Author Archives: Elena Sosa Lerín

Fuel scarcity fuels corruption in Malawi

Amidst severe fuel scarcities, frustrated drivers queue at a gas station after being tipped off that a tanker is set to arrive to offload petrol. Photo by Elena Sosa Lerín.

It’s a Thursday afternoon and the thermometer is about to hit 40 degrees.

Taxi driver Mike Msindira, 32, is sweaty, exasperated, but resigned to the idea of losing time and his daily income of $75 CAD – instead of driving passengers around, he must spend his time driving all over Blantyre looking for fuel.

He has now been at this gas station for nearly nine hours, has been without fuel for four days, and his tank is still at zero; but he won’t leave because his car is one of the first vehicles in the queue and he’s heard from different sources that this particular gas station will be receiving gasoline and diesel before the end of the day.

Msindira, along with thousands of other Malawians, is experiencing the fourth fuel crisis of the year.

Each crisis has been the result of the government’s inability to import gasoline or diesel due to its inability to acquire forex.

Fuel scarcity in the country has disrupted businesses, affected public services, and even regular activities, such as going to work or driving children to school.

But those who don’t own a car are also hurting.

Due to fuel scarcity, by the end of November, minibus operators announced a significant increase in their bus fares, from an average of 50 cents to around 70 cents per journey. Considering that most Malawians live on less than two dollars a day, many have chosen to walk to and from their workplaces and homes, as they cannot afford to pay the new rates.

But the one thing that the absence of fuel has been fuelling is corruption.

For instance, Msindira says that it’s becoming an unfair but common practice to pay “tips” to gas station attendants to get advanced notice of the day and time the station is set to receive petrol.

If you don’t tip them, Msindira says, you don’t get serviced at all.

The Malawi Energy Regulating Authority (MERA) has stated that it will revoke the licenses of operators who engage in corruption. It also says that it will work with the police and the Anti-Corruption Bureau(ACB) to arrest those attendants who ask for tips. However, to date, nothing has been mentioned as to how these measures will be implemented.

These crises have seen the emergence of a steady black market for the illegal sale of fuel with prices ranging from $5 CAD to $6 CAD per litre.

Adding insult to injury, unscrupulous traders are mixing fuel with other substances, such as paraffin or water, which can potentially harm car engines.

Blessings Nkhambure, 27, an electrical engineer, has waited for 48 hours to get gasoline.

“I’m stinky!” he says, showing the large and dark sweat stains under his armpits.

He hasn’t showered for two days. His meals have consisted of bananas or bread, which he passes down with Fanta. To avoid falling asleep at the gas station at night, he chats with the people around him, or listens to music from his cell phone.

“The government should assist us urgently,” Nkhambure says. “We can’t run our business, we can’t eat, we can’t do anything without fuel.”

In an attempt to pacify the public, the government announced in late October that the Reserve Bank of Malawi had made over $3 million USD available to Petroleum Importers Limited (PIL) to allow the purchase of 15 million litres of fuel.

But this only provided Malawians with 20 days worth of petrol, and fuel scarcity reared its ugly head once more.

Even Energy Minister, Goodall Gondwe, admitted in early November that this effort wasn’t enough, explaining that in fact, $30 million USD is needed to solve the issue.

Each crisis results in a significant economic toll for Malawi.

The CEO of the Malawi Confederation of Chambers of Commerce and Industry (MCCCI), Chancellor Kaferapanjira, estimates the fuel shortages are costing the economy up to $10 million US a day.

Meanwhile, customers waiting at the gas stations try to remain patient.

But just as nobody seems to know when the fuel shortages will end, it isn’t clear how long consumers’ patience will last either.

“Imagine you’ve got a patient in an ambulance that has no fuel and this patient has to make it to the hospital. If not, the patient dies,” says Msindira. “In this case, the patient is the whole nation.”

In the fight against malaria, it’s not just about mosquito nets

The Ministry of Health, in collaboration with donor countries, is working with local volunteers to both distribute mosquito nets and educate the public on how to use them correctly. Photo by Blantyre News Limited.

The World Health Organization (WHO) announced in October that nearly a third of all countries affected by malaria are on the path of eliminating the mosquito-borne disease over the next 10 years.

Malawi is one of them.

Elimination, of course, depends on whether or not current efforts are sustained.

But due to flaws in the country’s healthcare system and, more recently, given the fragility of the global economy, it seems that the fight against malaria is likely suffer a few setbacks in this country.

According to the Global Fund (GF), which is an international initiative against malaria, tuberculosis, and HIV and AIDS, approximately 95 percent of Malawi’s population of 14 million, is at risk of malaria infection. Two groups are particularly vulnerable to the disease: women (51 percent of the population) and children under the age of five (17 percent).

But malaria isn’t just a severe public health problem; it also has a direct impact on the country’s economic and social development.

The Ministry of Health reported that there were over six million malaria cases in 2010. Economically speaking, this means that the country’s workforce lost between 15-25 days of productivity due to malaria alone.

Furthermore, most families spend about 28 percent of their yearly income (approximately CAN$170) to treat it.

Still, experts affirm that progress is being made in Malawi.

The Ministry of Health, with the support of the GF and the President’s Malaria Initiative (PMI) from the United States, have since 2005 distributed across the country insecticide-treated, non-toxic mosquito nets, which have proven to be highly effective when it comes to reducing transmission of the disease, as they can kill mosquitoes for up to three years.

And according to the Ministry of Health, Malawi has seen a 50 per cent reduction in malaria transmission ever since.

Global statistics confirm this positive trend.

The latest report of the United Nations and World Bank supported-initiative, Roll Back Malaria (RBM), reveals that malaria deaths have dropped globally by an estimated 38 percent in the last 10 years, with an impressive 43 out of the 93 countries identified and included in this initiative – including Malawi – cutting malaria cases or deaths by half.

Wanting to continue with this success, Malawi’s Health Strategy Plan for 2011-2016 places malaria’s reduction as a top priority, along with HIV and AIDS.

However, Malawi’s generally underfunded and fragile healthcare system, and the uncertainty of any future external funding from the GF, and donor countries including the United States, the United Kingdom and other European countries, due to the world economic crisis, threaten to make those achievements accomplished so far moot, while putting at risk the implementation of future initiatives and programs.

The Global Fund announced in September that it has halved the estimated amount of money available in its next round of funding, from US$1.5 billion to US$800 million, the disbursement of which has been delayed until 2013.

This is worrisome as the Global Fund accounts for two-thirds of the malaria, tuberculosis and HIV and AIDS response in Malawi, and the balance comes from the donor countries. Malawi has been assured of Global Fund money until about June 2014 but has been warned to look for sustainable financial models to continue its programs.

And while Malawi’s National Malaria Strategic Plan has stated its aim to have 60 percent of the country’s health centres equipped to perform diagnostic testing for malaria, the Global Fund reports that Malawi is far from achieving this goal.

And even where diagnostic testing is available, both laboratory staff and hours are limited, with some facilities seeing more than 200 cases of potential malaria cases each day.

These studies also show that more than half of the patients that tested negative for malaria were still prescribed antimalarials, suggesting that health workers have very little confidence in laboratory test results.

When it comes to malaria in Malawi, significant gains have been achieved and lives have been saved; but without sustained financing to consolidate these accomplishments and enable the continuation of initiatives for malaria treatment and against its transmission, the progress that has been made may quickly backslide.

Food insecurity continues to plague Malawi

Experts believe that reducing the emphasis of maize in Malawi’s diet will require significant cultural change. Photo by Blantyre News Limited.

Much like kimchi is to Koreans, or tortillas are to Mexicans, nsima is to Malawians.

Nsima is a thick, starchy porridge made from corn, flour, or cassava, which is served with every meal (click here to see how it is prepared), but it has little nutritional value and no protein.

But in a country where over half the population survives on less than two dollars a day, having a balanced, varied and nutritious diet is – if not a challenge – nearly impossible.

Approximately 47.5 percent of Malawian children under the age of five have stunted growth due to deficient diets, according to a study conducted by the United States Agency for International Development (USAID), Malawi’s College of Agriculture, and the World Bank.

One of the biggest problems is that maize is the crop par excellence in Malawi; it is grown on up to 90 percent of the country’s arable land. Although crop diversification projects are starting to take place in certain regions of the country, for the most part, the production of other fruits and vegetables that would add more value and diversity to the Malawian diet remains largely overlooked.

Therefore, when something goes wrong with maize production, the country agonises.

Between 2001-2002, Malawi experienced a period of famine due to erratic rainfall that caused flooding and waterlogging of maize fields. Later in 2005, due to drought, the country suffered its worst corn harvest in a decade, which left five million of its then 13 million people experiencing chronic food shortages.

During both emergencies, food aid came from the World Food Programme (WFP), donor countries like Great Britain and several church groups. Yet, the United Nations Development Programme (UNDP) believes that the response to both crises, both at the national and international levels was delayed, slow and misinformed.

In 2005, President Bingu wa Mutharika, decided to implement a fertilizer subsidy program for Malawi to grow its own food and lessen its dependence upon foreign aid. This, in combination with good rains, helped Malawian farmers produce record-breaking maize harvests in 2006 and 2007, according to government crop estimates.

According to the Food and Agriculture Organization (FAO), Malawi has sustained high rates of maize production. For the period of 2010-2011, FAO reports that maize production is 14 percent larger than the previous year. It also considers Malawi has “generally favourable food security conditions,” although some southern districts remain a concern due to a dry spell.

Furthermore, Principal Secretary for Agriculture, Food Security and Water Development, Erica Maganga, recently declared that Malawi should shift its focus from food security to the achievement of nutrition security, since she believes food production targets have already been met.

Yet, critics, like McDonald Ndekha, a Senior Lecturer in Clinical Nutrition at the College of Medicine, disagree with Maganga.

Ndekha says that food and nutrition security goes beyond the production of surplus food.

“Research indicates that there is no single measure that accurately captures all aspects of food security,” he says, adding that other important elements to consider are the availability, accessibility and utilisation of food.

For instance, he says the accessibility to food could “be negatively affected by lack of income.” In other words, nutritious food may be available, but people simply may not have the money to buy it.

Ndekha also believes that variety in food choices is crucial to a healthy life, as this variety allows the body to get all the essential nutrients it needs.

But studies conducted over the past five years indicate that this isn’t the case in Malawi.

Between 2006-2008, the College of Medicine conducted a survey among HIV-infected anti-retroviral therapy clients at the Queen Elizabeth Central Hospital in the city of Blantyre.

Based on a 12-point mark, the study revealed that only 30 percent of those surveyed achieved just four of the 12 points.

“Vitamin A and iron deficiency are among the health problems of public health importance in Malawi,” says Ndekha, “Particularly [when it comes to] children.”

A 2010 report, conducted by UNICEF estimates that 21 percent of Malawian children under five are under-weight.

National Coordinator for the Malawi-US Exchange Alumni Association, Peter Mazingaliwa agrees that Malawi is far from being food secure.

Food security, he says, is about being “food sovereign” first.

“Food sovereignty means that a nation has registered surpluses in, at least, two or three key crops,” says Mazingaliwa. “We must have silos for maize, rice, beans, peas, among other crops.”

But, unless Malawi starts a national crop diversification program that favours other legumes, both Mazingaliwa and Ndekha agree that the health of the population will remain poor and the country will continue to be food insecure.

With files from Richard Chirombo

What’s missing in Malawian political cartoons: critical views and a bit of sophistication

Depending on the level of detail, it may take cartoonist Hazwel Kunyenje from 15 minutes to four hours to complete a cartoon. Photo by Elena Sosa Lerín.

Hazwel Kunyenje is a political cartoonist who has spent more than 15 years illustrating articles, editorials and short stories for one of the country’s largest media houses, Blantyre Newspapers Limited (BNL).

Of affable allure and with a serene expression and mild stutter which intensifies the longer he speaks, Kunyenje remembers drawing on any piece of paper or surface he could find as a child.

“Drawing was a necessity,” he says, “I just felt I had to do it and I knew I wasn’t bad at it.”

Although he studied painting at the University of Malawi, he is mostly a self-taught caricaturist, who has “picked [up] some tricks along the way.” He follows cartoonists at Newsweek and the Washington Post, and enjoys Dik Browne’s “Hägar the Horrible” because of its unclassifiable humor.

Political cartooning is relatively new in this country. Prior to the 1990s, the press was just an outlet for government propaganda, and cartoons were mere depictions of places or events, often published in lieu of photographs.

But between 1993 and 1994, the 33-year rule of President Hastings Banda came to an end and the press was liberated. Suddenly, there was a demand to graphically satirize the new political atmosphere and editors were hiring anyone who could caricature it.

Kunyenje started working as a cartoonist at New Voice, back then, a small, local newspaper in the northern city of Mzuzu – but he had larger aspirations.

In 1994, he mailed samples of his work to the editors of BNL, a move that has placed him on the national press scene for the past 17 years.

Political cartoonists in other countries (like Burkina Faso’s Damien Glez, Kenya-based Godfrey Mwampwemba, or Canada’s André Pijet) are usually accepted as serious commentators and analysts of political and social issues due to their satirical but critical look at local and world issues. But unlike them, Kunyenje feels that cartoonists in Malawi are merely considered “people that can draw well.”

He believes that editors and readers overlook the impact of cartoons on democratization.

As a matter of fact, Kunyenje has limited control over the creation of his cartoons, as they regularly follow the vision of his editors. Most of the time, they are the ones who decide on the subject of a cartoon, and, even the jokes.

“Editors in Malawi don’t have a good idea of what a cartoon can do,” he explains.

At this point, Kunyenje’s stutter takes over his speech. He stops talking, reaches for his briefcase and pulls out a folder. He starts flicking through dozens of carefully catalogued cartoon clippings from different national and international newspapers and magazines he has collected throughout the years, and soon finds what he wanted.

“This. This is what we don’t have in Malawi,” Kunyenje says holding a small, aged clipping dated 16 February 1989. It shows a fat vulture wearing a headscarf, about to prey on an emaciated bear lying on the ground. It is the editorial take by world-renowned Israeli cartoonist, Ranan Lurie, on the end of the Soviet occupation in Afghanistan.

“We aren’t this sophisticated,” emphasizes Kunyenje. He thinks Malawian cartoons lack the degree of visual metaphor and symbolism that other cartoonists bring to their work, in part due to editorial decisions, but also because cartoonists are still forging their identity in the newsroom.

Something that would contribute to the betterment of cartoonists in Malawi is criticism. But Kunyenje points out that he only gets positive feedback from the readers, who he says, “think cartoons are just something to laugh at.”

Yet there is always the occasional government official who threatens the papers with censorship, like the Minister of Information and Tourism, Patricia Kaliati, who in April 2006, considered cartoons from national newspapers The Daily Times and The Nation to be “disgracefully castigating the government.”

Although his editors deal directly with the censorship threats, he welcomes such comments about his cartoons – even if they’re negative – because such comments are an acknowledgement of the art of cartooning.

Big aspirations, small budgets – and disenfranchised mental patients

Epilepsy, depression, schizophrenia and bipolar disorders are some of the top mental afflictions in Malawi. Photo by Blantyre News Limited.

According to the World Health Organization (WHO), mental health problems are already the fourth leading cause of the global health burden, representing a third of all years of healthy life lost to disability among adults.

By 2020, they will rank second, behind ischaemic heart disease.

In Africa, regional WHO studies show that mental health issues such as epilepsy, depression, psychosis, mental retardation, substance abuse, and other psychotic disorders, are among the top ten causes of disability in the region.

But in Malawi, one of the poorest countries in the world, where health policies and development goals are primarily centered on the prevention of HIV and AIDS, the reduction of maternal mortality, tuberculosis, and malaria, mental healthcare is – at best – an afterthought.

Case in point, the Ministry of Health has no solid data on the nature and the extent of those suffering mental illness.

Its National Mental Health Policy Plan admits that in the absence of research on mental health patients, it has had to rely on studies done in neighbouring countries.

Based on these studies, health officials estimate that at least 10 per cent of Malawi’s 15 million people are affected by a mental health problem, also meaning that mental health afflictions are as common as infectious diseases.

And yet, given these dire statistics, the Ministry of Health’s Strategic Plan for 2011-2016 recognizes that the government’s budget for the health sector is “inadequate.”

Health places third in budgetary allocation, (at 10.2 per cent) after education (13.7 per cent) and agriculture (18.9 per cent).

Only 1.5 percent of the national health budget is spent on mental care.

In 2007 and 2009, respectively, Malawi signed and ratified the United Nations Convention on the Rights of Persons with Disabilities and its Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care.

Among the guiding principles of this Convention are accessibility to facilities and services, the right to health, as well as habilitation and rehabilitation services and programs.

Likewise, article 30.2 of the Malawian Constitution, addresses the right to development, declaring that the State commits itself to “take all necessary measures” to guarantee “access to basic resources, […and] health services.”

But with such a tight budget, intentions can only go so far.

Mental patients have to deal with public mental healthcare institutions that suffer chronic shortages of essential drugs, inadequate if not, deteriorating facilities, insufficient and overworked nurses and doctors, and no access to counseling.

For instance, the psychiatric section of the Queen Elizabeth Central Hospital (QECH), the largest hospital in the city of Blantyre, has been out of essential drugs, (like Chlorpromazine and Modecate, which are used in the treatment of conditions such as schizophrenia, psychoses and manic episodes) for over a year, while the one at the Bwaila Hospital in the capital, Lilongwe, has lacked medication for 10 months.

Based on hospital records, six out of 10 patients are relapsing due to the lack of drugs at QECH.

“There’s no hope for many patients,” says one of the psychiatric nurses from QECH. “It is a very sad situation to see – and we can’t do much about it.”

The little the nurses can do is to use substitute drugs if possible. But sometimes they have to turn patients away if there are not adequate drugs to treat their specific needs.

“We feel very sorry to tell the patients who have walked for many hours to get their medication that we don’t have any,” says another nurse from Bwaila Hospital.

As if the lack of essential drugs were not enough, there is also the issue of the scarcity of mental healthcare workers.

For instance, QECH has just one psychiatrist and 18 nurses to attend an average of 2700 patients a year. Bwaila Hospital does not even have a psychiatrist. It is entirely run by five nurses who attend about 200 patients every day.

Two years ago, Dr. Rob Stewart, the head of the psychiatric unit at QECH decided to shut down admissions of patients because the rooms lacked windows and toilets.

One of the nurses from QECH, when asked what improvements she’d like to see in the mental healthcare system, said having a computer would make a big difference, as patients’ records are still handwritten and usually get lost or mixed with other papers.

“The only piece of technology we have here is a telephone, “ she says.