This is David's report.
Although my visit to Embangweni only lasted 2 weeks, it was a wonderful experience and I shall always have vivid memories of the people I met and the places I visited.
Embangweni is a town with a population of about 5000 people, located in Northern Malawi, just 200 kilometres from the Zambian border, three hours drive north of the Capital City of Lilongwe. The whole of this small country runs along the magnificent Lake Malawi in Africa's Rift Valley. In the north, most of the people speak 'Citumbuke' but about 25% including the majority of the hospital staff, speak English.
The team arrived at the end of the rainy season, December to April, when there are some very heavy downpours and a lot of thunder and lightning. This leaves the countryside lush and green and very beautiful. It is summer time and most of the people work in the fields growing mostly corn, but also soya bean and pumpkin. Their staple diet is nsima - patties made from corn flour. The process from kernel to flour is labour intensive.
The hospital in Embangweni has 133 beds and is owned and operated by the Synod of Livingstonia, Church of Central Africa Presbyterian (CCAP). It also runs the church, a secondary school, a school for the deaf and a primary school. All are within walking distance of each other.
Rev Donald Fraser
and his wife Dr Agnes Fraser, Missionaries of the Free Church of
Scotland, established Embangweni (Louden) Station at the end of the
19th Century and began clinical work in 1902. In 1926, under the
direction of Dr W Turner, the facility expanded to become a rural
hospital and in 1989 the hospital increased to its present size under
the direction of Dr and Mrs Kenneth McGill. A Chapel has been built
to commemorate the work done by these 2 people and I had the pleasure
most mornings of worshipping there. At present their son Jim and
daughter-in-law Jodi, carry on the good work - Jim is a works
administrator for projects and maintenance.
The hospital is in the northern region of Malawi, the southern part of Mzimla District. The catchment area is bounded by the Zambian border to the south and west. The main north-south highway of Malawi - the M1 as it is known - was the road we travelled from Lilongwe passing Moses Chileuje and Emazwini villages in the north.
The hospital serves a population of approximately 100, 000 people with referral cases coming from as far away as Zambia and further. It also manages health centre at Kalakumbi, Mabiri and Mzasazi. The transport can be very difficult, especially during the rainy season as most roads, apart from the M1, are only dirt tracks. The hospital is a very busy place. The beds are usually full and the wards accommodate both men, women, children and maternity cases as well as the 'Nutrition Rehabilitation Unit' (NRU). The NRU is an important and growing project of the hospital which works primarily with mothers and malnourished children who may stay a month or two. This extended stay is quite a commitment for women who have other family back home to care for. Community health workers hold nutrition and health related classes, run a garden and a goats milk project. Malnourishment results mostly from over reliance on nsima which lacks adequate protein and abrupt weaning practices.
Poor nutrition reflects financial poverty. Most people are subsistence farmers without any other income. Malawi is one of the world's 10 poorest countries. One out of every 4 children die before the age of 5. Besides malnutrition, other major illnesses include malaria, pneumonia, tuberculosis, AIDS and obstetrical complications. To address these problems the Hospital's Primary Health Care (PHC) Department has developed 3 satellite health centres. These centres have radio contact and provide around 20 monthly mobile clinics where the health providers; comprising of a nurse, a midwife, community health workers and a medical assistant, see and examine children, pre-natal patients, update immunisations and give health talks. At one of these such clinics on Wednesday, 24 March some 200 people attended.
We also went to Kamsolo with the mobile unit where Anita the Midwife gave a talk to the mothers on good health practices. The mothers responded to questions with the unusual gesture of clapping in unison when they knew the answers to the questions. After the lecture the medical assistant began administering treatment - malaria tablets, aspirin and immunisation jabs. I assisted by completing medical records and updating data records. This helped speed up the whole process.
One of the more meaningful moments of our trip came one Thursday morning when, instead of having morning worship in the chapel, we held it in one of the hospital wards. As the majority of the patient population is Christian, they find the morning worship quite natural The staff gathers at 7:00 am in 2 groups and go to 2 wards each. The service in the children's wards was quite an emotional experience with hospital orderlies, accountants, grounds men and laundry men settling in next to the sick children and their mothers. The big grounds man, usually reserved and quiet, I'm told, bellowed out a Bible verse and gave a brief talk. Some children were wide eyes and alert while others were limp and tired, resting on worn mats or in the arms of their mothers or grandmothers (known as go-gos). The latter shared song books with the staff or quietly mouth the words to familiar tunes as the staff choir harmonised.
Anti malarial bed-nets hung from the ceilings above each bed, IV drips and blood transfusion lines running through tiny veins. I did not understand as the service was in Tambuka but the message was clear as the common bonds of illness and health, infants and 90-90s, blood and water, smiles and tears, hopes and fears, all made us pause before our God in the morning. Beauty and hardship sit side by side here like anywhere else in the world. While there was plenty of physical and material needs, there was also a lot of spiritual and community strength.
20 March 1999 - We set out to visit Mr Phakatis' village, a
journey of about 6 kilometres. He worked as a maintenance painter in
the hospital and cycled to work every day through streams and over
rough roads. Our main reason for the visit was to see part of the
'Shallow Well Project' and as a well and spring were located on Mr
Phakatis' land, we went to see how they worked. There was lovely
sweet water coming out of both the well and spring. The wells were
sunk during the driest part of the season, thus ensuring water. Mr
Phakatis also treated us to a meal and Mr Ngoma, VIC of 'Wells Comm'
joined us. On the return journey we met Mr Jerimiah Lungu who is over
90 years of age. He showed us photographs of some of the very old
missionaries. Mr Lungu's son was a minister. Unfortunately he has
outlived both his son and daughter-in-law. An uncommon occurrence in
this part of the world.
Monday, 22 March 1999 - We visited the Robert Laws Secondary School. We were greeted with rousing praise when we entered the assembly hall and were directed up on to the platform. It was quite obvious that there was a high level of discipline in the school. Maurice addressed the children, Jim read from the Psalms, Stephen prayed and John and myself then presented cheques for £650and £20O respectively. Richard presented a football and we then handed over some of the pencils, rubbers and sets squares that we had all gathered up during the weeks and months prior to our visit. The school choir then entertained us with a choice of music concluding with their National Anthem. The Headmaster, Mr Scotch F C Kondowe escorted us to his office. He explained that the students' ages varied from 13-19 years and that the average stay at the school was about 4 years. It was a coeducational school with both sexes boarding. Mr Kondowe had visited Scotland the previous year and one of our group, Stephen, had been familiar with where he had stayed. The school itself was well maintained and reasonably equipped. The science rooms etc looked similar to the secondary schools back home - without the graffiti. There was also an excellent wood work and metal work room, complete with lathes but unfortunately there was no electricity to run them. Mr Kondowe was very quick to point out that £3, 000 would buy a generator which would not only run the machinery but would also give light to the staff homes and dormitories. We thoroughly enjoyed the time we spent at the school We returned to the hospital to carry on with our work. Overall we had made very good progress, the delivery room was almost complete. Most of the day was spent working in the female ward, around mothers with their 'Mwana' - child. Children were breast fed while mothers were fed by their carers. This was all taking place in the same ward and no one seemed to be concerned. In fact it was probably a cheerful distraction from ward life. Mr Gondwe and his people also came to the hospital, they brought gifts of food, maize and pumpkin which they took to the church and gave thanks for. The weather was quite good although we had had a torrential downpour at about 4:00pm. It was a very tiring day.
Tuesday, 23 March 1999 - we went to our usual church service at 7:00 am, most of which was conducted in Tubuka. During the service one lady sang a solo of 'On the Wings of a Snow White Dove' - she had a beautiful voice. After church we went to visit the school for the deaf children. Again we presented pencils, rubbers and rulers. As part of a project within our local Boys Brigade Group one of the officers, Hilary Ferguson had asked me to take a little bear called Ben with me on my journey. I took Ben to the school. Jill Donnelly, one of the British teachers, explained in sign language about Ben's journey from Ireland - the children loved it. The school is sponsored by the Government and most of the children spend all their time there. We were shown round the dormitories which slept about 10 children with a mother or matron looking after them. I felt the kitchen area was a bit like the 'Black Hole of Calcutta' however the children seemed quite healthy. All the teaching staff were very dedicated. The Headmaster was Mr M E G Mtonga, a well 'spoken pleasant man who obviously enjoyed the confidence of the children. I gave Mr Mwale a copy of the 'New Testament' which he said would help the children with their English. We felt the visit was very rewarding. On leaving the school we then travelled on to the market were we bought the 'cha ten gess' - brightly painted cotton remnants sometimes worn as skirts. Once again we returned to our work in the hospital - this time in the maternity ward.
Thursday, 25 March 1999 - today we made a visit to the primary and nursery schools. Assembly was held in the Church. The children assembled outside until they were told to march in - and march in they did. Prayers, readings and praise took place. We then presented 2 cheques for £200 each. Pencils, books etc, were again donated to the Headmaster, Mr G G Gele and his Deputy, Mrs Guy Nhlema. The Headmaster had a Staff of 30 teachers with an enrolment of between 1500 and 2000 pupils, forms 1-8 streamed A, B and C. School commenced each day at 6:45 am and finished at 11:10 am-12:00 noon, 12:45 pm for The older pupils. There was an election taking place and one of the big classrooms was being used for registration purposes. The idea was to have a photograph on the registration form and on the voter's card. Subsequently the polling clerks had to match one against the other. We had an opportunity to look around the remainder of the classrooms which we found very grim. The children sat on the floor and there were no windows in the rooms. The nursery was very similar.
Friday, 26 March 1999 - Morning service in the church - this would be our last as we planned to drive down to Lake Malawi early on the Saturday morning. At the end of the service the people sang as we left the church. We lined up outside and the congregation came to shake hands with us. I presented two 'City of Londonderry' plaques one to the Hospital and one to the School. Again we returned to our work in the Hospital, this time to the female ward. We had had to replace quite a portion of the ceiling with fibre-board before painting it.
Saturday, 27 March 1999 - We drove to Lake Malawi, about 200 kilometres, - quite a tiring journey. Our destination was Sambani Lodge. When we arrived Richard Kerr with his wife and children and Stephen McCracken and his children were there waiting for us. We had a four hours on the beach, time for a swim and a bit of football. Then the rain started - it literally poured down.
Sunday, 28 March 1999 - We attended Bandowe Church. The service was in English based on Christ's entry into Jerusalem. A lady delivered the sermon and Stephen McCracken followed with a prayer. The church was the last resting place of M E Martin who died in child-birth. The rain continued for the remainder of the day.
Monday, 29 March 1999 - We had a break in the weather so we loaded up all the luggage and turned south heading for Lilongwe. We had not travelled far when we reached a police checkpoint where we were informed that the bridge had been washed away. We decided to have a look for ourselves. The first bridge we came to was passable but a lot of debris lay around. We moved this aside and walked over to the other side where there was another vehicle, the driver informed us that he had had to turn back as the next bridge along was washed away. We turned and headed back to Mzuzu. When we arrived the police officer told us that to the best o his knowledge the bridge was passable. Our reason for returning by Mzuzu was that it had a light aircraft which flew to Lilongwe Airport, however we were able to continue in the ambulance to Lilongwe - a journey of 550- 600 Km - 350 miles. We arrived at about 5:30 pm. We stayed for the night in the Baptist Mission - courtesy of Frank Dimmock, then went to have a meal in the Chinese restaurant. Ironically this was run by Koreans. Frank joined us and we splashed out ordering 7 or 8 different dishes, sharing them all between us. Frank's wife Nancy joined us as we were ordering our dessert. She commented on how much food we had eaten and we were amused by Frank's reply that "These lads have just spent 16 days in the bush". His statement made us all stop and think - indeed we had just spent 16 days in the bush.
Tuesday, 30 March 1999 - Up early as usual with breakfast from the provisions bought the night before. We had a short trip to the market where we had the opportunity to buy some local souvenirs to bring home, then it was time to leave for the airport for our return journey. 10:30 am Airport - flew out 3:30pm to Nairobi then Amsterdam to Belfast.