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Unfortunately we weren’t able to get the Land Rover into container, despite the valient efforts of the packing team, who tried all sorts of ways to it into a position where it could be driven on. Nevertheless we were still able to fill the container to the brim with hospital equipment, NRU supplies, school equipment and clothes.

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Tablets

1. Amoxyl
2. Ampicillin
3. Penicillin VK
4. Cotrimoxazole
5. Trimethoprim
6. Chloramphenicol
7. Ciprofloxacin
8. Cloxacillin
9. Cephalexin
10. Cefuroxume
11. Metronidazole
12. Multivitamins
13. Iron with ferrous sulphide
14. Paracetamol
15. Aspirin
16. Brufen
17. Indocid
18. Diclofenac
19. Morphine
20. Pethidine
21. Nitrofurantoin
22. Erythromycin
23. Metochlopromide
24. Phenobarbitone
25. Buscopan
26. Bisachudyl
27. Cocodamol
28. Magnesium trisilicate
29. Cimetidine
30. Ranitidine
31. Omeprazole
32. Lansoprazole
33. Diflucan
34. Acyclovir
35. Griseofulvin
36. Ascorbic acid
37. Propranolol
38. Hydrochlorothiazide
39. Methyldopa
40. Nifedipine
41. Allopurinol
42. Frusemide
43. Atenolol
44. Glibenclamide
45. Tolbutamide
46. Prednisolone
47. Hydrocortisone
48. Ketoconazole
49. Griseofulvin
50. Ergometrine Tablets
51. Piriton
52. Promethazine
53. Quinine

Injectables

1. Benzyl penicillin
2. Gentamicin
3. Benzathine Penicillin
4. Ampicillin
5. Chloramphenicol
6. Cefriaxone
7. Diazepam
8. Phenobarbitone
9. Diclofenac
10. Metronidazole
11. Lignocaine
12. Ketamine
13. Atropine
14. Pethidine
15. Morphine
16. Dexamethasone
17. Aminophylline
18. Dextrose 50%
19. Frusemide
20. Metoclopramide
21. Buscopan
22. Ergometrine

Ointments and creams

1. Dexamethasone eye/ear ointment
2. Chloramphenicol
3. Gentamycin
4. Gorofloxacin
5. Silver sulphadiazine
6. Any antibacterial cream
7. Mouth wash liquids
8. Acyclovir
9. Any antifungal cream
10. Any steroid cream
11. Any cream for burns patients
12. Atropine eyedrops
13. Any eye anaesthesia

Injectables

1. Any cough syrup
2. Any nose decongestant
3. Amoxyl syrup
4. Ampicillin syrup
5. Erothromycin syrup
6. Penicillin syrup
7. Metronidazole syrup
8. Paracetamol syrup
9. Mutlivitamin syrup
10. Iron syrup
11. Brufen syrup
12. Quinine
13. Nystatin
14. Promethazine
15. Salbutamol
16. Cotrimoxazole
17. Flucanozole

Other items

1. Nebulizer salbutamol
2. Assorted dressings
3. Splints
4. Antibiotic powder
5. Nebulizer machine
6. Suction machine for asthma patients

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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

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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)

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“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)

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Alex, now 26, is a landscape gardener who uses his bike as daily transport to and from work, and is also a keen tourist on his bike. Most weekends he covers between 80 and 100 miles, usually on Dartmoor or Bodmin Moor.

His marathon ride took exactly the 15 days he had planned. Each night was spent in a Youth Hostel or a Bed and Breakfast and he allowed himself only one rest day during the 959-mile challenge.

Why choose Medic Malawi to benefit from his exploit? “I chose Medic Malawi because it is a small charity with no administration costs, every penny going to Malawi, because it is a charity I know personally from my family’s association with St. Andrew’s Church, and because it is based here in Plymouth.”

If you would like to sponsor Alex, you can make a donation at any branch of Barclay’s Bank. The account name is Forsyth-Malawi, account number 90736813 and the sort code 20-68-10.

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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

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At the clinic were treated like royalty, with our host families sharing what they had with us, making sure we had hot water for baths, and European-style food.

We divided our time into three areas.

Firstly we assessed the current dental facilities, and looked at the needs of the local population. The facilities consisted of a broken wheelchair a few needles and anaesthetic cartridges, and some very elderly forceps. We marvelled at the skill of Cuthbert, the clinical officer responsible for extractions. During our time there we examined 160 patients, of whom 60% had tooth decay, about half of these complaining of pain.

Our second task was to extract teeth, and carry out some simple fillings for those where the decay was not too far advanced.

Our third task was to set up a preventive programme, consisting of simple tooth brushing instruction and diet advice. We visited the students in the local primary and secondary schools, and families in one of the nearby villages. We had taken supplies of brushes for Cuthbert and James to give to patients who may attend in future for dental advice. By the time we left James, Cuthbert and Millica, the nutritional educator, were ready to work as a team on outreach programmes, in the other nearby villages.

Sam was able to put to use his pharmacy skills in the clinic .One achievement was the cataloguing of medicines, reorganising them, allowing the clinicians to dispose of expired drugs, which had been taking up valuable storage space.

David worked in the laboratory, carrying out blood tests for patients with diseases such as malaria and AIDS. He also taught group of the local lads the finer skills of basketball, and was given permission to use the basketball courts of nearby Kamuzu Academy.

Jonny, made lots of friends at the local primary school, learning about Malaria and agriculture in his science lessons, alongside Maths and English. Education was different to that in the UK, but he really enjoyed it.

As we left we did make a promise to raise funds to provide a much-needed dental surgery to serve the forty thousand local population. In the words of Arnie…the Terminator….”I’ll be back”….

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At the beginning of our trip, we spent five days working in and around the hospital. We spent our time working in the kindergarten and feeding programme, painting murals in the reception and painting the new operating theatre. This was a special experience because not only were we helping practically but we were also in the centre of the community, meeting new people and playing with the children.

Everyone at the clinic was so welcoming – they really went out of their way to look after us and make us feel that we were doing something valuable for the hospital. In the NRU we were able to help the nurses weighing and measuring the children, mixing feeds and keeping records up to date. Some of the children were really sick and their mothers had walked for miles to bring them to the hospital, but when we started to play with them and give them toys or balloons, they became really excited and animated.

It is good to know that the decorating we did in the new Operating Theatre has helped in a small way to get this fabulous new facility completed. We heard how, at present, people have to travel 30km to Kasungu for emergency operations such as Caesarean Sections and that many patients don’t survive the trip or the wait in the government hospital. When the Operating Theatre is open, it will make a huge difference to the care that St. Andrew’s can offer.

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