under twos toddling and crawling about or just sitting on the floor looking around them. There were three staff, one sitting on the floor playing with the half-dozen or so children clustered around her. The other two were occupied distributing first bottles and beakers of milk to each child and then little peanut butter sandwiches for mid-morning snack. Joan and I sat on the floor and were immediately swamped by tiny children desperate to be the one to get to sit next to us, or better still on our laps, snuggling in to complete strangers. My heart lurched to my throat and I had to fight back the tears, but these children are the lucky ones, cared for by a project that sees that they are as well-fed and healthy as they possibly can manage. There are toys and a few books, a few plastic slides and the like. How can these care givers provide the love and affection and individual attention that these children deserve? All three carers were busy the whole time we were on the khonde just attending to the children's immediate physical needs. Joan and I started playing singing games with the children around us, hoping that keeping the children busy would be helpful to the carers. As they finished their snacks the children were taken off to the bedroom for their rest time. We were left completely alone with about eight two-year olds and we continued to play with them for about twenty minutes. It became obvious that they were familiar with several of the songs and games we played, so they must get such input on a regular basis. Eventually a carer came back and said she would show us around. Off we set with our eight little friends holding hands and clustering around us. The first call was the dormitory bedroom. The carer opened the door, encouraged the children to lead the way and then the minute they were all through the door she closed it and left them to put themselves to bed for a rest and led us off to see the rest of the orphanage. We could hear howls of distress from the other side of the door. We saw the house for the under twos and then went across the garden to the house for the three to four or fives. These were all playing with some of the neighbours children in the garden as this was not a school day. A few carers sat in the shade. Everyone was friendly but no one was interacting with the children. There was one of those swings that look like a horse and are made out of recycled rubber tyres hanging from a tree. I started pushing a little girl on this and all the others came running. Joan and I had to organize a rota system and give them all a turn! After the tour we met an azungu who is part of the management of the project. She was very helpful and took us into the office and showed us lots of photos of children, explaining that when they leave the orphanage some go back to their extended families as they are now old and strong enough to survive in the villages. For others who have no suitable family the project buys houses and the children live in small groups with house mothers until they are grown up and can be independent. The education and support the children receive is a far cry from what would be considered ideal in UK, but so much better than they would get without the project. So many would die without the nutritious food, and the care of the house mothers in the orphanage. We learned a lot from this place. They must have some sort of sponsorship arrangement from Johnson and Johnson as the bathrooms were full of their products. We could do with an arrangement like that with the CC. Joan took a photo of their baby bathroom with its clean, efficient and comfortable facilities for changing lots of babies. The manager said that one of the biggest challenges they face is staff training. Maybe there is an opening for Beehive here? The training is written now. I wonder if there would be a market for other NGOs etc to buy training places off Beehive when the next cohort of trainees gets going, possibly in September.

We spent a fascinating couple of hours being shown round the paediatric services at Queens Hospital by Dr Neil Kennedy who is head of this department. He gave us a lot of time and trouble and we were grateful for his attention. I could write so much about this visit, but it was several weeks ago and the detail fades a bit as time passes. Next time I am tempted to complain about the NHS I will remember this visit and be grateful! The wards were huge, the number of nurses was small. Each baby has to have a guardian staying with them. In one ward there were 110 cots and 3 nurses, but the nurses don't always all turn up. There is really only time for them to give out the medication. Personal and nursing care is done by the guardians, usually the mothers. Meals are available but you have to sit outside on the concrete floor to eat them. This is the largest and best public hospital in Malawi. The services are free at the point of delivery. I wish I had written this earlier as I cannot remember all the facts and figures Neil told us, but I remember that the number of babies delivered each month is more than the number per year in many UK General Hospitals. We visited the Special Care Baby Unit which has some babies cared for in incubators and some by the 'Kangaroo' method where they are held against the mother's body by strips of cloth. I was impressed and humbled by the dedication of Neil and his team. Women come from far away when the time to have their baby approaches, and camp out as close as they can to await the delivery. He has been here something like 16 years. There is a separate accident and emergency unit for children and many other projects concerned with the health of children.

Most recently we went to see a place where they make made-to measure seating and standing frames for children with disabilities. They are basic and old-fashioned to our eyes, but we have met one or two children with CP who have nothing but a particular shaped hole in the ground to support them in a comfortable seating position. I dare say we shall use this place as children with special needs come to the CC. For MK3500, about twelve pounds, you can get a made to measure, wooden, corner chair. To have rexine covered padding costs extra, so this is not ordered so frequently. We met the man who makes the chairs who himself has a physical disability. Like so many NGOs in Malawi this organization is not able to maintain all the services it has managed in the past, and much of its extensive building is under-used. They continue to do what they can with the money they have, but the lady who showed us round was keen to know whether we had any jobs with children with special needs available in the CC. We met some families with children who were waiting for operations as the orthopaedic hospital. When they arrive from the villages they often come in with infections and malaria and so on, and they stay here until they have a clean bill of health and are strong enough to tolerate the curative surgery.

Joan also visited a school for deaf children, but I was not able to accompany her on this occasion.

I began writing this piece about three weeks ago when Joan was still here, but have been so busy, and have also had a holiday so I have only just completed it. Joan has now returned to the UK and I miss her very much. Not only was it a delight to have someone here who I know from home, we are both from the Norwich area, but also her enthusiasm and energy have been an inspiration. I am determined that the research she has done will not be wasted and that her ideas about services for children with disabilities will be passed on to the new manager and the outreach manager who we expect next month.

Malawi is really not the country of choice to be born if you have a disability. Already the teacher who has responsibility for SEN support for all the 22 schools in Chilomoni, Government and private, has made herself known to us and we are able to help with some of the families she knows with pre-school children with disabilities in the area. This will be part of the outreach work of the CC and is not really part of my brief, but certainly there is a lot of work to be done. We will be starting two children with cerebral palsy and one who is profoundly deaf tomorrow. We have appointed four of the Care Givers as SN support workers to work with these children, so we have made a beginning…….