Volunteers’ Stories: Mark and Triona
“At the end of my time in Malawi, I have a nagging feeling of unfinished business. It’s not caused by frustration or unachieved goals. Rather it’s down to too short a time here and the idea that if I could do it all again I could have an even more gratifying experience and do so much more here.”
My two months in Malawi was the most enjoyable and worthwhile of my life. It’s a statement that is as true as it is clichéd. Prior to coming here I had notions of performing bush medicine, the like of which would make me a local legend, perhaps even retold in years to come through rhythmic dancing and chanting. The fact of the matter was less spectacular, more challenging and despite the obvious appreciation of locals, unlikely to make it into local folklore.
Having decided early on that I should concentrate on nursing in a single health centre rather than dividing my time between the three situated locally, I gravitated toward Kachere. It’s a vigorous 30 minute cycle from Mwaya Beach on a bicycle made for a genteel old lady who must be many, many years dead. Although Kachere village itself is of the one horse type, catchment for the clinic is over 10,000 people. There I made an instant friend in Charles Bauden. His role as “hospital attendant” means he does the lion’s share of the physical, clinical work. This includes, but is not limited to, malaria testing, condom distribution, wound dressing and review, medication dispensing and advice, and performing all of the minor surgical work in the clinic. This is done after being provided training so minimal it was delivered over hours rather than days. Coming from an emergency department background, I decided to focus on wound care. The Ministry of Health provide little in the way of education and dressing supplies, really limiting it to gauze, cotton wool, iodine and too few bandages. Using the dressings jettisoned by previous volunteers, myself and Charles could perform quality wound care. Due to the poverty, lack of education and outdoor life of the people here, we experienced all types – machete injuries, crocodile attack, infected insect bites, and more abscesses than you can shake a scalpel at.
Charles’ good work was mirrored on the maternity side of the clinic by the sole nurse/midwife, Janet. She is the workhorse and a wise mind in the clinic. She could not hide her disappointment when I told her that nursing and midwifery are separate roles in Ireland and that I had no clue of fundus height, dilation, etc., and would have to wait until mammy and baby were separate before I could be of some use. Once that had happened though I was in like a shot – successful baby resuscitation by Day 2!
- Mark and Kate at one of the Under 5s clinics
- Giving one of the pre-school learners a go on the new swing
- Triona and Mark with Maxwell at Mwaya Beach
Since the clinic’s workload was 90% complete by 1pm, the afternoons were for all sorts of activity. Monday and Thursdays was Health Club meetings. This was an Am-Dram group for young adults focusing on education and raising awareness of public health matters just in a bizarre and hilarious fashion. I was able to catch their critically acclaimed inaugural performance at the village of Chief Mpimbe. Health Club is led by the inspirational Mike Chirwa. Often lead actor in the performances, he is a 19 year-old chameleon in flip flops. He was also my partner and translator in informal but extensive interviews on local mens’ attitudes to contraception, family planning and size, and women’s role in family decision making. This was done by a team of resident healthcare workers and healthcare volunteers and yielded vital information necessary to understand family planning in the area. This was the time I most enjoyed actually, literally wandering around the villages, sitting down chatting to people.
I had many more opportunities to do this when out and about with Catherine on the Changu Changu Moto project. I don’t think I could ever tire of poking my head into people’s kitchens, chatting and lighting fires. The stoves are brilliant – efficient, simple, cheap, durable and beautiful. I’m planning on introducing them to my scout group and our local campsite so watch this space. Catherine herself is a contender for the charity’s most valuable asset. She is equal parts eloquent, passionate, confident and charming. Regardless of background or expertise I feel every volunteer cherishes their time with her.
RIPPLE Africa’s Mwaya Beach is a paradise. The volunteers it attracts are wonderful. My fears of living rough, half starved were completely unfounded. The staff are fantastic and highly skilled, particularly in the kitchen. Although meat is not a staple, gin and tonic is and guarantees instant conversion to those unaccustomed to its magical, medicinal properties.
At the end of my time in Malawi, I have a nagging feeling of unfinished business. It’s not caused by frustration or unachieved goals. Rather it’s down to too short a time here and the idea that if I could do it all again I could have an even more gratifying experience and do so much more here.
“…enjoy every minute of every day. Swim in the lake at sunrise, explore the communities every once and a while by going out with Catherine the Great on her Changu Changu Moto work, visit the pre-schools and go a bit daft, freewheel down the dirt track without clutching the brakes and, most importantly, enjoy the wonderful people here. You will make great friends and will promise to come back again someday.”
After a few failed attempts at volunteering, I finally stumbled upon RIPPLE Africa online. Contacting Susie was the first step in a very quick process that saw my boyfriend Mark and I on our way to Malawi. Arriving in Lilongwe I have to admit was nerve wrecking. I thought how am I going to slot into this way of life for two months? The bus journey two days later to Matete was long and arduous but we arrived! Met by Arnold and Mavutu at the roadblock, we quickly came to realise that Malawians were a lot like the Irish – chatty, friendly, and very welcoming. We quickly got settled into our chalet which was a lot less basic than we imagined and realised that plans to lose weight while in Africa were unlikely to succeed as Martha, Geddess and Fabiana demonstrated without fail the art of home cooking daily.
Working in healthcare in Malawi was a lot more frustrating and challenging than I could ever have imagined. I based myself two to three days a week at Kande Health Centre. I had been told that wound care practices were very poor and thought I was prepared for that. Turns out I was not! The challenges of no running water, little access to soap, and inconsistent supplies of necessities like gauze and bandages were difficult to deal with. Education among the untrained healthcare personnel who run dressing clinics in these health centres was another major obstacle. I quickly came to realise that turning up every couple of days and taking over how things were done was an inefficient use of my time and expertise. Instead, I realised that training some of these personnel on basics such as proper cleaning of wounds prior to dressing was far more important.
Two days a week, we attended Health Club. This is a club for older teenagers from the area run by Collins, the healthcare coordinator for RIPPLE Africa. Health Club aims to bring education on health and wellbeing topics to the wider community through drama and song. During our stay, we did so in two villages with up to 150 people attending to watch, each ending in rapturous applause. The young people we worked with in Health Club are inspiring, but they do benefit from direction in terms of organising when and where dramas will be performed. This is where other volunteers can be of assistance as they need a lot of encouragement to keep going when they are on a roll! However, imagination and entertaining are not areas that they lack.
- Triona making a Changu Changu Moto
- Working at one of the Health Centres
- Triona and Mark with friends at Mwaya Beach
Once a week I accompanied Collins when he went out and about on his rehabilitation work. As a paediatric nurse I found this most interesting as the majority of the work is with children with varying degrees of developmental delay due to a variety of causes, mostly unknown. Collins is fantastic at his job. His work is tough and his monthly budget is limited. However, he is bursting with enthusiasm and new ideas. He could benefit greatly from an occupational therapist, physiotherapist or speech and language specialist joining him for a few months. Seeing children like Isaac, who, a few months ago at the age of three, could not support his own head or even smile, take his first independent steps today was a real milestone for Collins. He gets a real kick out of his job and is constantly seeking to improve the quality of life of others and reduce stigma towards physical and learning disability.
As a paediatric nurse, the area I was most interested in was Under 5s clinics. Luckily I got to do this at least once if not twice a week. I mainly did outreach clinics with Fletcher as these are very understaffed with just him, Henry and occasionally a community volunteer carrying out the clinic. This was an area I really felt useful in as I could weigh, document, do statistics and vaccinate both babies and mothers. It felt more familiar to me than any of the other work I was involved with and it was an area where I could use my own expertise.
While here, we were asked to provide first aid training to the pre-school teachers. There are eight pre-schools which are run by RIPPLE Africa, each with three teachers. We ran two days of training, four schools each day. This went down really well. The pre-school teachers were so receptive and interested. It was definitely worth doing, especially when we heard some of the questions and suggestions for various scenarios! I typed out First Aid manuals for each of the pre-schools and this would be kept with the limited first aid supply kit they have. UNICEF has in the past given each pre-school a first aid kit but no training so refresher courses on this, and organisation and supplement of the kits every six months or so would be most beneficial.
Sexual and Reproductive Health research is another area I have been involved with. Currently, we are at the stage of seeing what the general opinion of the community is to the topic and holding meetings trying to come up with ideas around family planning and STI prevention. It is an area that is in its infancy. However, other volunteers will continue this work as it is an area that is vastly under-recognised as a problem, and an area that is misconceived among the public here.
Finally, I have been tutoring a girl in biology one evening a week. Thankfully, another volunteer is continuing this when I leave. The girl has failed Form 4 and is returning to Form 3 next September after taking a year out. From what I have learned about the school system here regarding class size and curriculum content, it is no surprise that so many young girls are failing school. She wants to finish secondary level education so she can apply to train as a nurse. As a nurse myself I see great potential in her.
Suggestions for future healthcare volunteers:
- Teach the healthcare workers what you know. Do not go in and take over an area and think you are making a difference. When you leave they will be back to square one. Pick a subject that you find to be lacking and focus on that. In my opinion, wound care and sharps disposal are a priority.
- Really try to encourage and motivate the Health Club to continue their great work. I know Collins has great plans for them to become ambassadors and leaders in their own communities. Encourage them to do so. Remember they are young, have never had a job and some have never completed school. They do great work and have great potential, but they need support and encouragement.
- Continue to work with the pre-school teachers in refreshing first aid training and replacement of used up supplies for first aid.
- Assist with outreach Under 5s clinics when you can. Try to incorporate it into your weekly routine. Ask Fletcher for a timetable of clinics. He will be very grateful for your help.
- Continue to develop the area of Sexual and Reproductive Health. Include the Health Surveillance Assistants (for example, Fletcher) as much as possible as this is a matter for public health.
- Finally, enjoy every minute of every day. Swim in the lake at sunrise, explore the communities every once and a while by going out with Catherine the Great on her Changu Changu Moto work, visit the pre-schools and go a bit daft, freewheel down the dirt track without clutching the brakes and, most importantly, enjoy the wonderful people here. You will make great friends and will promise to come back again someday.
Mark and Triona (Volunteer Nurses, April 2013 – May 2013)