Volunteers’ Stories: Elmar and Jorien
Elmar’s and Jorien’s Story
“All in all, we had a great time which we will never forget. We still think about Malawi a lot, and we’re glad that we had the opportunity to experience all this.”
In 2005, Jorien and I applied to RIPPLE Africa to do voluntary work at Kachere Health Centre in Malawi. We both study medicine at the Radboud University in Nijmegen, the Netherlands. We were in our second year at the time and knew that there was the possibility to earn study points at the beginning of the third year in an alternative way. This is by means of research, in the Netherlands or abroad. Because we both wanted to go to Africa, we were looking for a place where we could combine voluntary work with doing research about HIV. RIPPLE Africa turned out to be the perfect choice to do this. We applied for two months and were welcome to start in August 2005.
On 18 August, we arrived in Lilongwe and were immediately shocked by the poverty of the country. We stayed in Lilongwe for a day and travelled on to Mwaya Beach. This was the first time for us to experience the real Africa. The bus broke down after only 15 minutes, and we had to wait hours before our journey continued. We were surprised by the warm and friendly people in the bus, and chatted with them all the way. This inevitably turned out in a big exchange of addresses — everybody in Malawi seems to be looking for a pen-pal!
When we reached Mwaya Beach, two friends were waiting for us. They had been travelling through Africa for a month and were visiting us just before they returned to the Netherlands. We spent the first two days with them, and then they left and we went to work. The beauty of everything around us was amazing — the lake, the people, the lodge … everything! Adi and Christine (two other volunteers) were just about to leave when we arrived. Paul and Amy from England and Donncha from Ireland were also volunteering at Mwaya and were staying for a longer period. In the following days, the group was joined by Crt from Slovenia, and Peter and Anne from England.
We started working at the clinic on Monday 22 August. We were able to use two mountain bikes to cycle to and from the Health Centre every day, which was about 30 minutes each way on dust roads. There we met the staff of the Health Centre, comprising: one doctor/medical assistant (Mathias), one midwife (Jane, later succeeded by Ms Songa), and one Public Health Officer (Dyson). There is also a cleaner (Jessie), a medicine distributor/wound cleaner (Andrew, later succeeded by Kalod), and some other ‘watchmen’ who usually hung around the Health Centre.
We were quite surprised by the fact that the Health Centre didn’t even have basic things like electricity and running water. This meant that Mathias had to work in the dark at night and had to insert an infusion by candle light, which is almost impossible. The lack of water meant that wounds and instruments were not cleaned properly, and that there was nothing to drink. There was also a shortage of nearly everything, and we were especially shocked by the way the clinic disposed of contaminated medical materials. They were thrown into a shallow pit just next to the clinic and were burnt about once a week. In the meantime, children could easily take things out of the pile, like used needles, bandages and even condoms. In a country which is hit so hard by the HIV epidemic (15% are HIV positive), this seemed to us to be an intolerable way of disposing of garbage. That’s why we started to design an incinerator, together with Frank from RIPPLE Africa and the staff of the Health Centre. This would ensure the safe burning and disposal of contaminated materials. Fortunately, it was ready when we left in October and is in full use now!
We also tried to get the electricity connected in the two months of our stay, but this turned out to be a difficult task. After a lot of talking, filling in forms, waiting, and paying the required bills, the electricity was eventually connected a couple of days before we left. There were still some problems to be solved, but with the help of Ben (another volunteer who arrived after us), this is working fine at the moment as well.
Elmar standing beside the incinerator which he helped to construct at Kachere Health Centre
Jorien with Chimwemwe
At the Health Centre, we first assisted Mathias a little with his administration, but soon stopped doing this because we felt there were more useful things to do. We mainly helped Dyson with the busy vaccinating schedule at Kachere and the nearby villages. The mothers would bring their children to these Under 5 Clinics to get them weighed and vaccinated. The atmosphere was usually great with lots of singing and dancing. These songs would educate the women about a range of health topics, like birth control. Of course, we also joined in with the singing and dancing, which was absolutely fantastic! Here again we were shocked by the number of children who were underweight and undernourished. In some villages, this was more than 50% of the children.
We also spent quite some time at the VCT (Voluntary Counselling and Testing) centre at Kachere, where we did a great deal of our research about HIV in Malawi. The VCT centre is a place where people can get free counselling and testing for HIV and where they can collect free condoms. The only problem is that not a lot of people go there, for several reasons. One is the distance people have to walk, which can be more than two hours. Other reasons are poor knowledge about HIV, and the taboo and stigma that is associated with the disease. That’s why we discussed ways of changing this with the people working at the VCT centre. Eventually, we organised a meeting for a total of 45 influential people in three villages (Mwaya, Kachere and Tukombo). The meeting lasted for a whole day, and they were taught about HIV and the VCT centre. They were asked to spread the information and to mobilise the community to go to the VCT centre. We also planned to organize a weekly or fortnightly VCT outreach session at Tukombo and Mwaya, but this was difficult to organize and Ben is still busy with this at the moment. [Editor’s Note: Since this story was written, we’re delighted to report that AVERT have given us funding for an outreach programme in Kachere and the surrounding villages.]
Working at the Health Centre was also pretty tough. Malawi is not only “the warm heart of Africa”, but it is also one of the poorest countries in the world, struggling with poverty, diseases like HIV, tuberculosis and malaria, famine and corruption. When we arrived in Malawi, we were quite passionate but it was very frustrating to see so many insolvable problems. We didn’t know where to start and what we could do. We did as much as we could, and it was good to see that our enthusiasm also encouraged other people. Now, when I look back at our time in Malawi, I’m quite satisfied about the things we accomplished. It was also a good experience for us to see how the health system works in a poor country with no facilities. Or, maybe more truthfully, how it doesn’t work.
At the lodge everything was great. There was ‘running water’, a beautiful beach and nice chalets. We were looked after by Harry and Nephia (the cooks) and Martha (the cleaner).
One night we had a ‘meeting’ with all the other volunteers to discuss what to do with the numerous clubs that volunteers were running before us. We realised that sustainability is very important in a place where so many volunteers come and go. That’s why we chose to focus on a couple of important things. For us, this meant that we ran a weekly Youth Health Club, and Jorien would run a Women’s Health Club with Anne. We taught the children and women about certain health topics, like HIV, malaria, nutrition, pregnancy, etc. This was a lot of fun, and the participants became more enthusiastic every week.
Together with Crt, I also started a Swimming Club, which turned out to be more difficult than we imagined. It’s amazing that practically nobody can swim along the lake, not even the fishermen. Just before we arrived, a fisherman had drowned near Mwaya and, during our stay, three girls and a teacher drowned at Kande. We made floating objects from polystyrene and tried to teach children of about 10 years old how to swim. We also played a lot of volleyball and frisbee during the lessons, which was great fun. Crt was just as competitive as me, so the game usually turned out in a heated match. The plan was that eventually this would be integrated in the physical exercise timetable of the primary school. When we left, a few children could actually swim without help, which was great to see! Crt stayed a little longer than us, and he said he would try to convince the teachers about the usefulness of these lessons. I don’t know if he succeeded.
Besides all this, we also had a Youth Club on Friday, during which we played soccer, volleyball, frisbee and korfball. There were also some puzzles, and we were amazed that the children didn’t know how to use these. An 18-year old couldn’t even solve a puzzle of six pieces just because he had never learned how to use them. During these ‘playing hours’, there was also a heated battle in the field between Crt and me — it was great fun though!
It was always busy at the chalets — there were always children who wanted to play or chat. Fisani and Lottie, two boys from Mwaya, visited us very often. They taught me how to keep my balance in a dugout canoe and took me fishing. It was difficult, but I really enjoyed it. The lake was beautiful and great for swimming as well. Because there was no electricity, we woke up everyday at sunrise and had breakfast on the beach. It was so peaceful and quiet in the morning — wonderful!
We also had the privilege of staying at the lodge with a fantastic group of volunteers. We went to Nyika National Park with the whole group and had long conversations after dinner. Jorien and I were the first to leave and missed them as soon as we left.
After Malawi, we travelled through Tanzania and Kenya for a month, which was great. We climbed Mount Kilimanjaro, went diving in Zanzibar, had a 7-day safari in the north of Tanzania and ended up on the beaches of Lamu, a beautiful and peaceful island in Kenya.
All in all, we had a great time which we will never forget. We still think about Malawi a lot, and we’re glad that we had the opportunity to experience all this.
Elmar and Jorien (Volunteer Health Care Assistants, August-October 2005)