Newsletter: August 2007
We have recently returned from Mtunthama, and can report that over the last twelve months there has been the most impressive progress. The Operating Theatre is finished and awaits only the necessary equipment and an anaesthetist to start functioning; there is a large surgical ward nearing completion, which should be finished by end of October; a very large storage building has been constructed to keep goods supplied by various NGO’s such as World Food Programme for the NRU.
NRU Supplies
The Orphan House has doubled in size, and will be able to cater for about 50 orphan children; the laboratory now has a blood bank; there is a dedicated Voluntary Counselling and Testing room for HIV/AIDS patients; Dentaid will be sending out a refurbished Dental Surgery in the third week of September, and we already have staff who will be able to carry out dental procedures.
Florence and Boyson Kwaderanji, who look after the orphans
Group Visits
During July, three groups of young people from UK visited the campus to work on various projects.
Wrekin College from Shropshire paid a second visit in order to complete the second wing of the Orphan House. Quite apart from general support for Medic Malawi, they have made the orphans their special concern. This year they funded the construction of the second phase of the Orphan House, and built a kitchen to cater for 50-plus people. Additionally they started work on an irrigated garden to provide “relish” throughout the year, and made a play area for the children.
At the end of each day Florence and Boyson check all the children, a necessary precaution because they often find more children than they expect: other village children try to stay in the Orphan House rather than in their own homes!
St. Peter’s School, Exeter also paid a second visit. Whilst working with the NRU is one element of their activities – they livened up the NRU with some fun logos on the walls - they are most closely involved with the Secondary School. They have set up an internet link with the school, and have funded project work for the students of both schools to share their research. For example, they arranged for the All Saints’ students to spend time at the lakeshore studying geography topics, whilst the St. Peter’s students worked on similar research in Devon both groups were then able to share the information they had learned. St. Peter’s hope to arrange an exchange for teachers and students in the near future.
A group of young people from Islay spent some time in Mtunthama as part of an adventure activity under the auspices of Outlook Expeditions. They began the work of building a science lab for the Secondary School. There were two other groups from Outlook Expeditions at other locations in Malawi we hope that the All Saints’/St.Andrew’s campus will become a regular feature of their activities.
Foundations for the Science Laboratory.
St Andrew’s Hospital
It is remarkable that only six years ago St. Andrew’s was a small rural clinic with only a dozen staff: it is now a Community Hospital with a staff of 58! Many of them have been with the project from the beginning, and one of the really encouraging things is the fact that so many have progressed by dint of training courses to upgrade their qualifications.
The schools have grown enormously in both numbers and buildings/facilities, the kindergarden goes from strength to strength whilst provision for orphans is improving all the time. It is good to see more and more volunteers choosing to spend time at one or other of the projects, and we aim to build a house over the next year or so to provide accommodation for them.
We noted that not only are health professionals from Kasungu General Hospital choosing St. Andrew’s, but also the maternity unit is becoming popular with the midwives from Lilongwe General Hospital to have their own babies! The MP for Kasungu East chooses St. Andrew’s for his family’s health care.
NRU
The NRU continues to be central to the work of Medic Malawi. Several NGO’s support the work, but their criteria are more rigorous than we would wish, in that children have to be seriously malnourished before they become eligible for help. As almost half of all children in Malawi are chronically malnourished, at St. Andrew’s we seek to provide food and health care to children before they reach the point of malnutrition which would attract help from the NGO’s. This means that we need to fund both feeding programmes and health care supplements. We are also hoping to increase the follow-up procedures once children are discharged, in order to ensure their ongoing treatment and support.
Carers with their children in the NRU. The smart, warm clothes the children are wearing were sent by well-wishers in UK. There is always a need for warm clothing for children.
Helping people to help themselves
It has always been the philosophy of Medic Malawi that the projects belong to the people of Mtunthama, that ultimately they must be responsible for managing and developing the work initiated by supporters here in UK. It is therefore especially encouraging to find an HIV/AIDS project in nearby Wimbe run entirely by volunteers, headed by Peter Minjale, one of our Clinical Officers. There is a team of 7 trained counsellors, each of whom has accepted responsibility for three villages, which he/she has undertaken to visit at least three times a week. Some of those villages involve a journey of 15kms each way. As there is no transport, they go on foot! We hope that we shall be able to send out some bicycles with the container due to go at the beginning of September.
The volunteers, and the building from which they work.
Another impressive project being run by local people is an agricultural cooperative. Having been provided with initial funding for seeds and fertiliser, they are now producing excellent crops for sale. The profits are used to purchase more seed and fertiliser, and to further develop the scheme. Those currently involved have their own bank account for the cooperative, and there is a waiting list of people wishing to join. The scheme does depend on a reliable water supply, and at present there are four locations adjacent to dambo areas (marshy land) in use, but the intention is to find and develop more such areas.
At the end of this month we are sending a container of goods and equipment to Mtunthama. This will include medical equipment, computers for both Hospital and Secondary School, books for both Primary and Secondary Schools, and of course the Land Rover/ambulance.
Our visit this year has been immensely encouraging. Not only are all the projects with which Medic Malawi is involved running successfully, but we gained a sense that the whole country is much more positive than previously. The harvest this year ranged from good to “bumper” and we can be optimistic that any food shortages will be relatively minor.
One final thing: the increasing number of young people visiting Mtuthama, either with groups or as individuals, is serving to build bridges and foster understanding across the divides of distance and cultures.
Ambuye akhale nanu!
May the Lord be with you!
Dot and Mac Forsyth
Newsletter: June 2007
Visit of Felicity Derry-Thomas and Ann Tregarthen of ‘Operation Sunshine’ SW England.
“While planning a visit to Zambia to see the projects we support there through ‘Operation Sunshine’ we thought it a good idea to see St. Andrew’s Clinic /Hospital in Malawi, and what a good idea it was - full of interest, facts, figures, work, wonderful people, sadness, laughter and joy.
This is an excellent hospital run and supported by exceptional people both in Malawi and England and elsewhere We saw the whole hospital: maternity unit soon to be enlarged and upgraded; the women’s ward with their small children with them— they have no where else to leave them; the HIV/Aids unit; the out patients and children’s ward—often two or even three children to a bed.
We worked in the pharmacy counting pills by hand, and cutting materials and rolling cotton wool balls for the dressings. Oh for a pill counter and some good scissors! We helped with the baby feeding programme for the wee malnourished babies needing help to stay alive, and their thin young mothers so quiet and dignified. We were told of the outreach project , keeping an eye on the little ones who have returned to their villages. We heard about the teaching of family planning - the women are keen but the men are not so!
One of the highlights was hearing the orphans singing for us; it was superb. I think the African has a different throat mechanism from the Westerner; the power and harmonisation of even a small child is incredible.
I spent time with Snowdean Njiwa the hospital administrator and learnt so much about Malawi, its politics, its peoples and customs, its problems and its joys, and of course about St Andrew’s and how this great project has evolved and is still evolving.
God’s hand is surely in all the planning and work with these lovely people—thank you Medic Malawi.” Felicity
School visits
In July two schools will be sending groups to Mtunthama. Wrekin College, Shropshire will complete the final stages of the new wing of the Orphan House, which they have fully funded, and St. Peter’s School, Exeter will be working in the schools. Both groups will also help in the Hospital and the Under-5 feeding programme. No doubt there will be plenty of sport and social contact, and the church services will be very special indeed, as both schools are already rehearsing their hymns/songs, and All Saints’ choirs will seek to be even more impressive than usual!
Dental Surgery
A complete Dental Surgery provided by Dentaid is about to be shipped out from UK, and plans are under way to send a container in September.
Hospital Equipment Shopping List
We would like to be able to include as much of the following as possible in the container going out at the beginning of September.
If you can help by donating anything from this list, please get in touch. Thank you.
- 8-10mls test tubes
- Adhesive plaster
- Anaesthesia machine and monitors (Pulsoximeter)
- Autoclave (110 litres)
- Biohard bins
- Caesarian section full set x 4
- Centrifuge (12 rotor)
- Chemistry Analyser (Liver function)
- Cimetidine
- Cotton wool
- Crepe bandages
- Crutches
- D & C
- Dental needles
- Dental syringes
- Diagnostic sets
- Digital scales (0-250g capacity)
- Dispensing bottles
- Drug trolleys
- Dry gauze
- Eusol
- Evacuation full set x 2
- Examination gloves
- Face masks
- Gallipots (various sizes)
- Gauze bandages
- Goggles
- Haematology analyser
- Hernia repair kit
- Kidneydishes (assorted sizes)
- Laparotomy
- Medical/Nursing books
- Nebulae machine
- Needles
- Office fans
- Office file trays
- Olympus microscope
- Operating Table
- Oxygen concentrators
- Paraffin gauze
- Patient screens
- Photocopier
- POP cutter
- Safety cabinet (fume hood)
- Savlon
- Sharps containers
- Sphygmomanometers
- Sterilisation drums
- Sterilisation pouches
- Stopping bottles
- Suction machine for newly born babies
- Surge protectors
- Surgical gloves
- Sutures
- Syringes
- Tablet cutters
- Theatre canvas
- Theatre Lamp (portable)
- Thermometers
- Toothbrushes
- Weighing scales (Kg)
Newsletter: September 2006
The Operating Theatre
The entrance to the new Operating Theatre, in the final stages of completion
It is really exciting news that the Operating Theatre will be in use very shortly thanks to a generous donation from Aspect Capital Ltd., a hedge fund management company in London. The building houses a large and light main theatre, a minor ops theatre, prep rooms, post op room, nurses’ room, clinicians’ room, showers and all necessary storage areas. The Theatre building is located adjacent to the labour ward/delivery rooms which, even though they are regarded as among the best in Malawi, will be upgraded in the next phase of development to give an additional delivery room. The need to enhance the maternity facility is a result of the popularity of St. Andrew’s Hospital and the campaign to persuade mothers to deliver at a Hospital, because statistically one in seven mothers in Malawi dies in childbirth. Patients are now coming to St. Andrew’s not only from Kasungu, 30 kms away, but also from Lilongwe, 130kms away, because of the quality of care they receive. And some of them are health professionals working in other medical centres!
The interior of the Main Theatre showing the large windows.
More exciting news is that St. Andrew’s, which opened in August 2001 as a small clinic, has been upgraded first to a Rural Health Centre and in August 2006 to a Community Hospital. As the Hospital grows so the demand for more Staff and therefore more houses grows. We are making application to various NGO’s for funding for several new projects. We want to build a post-operative ward with ICU and HDU facilities, an Administrative Block containing all administration offices, accounts, Staff Rest Rooms, (to date the Staff do not have anywhere to “switch off”) a Library, and a purpose built VCU (Voluntary Counselling and Testing Unit) for HIV/AIDS patients. We plan to open a Dental Unit as soon as the equipment becomes available – the room has already been set aside for such a development. Kyle Danielson from Canada has set a target of raising sufficient funds for a new 45-bed ward. Additional staff houses are required, as is a bore-hole to supply water to some of the staff houses. Thanks to South West Water and St.Peter’s School, Exeter, the Hospital has a new bore-hole as a stand-by should there ever be problems with the main water supply.
The new bore-hole for the Hospital
More Construction Work
We need also to construct a storage unit, a Guardian Shelter for those caring for patients, and to build a much larger NRU for the Under-5 programme. In mid-August the NRU had only two patients, but by mid-September the number had risen to nine. There is no doubt that over the next weeks that number will continue to increase as the food shortage resulting from very poor rains begins to take effect. The NRU/Under5 programme is the biggest in the whole of Central Region.
This child shows the swollen belly typical of Oedema (malnutrition)
We have been able to make significant purchases of maize while prices are low so that we now have a store of maize ready for the time when people have no food and no money to buy any. It is expected that there will be in the region of 90/100 children seeking help at the NRU by the middle of November. By that time it will be necessary to run an adult feeding programme, but again we have made provision in the purchase of maize while it is available and relatively inexpensive.
Maize bags being closed up after the addition of Actelic Dust to prevent weevil infestation. Each bag contains 100kgs of maize; we have 100 bags.
Staffing at St Andrew’s Hospital
You may like to have an idea of the staffing of the hospital. We currently employ:
two Clinical Officers;
one matron and one deputy matron, both of whom are Nurse/Midwife/Technicians;
four other Nurse/Midwife/Technicians;
one nurse;
one Medical Assistant who also does dental work;
one Lab Assistant;
one Pharmacy Assistant;
one Dental Aide;
one Patient Aide;
seven Ward Attendants;
four Homecraft Workers;
two Cleaners;
two Drivers;
one Laundry worker;
one Administrator;
one Accountant;
one Accounts Clerk;
one Cashier;
one Receptionist;
ten Watchmen/labourers;
and two Maize Mill Operatives.
We are advertising for a Clinical Officer Anaesthetist to start as soon as possible.
Also interesting is a guide to net monthly salaries - Matron: £82; Nurse/Midwife/Technician: £74; Lab Assistant: £31; Driver: £27; Cleaner: £13. And St. Andrew’s pays good salaries!
Set against salaries the cost of basic requirements: rent for a tiny two room house - £4; a month’s supply of maize - £2.00; a month’s supply of firewood to cook for a family of four - £2.00; soap for a family of four for a month – 60p. A farm worker employed on a local estate, after ten years (non-pensionable) service, receives £8.50 a month.
The Orphan House
The Orphan House now has 32 children living in it, and other orphans who are living with foster parents are fed every day. Fifty children are sponsored at the Primary School, 87 at the Secondary School, and the Kindergarten has 40 children, over half orphans, who are fed each day as part of the Kindergarten programme. Funds are now available to complete the second half of the Orphan House, so that we shall soon be able to accommodate another 30 or so youngsters.
Bunk beds and happy inmates at the Wrekin College Orphan House
Future Developments
In order to permit future developments, we have purchased a tract of land adjacent to the Hospital. It will obviously be quite some time before we can afford to build on that land, but in the meantime we hope to establish a drip-feed irrigation system which will enable the growing of two or even three crops a year, and which will also be a tremendous teaching aid in showing what can be done if water is available. Sustainability and self-help have always been at the core of all that we have sought to achieve through Medic Malawi, and such a project could prove immensely valuable over the next few years.
Prideaux Family Visit
In July the Prideaux family from Plymouth – two dentists and their three sons – visited St. Andrew’s. They set up a dental education programme, carried out many examinations, fillings and extractions, and prepared the way for us to apply for help from Dentaid, UK. Their two older sons helped in the Pharmacy and the Secondary School, the youngest one attended the Primary School. You can read their report here.
Finances
We do not usually write much about the detailed finances of St. Andrew’s in the Newsletters, but having given some idea of staff salaries and the cost of basic foodstuffs, we thought supporters might like a more precise indication of how the money raised in UK is actually spent on a month-by-month basis.
Salaries – £600 (CHAM now pays £1600)
Drugs/consumables - £1500
Outreach Clinic - £50
Fuel - £150
Maintenance - £100
Lab Facilities - £600
HIV Testing - £70
NRU - £400+
Electricity - £150
Water - £60
Telephone/Postage - £30
Insurance - £200
Maize Mill maintenance - £70
Orphans - £15
Registration fees - £5
Misc. - £250
In addition, there is the cost of all project work, such as buildings. We also endeavour to offer staff the opportunity to enhance their qualifications, provided that they undertake to continue working at St. Andrew’s after they have qualified.
Sometimes a reminder of why the work of Medic Malawi is so important may be useful. The following experience serves such a purpose.
“I asked the house boy this morning if he had a mosquito net. ‘They are too expensive,’ he replied. (They cost 25p.) Just imagine being so poor. But then he told me an even more heart- rending tale. Yesterday he had met a young boy aged about 13 in the market. The boy explained that last year both his parents had died, and that a week ago his older sister had run away. The boy himself had been thrown out of the house where he had been living by the village headman. The lad had nowhere to go, no-one to pay his school fees, no-one to give him food or shelter. Thankfully, with the Orphan House and the sponsors who support pupils at the Secondary School the boy now has a roof over his head, food to eat, a caring community and the chance to be educated.”
In the past we have not used the newsletter to ask for funding, but on this occasion we would like first of all to thank all those who contribute as members of the “100 Club”, for it is those donations which are the basic source of revenue for Medic Malawi, and to ask all supporters to consider whether or not they are in a position to increase the level of their support. Most people have submitted a Gift Aid Form which allows us to reclaim tax paid on eligible donations; if you have not done this please obtain a form from the web site or contact us direct. As you can see, the original target for the “100 Club” of 100 people each to donate £10 a month, thus raising a regular monthly income of £1000, now falls far short of what is needed. Are you in a position to increase your monthly support; or could you perhaps encourage friends to help by joining the “100 Club”? Please remember… every penny raised goes to Malawi.
May God bless you all.
Dot and Mac Forsyth
21 September 2006
Newsletter: February 2006
Looking ahead, we fear that prospects for a reasonable harvest this year are not good. The growing season began well in December last with adequate rain, but by the end of January there had been no rain for three weeks and crops were beginning to dry out. Without significant rainfall in early February there will be further food shortages later in the year.
Last year a group of students from Wrekin College, Shropshire, travelled out to Malawi to work on the new Orphan House for which they had already raised the building costs. As well as completing the interior decorating with bright, lively cartoon figures across the walls, many of them undertook a range of tasks within the hospital, such as in the laboratory and in the under-5 clinic. The orphan house now accommodates 21 residents and provides meals for many more who live with adoptive families in the village.
The new orphan house
For the last month Alice Dwyer, a medical student from University of Sydney, Australia, has been working as a volunteer at St. Andrew’s Hospital, as part of her Elective. We hope to have an account of her time in Mtunthama shortly, but have received glowing reports from hospital staff, including “Alice loves the little ones very much”. She has spent considerable time in the Under-5 unit.
Last year Kyle Danielson, from Canada, spent six weeks working as a volunteer at the hospital. He made an enormous contribution to the life and work of the hospital while he was there and this year he is planning to go again, this time accompanied by a group of nurses and possibly even a surgeon! Kyle has also, since his return to Canada, raised significant sums of money and sent valuable equipment out to St. Andrew’s. He is looking at the possibility of establishing Medic Malawi, Canada, as a charity in its own right.
Two experienced dentists from Plymouth, UK, plan to spend about three weeks at St Andrew’s Hospital during late June/early July. They will also spend some time in the Dental Unit at Kasungu General Hospital. This is the way they have chosen to celebrate their Silver Wedding!
Sally Symonds, an English lady resident in Australia, decided that she would celebrate her birthday lasat year by doing a sponsored sky-dive to raise funds for Medic Malawi. We are so grateful for the £1300 thus raised. And incidently, it was her 70th birthday she was celebrating!
In April this year a group of students, all girls, from St Peter’s School, Exeter, will be travelling to Malawi to work on a number of projects on the campus, including work in the Under-5 clinics and quite possibly with the orphans in the new Orphan House. We wish them a safe trip and hope they have an exciting time. We look forward to hearing their reports.
Newsletter: August 2005
The Staff at the Hospital now numbers 43, with the prospect of an increase in staffing this month, if the Malawi Government implements its promised review of establishments in Rural Health Centres.
DFID has funded “top-up”allowances for Clinical Staff in an attempt to persuade them not to apply for posts in other countries where the financial rewards are so much higher. We are fortunate at St. Andrew’s in having a waiting list of applicants for Clinical posts.
Harvests this year have ranged from ‘poor’ to ‘very poor’, with the consequence that serious food shortage is inevitable within the next few months. Already the Nutritional Rehabilitation Unit for Under-5 children has 10 in-patients and 17 out-patients: at this time of year we would normally expect 2 or 3 in-patients. Ours is the only NRU in the District, and is training other health care workers in the management of chronic malnutrition. What was built as the Guardian Shelter for the Clinic is now completely taken over by the NRU, and so a new Guardian Shelter will have to be constructed. Malnutrition in children continues to be a major problem.
Over the last four months 120 under- fives were tested for anaemia: of those, 5 had normal haemoglobin levels, 43 had mild anaemia and 72 severe anaemia. Link those figures with 44% of under fives tested for malaria being positive, and you see just how vulnerable these children are.
In the ante-natal dept. there are integrated education programmes taking place every day – nutrition, baby care, family planning, HIV education. We currently have one Outreach Clinic which involves an 80 km round trip every month for a Clinical Officer, a nurse and a Health Care worker. We are in discussions with the District Health Officer to begin a second Outreach Clinic (this one only a 60 km round trip!). At these Clinics work is done in clinical, immunisation and health education spheres.
St. Andrew’s is also working with Government and NGO sources in the treatment of HIV/AIDS and other STI’s. Currently in Malawi there are estimated to be 170,000 patients in need of ARV drugs, but only sufficient medication this year for 35,000. We also now have access to free palliative care drugs such as morphine. A room in the Hospital is being refurbished as a VCR(Voluntary Counselling and Testing) centre whilst we wait for the result of an application to the Global Interfaith Programme for funding to develop a purpose-built centre. Local volunteers from the villages are being trained as counsellors.
The Maternity Unit goes from strength to strength. Increasingly expectant mothers are being persuaded to have their babies in hospital where proper care is available in the event of problems, and more and more they are staying in hospital for 48 hours after delivery.
One new baby weighed only 800grms at birth, but because she was born in hospital where she can be kept warm in an incubator, she will survive. Her twin sister weighed 1.2 kg., and is also progressing well.
Wrekin College in Shropshire funded the construction of an Orphan House which will eventually accommodate 32 children and their carers, as well as being a day-centre for many more local orphan children. The centre will provide a meal every day for all the needy orphan children in the Mtunthama area. A group of students from Wrekin spent a couple of weeks decorating the inside of the orphan house, as well as working at the hospital. In addition other young people from St.Andrew’s Church, Plymouth, and one volunteer nurse from Canada have spent time at the Hospital in July and August.
The current situation is immensely encouraging. A significant amount of maize has been purchased ready to respond to the expected food shortage; the Maternity Unit is delivering over 50 babies a month; the NRU is now providing a sophisticated and well-funded programme to counter some of the effects of chronic malnutrition in children; the orphan house will open this month; almost 100 children are being sponsored through school. Of course there are problems. In the cold weather there have been some very serious burns cases – all children; malaria and pneumonia are rife; malnutrition is an ongoing problem; and anti-malarial drugs, on sale cheaply in small shops throughout the country, are literally poisoning people as they contain dangerous chemicals.
The Operating Theatre in early August. Construction is now at lintel level, but we desperately need funding to complete the building. Once completed, this facility will make a huge difference to the range of procedures the Hospital will be able to carry out.
Looking ahead, our immediate aims are:
- to complete the building of the Operating Theatre;
- to achieve a purpose built VCT unit;
- to construct the necessary post-operative wards;
- to build a Dental Unit;
- to build a new Guardian Shelter to replace the one now used for NRU;
- to build the extra staff houses we need as staff numbers increase;
- to construct an administration block, releasing rooms in the Hospital for clinical work.
The “100 Club”, our main source of income, was set up to meet routine running costs; these have more than doubled as the Hospital has grown. Members of the “100 Club” make regular monthly contributions of £10 or more. If you could help in this way, please contact us.
Thank you all for your continuing support.