Author Archives: Karissa Gall

About Karissa Gall

Karissa Gall has demonstrated considerable passion for journalism, human rights and international development from an early age. While still in high school, she pitched and penned a youth column with the Chatham Daily News. Since then her skills and desire to tell compelling stories has flourished. She ‘officially’ began her career in journalism as a reporter and photographer at the Edson Leader in Edson, Alberta and then the Osoyoos Times in Osoyoos, B.C, she has also worked with the Olympic News Service and Industry Canada. In 2010 she graduated with a B.A. (Hons.) in Political Science from Carleton University, where she specialized in African politics and human rights. Karissa will be working at The Daily Times in Blantyre, Malawi as a Rights Media Print Intern.

Secret Women

In Chichewa, the widely-spoken language of southern Malawi, being pregnant or “kunkhala ndi pakati” translates to being in the middle of life and death.  For many pregnant Malawian women, however, death comes much sooner.

As the African country with the second highest maternal mortality ratio, Malawi is struggling to eradicate a crisis that in 2006 claimed the lives of would-be mothers at a rate of 807 deaths per 100,000 live births.  And while 2006 figures showed an improvement on those of 2004 – 984 deaths per 100,000 live births – the 2010 Malawi Millennium Development Goals Report has already projected that Malawi will not achieve the targets of the fifth MDG to improve maternal health by 2015.

Contributing factors identified in the 2005 Ministry of Health (MoH) “Road Map for Accelerating the Reduction of Maternal and Neonatal Mortality and Morbidity in Malawi” include shortage of staff and weak human resource management, limited availability and utilisation of quality maternal health care services, and weak procurement and logistics systems for drugs, supplies and equipment.  Underlying such problems of infrastructure and resources, the report reads, are harmful social and cultural beliefs and practices.

Naswit Chitalo of Namila Village in Traditional Authority (T/A) Mlilima in Chikhwawa District is easily able to recall a time when “most pregnant women were dying from pregnancy complications” because of social and cultural beliefs, which include the belief that the firstborn child should be delivered by a traditional birth attendant (TBA) in the home as opposed to a health facility.

“I actually know of three women we lost in 2009 because they sought the services of elderly women from the village instead of rushing to the hospital,” said Chitalo, adding that TBAs would use herbs to make pregnant women “feel so confident about the outcome of their pregnancy” that professional maternal health care would be neglected altogether.

According to Malawi Health Equity Network (MHEN) Executive Director Martha Kwataine, these kinds of social and cultural beliefs surrounding TBAs have done more harm than good when it comes to maternal mortality in Malawi.

“There have been several researches whose results have shown that traditional birth attendants have made cases on maternal death high because they are not properly equipped,” said Kwataine.  “We tried to train them so that they should handle referral cases but they did not comply.”

President Joyce Banda has also added her voice to the case against TBAs; on June 18, after laying a foundation stone for a maternity holding shelter at Mulanje Hospital, the first of 130 holding shelters pledged as part of the Presidential Initiative on Safe Motherhood launched in April, Banda told TBAs to stop offering delivery services to expectant women.

“Traditional birth attendants must stop giving delivery services,” she said at the function, adding that “traditional birth attendants can have a good role to play… because they are experienced they can be referral point.”

News of the ban on TBAs has been met with both controversy and commendation throughout the country.  But to women like Chitalo, the rationale behind the ban is not news at all; as one of the T/As where the Centre for Alternatives for Victimised Women and Children (CAVWC) has been working to realize the MoH Road Map objective of improving obstetric care, a new, “good role” for TBAs is already one of Mlilima’s best kept secrets.

Former traditional birth attendant Dalia Issa stands with her husband outside of their Namila Village home. In 2010, with training from the Centre for Alternatives for Victimised Women and Children, Issa stopped offering village-based delivery services and took on a new role as a Secret Woman. Photo submitted.

In 2010, CAVWC identified two women in each village of T/A Mlilima and T/A Kasisi to be “Secret Women.”  The women, many of whom had been working as TBAs, attended three days of training on maternal health using a standardized MoH handbook.

According to CAVWC Project Officer Talimba Bandawe, women like Chitalo were trained to take on four main roles and responsibilities: referring pregnant women to antenatal facilities by carrying out door-to-door campaigns; educating women on family planning; collaborating with Village Health Committees to form Community Safe Motherhood Task Forces and conduct awareness-raising community meetings; and recording how many pregnant women deliver in the community or in a health facility.

“We depend on these Secret Women because they have been trained; they can convince a woman on the importance of delivery at a health facility with a skilled attendant, because in the rural areas they are used to having TBAs,” said Bandawe.  “We’re trying to change that mindset – that anything could happen with a TBA so it’s better to deliver at a health facility.”

Bandawe said the women are called “Secret Women” because of the social and cultural beliefs and practices surrounding pregnancy in Malawi.

“When you talk about traditions and beliefs, the pregnant woman is vulnerable,” she said, adding that traditional beliefs in witchcraft scare some women off of sharing how many months they are into their pregnancy.

“The concept of Secret Women is based on that whatever you talk about with a Secret Woman should be kept confidential,” she continued.  “Whatever issues that you discuss, the Secret Woman is not expected to go and disclose that anywhere because some of the things can be really private.”

According to Esnart Dzoma, who has been volunteering as a Secret Woman in Namila Village for two years, “the most important thing is confidentiality.”

“If I begin to shout that ‘so and so sought this help from me’ they will inform each other, and we will have the health problems that used to compound issues such as pregnancy again,” said Dzoma.  “I have an obligation to help these women with compassion, and without malice… the secret to being an effective Secret Woman is to be open-minded.”

Based on principles of compassion and confidentiality, Bandawe said the Secret Women project has helped to address some of the harmful social and cultural beliefs and practices, “especially through the door-to-door campaigns” as pregnant women have been comforted by and more likely to accept confidential counselling.

A bicycle ambulance donated by the Centre for Alternatives for Victimised Women and Children being used in Namila Village. Photo submitted.

“The Secret Women were really successful in that a number of women were referred to the hospital,” she said, adding that other Road Map interventions such as the provision of bicycle ambulances and village bylaws enforcing fines for births that take place outside of a health facility have also contributed to the success of the initiative.

The data collected by the Secret Women also speaks to their success; in 2009, when CAVWC was working to reach out to practicing TBAs and provide safe-birthing training and equipment, approximately 30 percent of pregnant women in the two T/As were reportedly giving birth at a health facility.  In 2012, the Secret Women are reporting that 54 percent of pregnant women are now giving birth at a health facility.

But despite their success, Bandawe said that the new role for TBAs has not been implemented without resistance.

“Some women still resist the counseling of the Secret Women, and sometimes even the husband can be a challenge,” she said.

“There are some materials that the hospital recommends that you should have when you go to the hospital – a plastic paper, a razor blade and a basin.  Some of the husbands don’t welcome this idea, so (the Secret Women) have a negative reception from some of the families.”

For their part, Bandawe said that CAVWC will “revive the Secret Women” by holding refresher training courses at the end of June.

“It is really important to have these sorts of people in the communities, mainly in the rural areas where literacy levels are low,” she said.

“Maybe after there has been a lot of sensitization, when everyone even in the rural communities is aware of the health benefits of delivering at the hospital and when we have managed to reduce the maternal mortality ratio, that’s when we can do without the Secret Women.  But right now, they still have a major role to play.”

***

With files from Richard Chirombo and Madalitso Musa

Lucius Dimiano of Kafupa Village.  Roughly translated, "kafupa" means "hard as bone".  Photo by Karissa Gall.

“Mind the gap” – The crippling impact of HIV/AIDS on family composition and elderly Malawians

The old “respect your elders” adage has customarily been an important part of Malawian culture, with the elderly able to depend on the social and economic support of their children and the community.  However, the HIV/AIDS epidemic has had a crippling impact on family composition and tradition.

While the 2012 Malawi Country AIDS Response Progress Report found that from the start of the epidemic the number of deaths per annum had been reduced from nearly 100,000 to approximately 48,000 in 2010, the report also found that the number of children orphaned by AIDS has been on the rise.

Antenatal Clinic sero-surveys (surveys of blood serum) found that the number of children orphaned by AIDS increased from 576,458 in 2010 to 612,908 in 2011.  And with over half of orphans being cared for by their grandparents, men like Lucius Dimiano of Kafupa Village will be celebrating their 70th birthday before that of their retirement.

At 68-years-old, Dimiano is still working three jobs to support six grandchildren orphaned by AIDS.  He works as a guard from 6 p.m. to 6 a.m. at a nearby church, goes to the garden to get maize for his family, weaves baskets to sell at the market and then, does it all over again.

“I cannot sleep, so it’s hard,” Dimiano said.  “As a night guard, I need to always be awake because sometimes there are thieves in the dark.

Still working three jobs at 68-years-old to support six grandchildren orphaned by AIDS, Lucius Dimiano of Kafupa Village demonstrates panga knife techniques he uses as a night guard. Photo by Karissa Gall.

“When I knock off in the morning I go to the garden, when I knock off in the garden I eat and then I start making baskets so I can make more money, but it’s still not enough to care for all six grandchildren.”

In the same township of Chigumula, 55-year-old Mrs. Kandikole has also lost children to AIDS; her oldest daughter passed away in 2005 orphaning one grandchild, and her second oldest daughter passed away in 2010 orphaning three grandchildren.

“I’m the one who’s left looking out for them,” she said.  “And not only those four; I have other grandchildren at my home who have only a mother but not a father.

“It’s very difficult for me to look after these children because I’m very old.  I’m not working,” she continued.  “Things are very expensive here in Malawi.  Food is very expensive.  I cannot manage to buy clothes for them.  It is very difficult for me to take them to the hospital.  To get good medicine, one needs to pay money at private hospitals, but I can’t manage to do all those things.”

Kandikole said she had been working at a nursery school, but had to quit when her daughters died because “(her) grandchildren were alone, so (she) had to look after these children all by (herself).”

She said her husband, 57, is still working as a telephone operator but “he makes very little money.”

“I don’t think he will be able to continue working much longer because he is now 57 years old and his body is very weak.  He is very sick,” she said, adding that they both suffer from chronic bouts of malaria.  “Before, we could manage to do all those things, but not now.”

Without the proper means or support, Kandikole said she “couldn’t manage to send (her) grandchildren to school, because when you want to send a child to school these days, even a government school, you need to buy a uniform, pencils, exercise books and the child needs to eat porridge.”

She said her grandchildren “were just staying at home” until they were accepted at the Jacaranda School for Orphans in Limbe, a free primary and secondary school in Malawi providing education and daily meals to orphans.

“If we did not have Jacaranda, these children would just be doing nothing at home,” she said.  “They go to school without taking anything.  If Jacaranda didn’t provide porridge I don’t know what we could do.  Before, I thought my children would go to school up to college and help their children by themselves.  But their deaths brought everything down.”

The late Nelley Daniel M’maligeni of Che Mboma Village suffered in the same way.

Deaf and blind, M’maligeni struggled to care for herself yet alone her grandson, Vincent, who was orphaned by AIDS.  In March, at the age of 105, M’maligeni passed away and Vincent lost another primary caretaker.

The late Nelley Daniel M’maligeni of Che Mboma Village waits with her daughter-in-law for her grandson Vincent to return from school. Photo by Karissa Gall.

According to M’maligeni’s daughter-in-law, M’maligeni and Vincent had been sleeping in a small hut.

M’maligeni’s daughter-in-law said her family was able to give extra food to M’maligeni and Vincent once a week, but “sometimes it (was) hard because there (was) not enough money.  Sometimes M’maligeni (could) not eat.

“Sometimes we just (bought) panado, because panado is cheap,” she said.

Dimiano, Kandikole and M’maligeni are each representative of the ways that elderly Malawians are struggling to survive in the wake of the HIV/AIDS epidemic.  According to the Catholic University of Malawi’s December 2010 report “Impact of HIV and AIDS on the elderly: a case study of Chiladzulu district,” 59 percent of the enrolled elderly people had difficulty sourcing money for school uniforms, food and hospital bills for orphaned grandchildren; 55 percent were affected through the sickness and death of their children; and 22 percent had to halt their own development to take care of orphaned grandchildren, spending their reserved resources to make the lives of their grandchildren better while impoverishing themselves in the process.

When asked if there can be greater relief for elderly Malawians struggling to care for themselves and their orphaned grandchildren than panado, an over-the-counter pain medication, Finance Minister Ken Lipenga said that government has put in place safety net programmes that target both the elderly and other vulnerable people in the 2012/13 National Budget.

“These programmes are aimed at assisting the poorest in our communities to cope with life,” he said, adding that during the 2012/13 fiscal year  programmes will be scaled up to capture those that may have fallen below the poverty line due to devaluation.

“A total of K27.5 billion has been provided for four programmes, mainly the Intensive Public Works Programme, the School Feeding Programme targeted towards 980,000 pupils in primary schools, the Schools Bursaries Programme targeting 16,480 needy students, and the Social Cash Transfer Programme which will reach over 30,000 households across the country.”

Lucius Dimiano of Kafupa Village. Roughly translated, "kafupa" means "hard as bone". Photo by Karissa Gall.

But until social cash transfers can be expanded to cover the whole country or non-contributory pensions can be provided to ensure income security for the majority of elderly Malawians who have never worked in the formal sector, government will continue to miss men and women like Dimiano and Kandikole who are fighting for the survival of their family and against the intergenerational transmission of poverty, often without sufficient resources or physical strength to do so.

As Dimiano put it: “If I still had children that could help me, I could have just stayed home, but there is no one to help me, I’m only working because of my grandchildren.

“The only ones who can decide if I stop working are my grandchildren.  Maybe they will see that we are very old and cannot work anymore and they will help us.  But maybe they will finish school and go away.

“At the moment, I do not know.”

 

With files from Richard Chirombo.

When beggars should be choosers – How the promise of remuneration is heading off freedom of movement and free choice of employment in Malawi

Not long after cutting their teeth, North American children are encouraged to call forward their dreams and consider the question, “What do you want to be when you grow up?”

The kindergartners’ query is not a foreign concept in Malawi – in fact, up to December 2010 Blantyre Newspapers Limited’s (BNL) Saturday paper Malawi News regularly ran a “When I Grow Up” piece encouraging parents to help their children picture and pledge their ambition for the future.

At the same time the query is not yet ubiquitous – as a country that ranks in the lowest group on the Human Development Index (171 out of 187 countries in 2011), problems such as poverty and underdevelopment mean that for many, filling their stomach is difficult enough to do without considering the most fulfilling way to do it.  And for 21-year-old Alinafe Phiri and her friends at the Nkhata Bay boma, it means that when you ask what they want, they simply tell you how it is instead.

According to Phiri, it isn’t uncommon for girls to be taken from their homes in Nkhata Bay to “faraway places” where they work as house girls.  Others are taken from their homes to work in bars.

“This is considered normal because they are paid something at the end of the day,” she said.  “Isn’t it normal for someone to be taken from their homes for work in faraway areas?  What about those that leave their villages and work elsewhere in cities or otherwise?”

No mention is made of the use of force implicated in being taken to faraway places for work – a form of human trafficking – or of unrealized universal human rights to free movement and free choice of employment.

On May 16 Norwegian Church Aid (NCA) held a public discussion at the Nkhata Bay Conference Centre to discuss where and why human trafficking occurs in Malawi. Photo by Karissa Gall.

To raise awareness of such rights abuses, Norwegian Church Aid (NCA) held a public discussion at the Nkhata Bay Conference Centre on May 16.  Three panellists were on hand: Youth Net and Counselling (YONECO) District Manager for Nkhata Bay Wezzie Mtonga, Nkhata Bay Police Station Community Policing Coordinator Brown Ngalu and NCA Programme Coordinator for Human Trafficking Habiba Osman.

During the discussion, Mtonga said that the area is a “hotspot of instances of human trafficking” for the purposes of labour, sexual exploitation, organ removal, or domestic servitude, and that Malawian women like Phiri are the most vulnerable to being victimised “because of their vulnerability when it comes to economic issues.”

“One of the reasons people fall victim to human trafficking is they are looking for greener pastures, and when they go there, things are different,” she said.  “Malawians are vulnerable and they don’t have access to (anti-trafficking) laws.”

Osman, one of the commissioners involved in the drafting of an anti-trafficking bill in 2007, took the opportunity to stress that “the bill is ready, cabinet approved it, so what we need is parliamentarians to discuss it and pass it into law to give us a framework on what should be done and who should be doing what.”

Norwegian Church Aid Programme Coordinator for Human Trafficking Habiba Osman. Photo by Karen Msiska.

“The problem is huge, it is diverse,” she said.  “We need awareness, we need a lot of capacity building not only for the police but other service providers, and we also do need proper data collecting mechanisms.

“We do not have people coming to report on cases of human trafficking because they have been not been trained to collect data, they have not been trained to identify the victims; they have not been trained to identify the traffickers,” she continued.  “Even our parliamentarians also need training on these issues.

“A new cabinet means that new people are in place.  We need to put pressure on them to tackle these issues.”

In the interim, Osman cited Section 27 of the Malawi Constitution, which prohibits slavery, as a standing protection against human trafficking or “modern-day slavery.”  She also cited the Employment Act, the Penal Code, the Corrupt Practices Act, Immigrations policies and the Corrupt Practices Act as statutes that criminalise certain transactions appearing in the various forms of trafficking.

***

Despite Malawi having adopted the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons in 2005 and making progress towards the guarantee of protections for children with the launch of a universal and compulsory birth registration process this March, the International Trade Union Confederation 2011 report for the World Trade Organization on Internationally Recognised Core Labour Standards in Malawi found that, “Trafficking is a problem and is conducted mainly for the purposes of forced labour for males and commercial sexual exploitation for females, as well as child trafficking which has also been steadily rising.”

“Typically the traffickers deceive their victims by offering them false promises of employment or education in the country of destination.  In Malawi there are also estimated to be between 500 and 1500 women and children who are victims of internal trafficking,” reads the report.

“In 2009 the authorities arrested and prosecuted child traffickers who intended to deliver boys to cattle herders.  Other usual destinations of internally trafficked persons are the tobacco plantations, domestic servitude, and small businesses.”

The United States Department of State 2011 Trafficking in Persons Report for Malawi further found that while government “is making significant efforts” the country still “does not fully comply with the minimum standards for the elimination of trafficking.”

“Adults in forced prostitution or forced labour and children exploited in domestic service and prostitution still did not receive adequate attention and the government prosecuted no such offences during the reporting period,” reads the report.

“While one trafficking offender received a short prison sentence, most convictions resulted in sentences of fines or out-of-court settlements with compensation to victims, both of which failed to provide an adequate deterrent.”

While comprehensive anti-trafficking law enforcement statistics were unavailable, the report found that some individual districts provided data on their actions, totalling 18 prosecutions, 11 of which concluded with convictions.

“Although the government prosecuted and convicted offenders using existing legislation, only one of nine convicted offenders served jail time and sentences varied widely across district courts,” the report continues.  “Additionally, labour inspectors and child protection officers were trained to seek remuneration for workers in labour dispute cases – including forced labour – rather than to refer to law enforcement for prosecution.”

According to the report, “the government’s continued failure to seek criminal prosecution of forced labour offenses with significant prison sentences hinders an effective response to Malawi’s trafficking problem.”

In Malawi, the Inter-Ministerial Taskforce on Human Trafficking, led by the Ministry of Gender, Child Development and Community Development; the National Steering Committee on Orphans and Vulnerable Children; and the National Steering Committee on Child Labour have responsibility for trafficking issues.

***

Individuals who are aware of any incident of human trafficking in Malawi can contact the YONECO anonymous National Help Line for assistance by calling 8000-1234.  YONECO encourages victims of human trafficking to call the help line as the centre will mobilise to free them and provide counselling and support.

***

With files from BNL-Mzuzu Bureau Chief Karen Msiska

Vanessa Nsona

Driving change in Malawi – Signposts and speed bumps on the road to gender equality

With two hands gripping the steering wheel and the right turn signal flashing, 21-year-old Vanessa Nsona’s concentration does not waver when a minibus caller passing by her driver seat window lets out a shrill catcall – she is about to complete her third driving lesson and she’s part of an increasing number of Malawian women who are doing so.

According to Precious Kumbatila, the director of Blantyre’s Apule Driving School,  female students in Malawi have been enrolling at increasingly higher numbers over recent years.

“When we opened in 2003, most of our students were male,” said Kumbatila.  “Very few women came in.

“It was in 2004 when we had the second government that women started learning to drive,” he said.  “At that time there were a lot of vehicles coming into the country; a lot of families were buying cars, and as a result, men started wanting their wives and their girl children to learn how to drive.”

Although Kumbatila said the poorly performing economy adversely affected enrolment numbers for both male and female students in 2011, he added that overall, the gender gap is narrowing.  In 2008, 163 female students registered for driving lessons at Apule compared to 301 male students.  In 2011, 190 female students registered for lessons compared to 282 male students.

For Nelly Kalunga, a single mother working full-time and currently taking driving lessons at Apule, learning to drive is a “privilege” and will mean a new skill set, new opportunities and economic empowerment.

“Nowadays, women are given chances to do what men do,” Kalunga said.  “I decided to start driving because I want to be like the men who are driving.

“If I have a driving license, that means I can do any work that men can do, I’ll have better chances of winning other jobs,” she said.  “Myself, I want try to be like the men who work in peacekeeping.”

Kalunga said the jobs that she will be qualified for once she learns how to drive are higher paying and that “the more you learn, the more you can get good things.”

“We used to think that driving was only for men and not for women, but nowadays we’ve seen that even women can drive,” she said.  “I think we can be 50/50 with men if most women can drive.”

However, according to Kumbatila, still “very few women can come and pay for lessons on their own” like Kalunga.

At Apule, registration for the 40 required driving lessons costs MK45,000 (CAD180).  With the additional costs of the MK4,000 (CAD16) provisionary license, booking a road test for MK4,000 and MK8,000 (CAD32) for the full license if you pass, learning to drive costs over MK60,000 (CAD240) in total.

“It’s the men that pay for the women,” said Kumbatila.  “Either their husbands, their boyfriends or workmates.  They are trying to push the women to learn how to drive so that they can do their chores on their own.”

Nancy Nyirende is one such woman.  A housewife and stay-at-home mother, Nyirende began taking driving lessons at Apule in March after her husband, who has been driving since 2001, decided to register her and pay for her.

“We have two cars now so he wanted me to escort my sons to school,” said Nyirende, adding that none of her female friends drive “because they are poor.”

Despite these roadblocks to closing the gender gap between male and female drivers, Kumbatila said he believes the slowly but surely increasing number of female drivers is steering Malawi in the right direction.

“It is imperative that women drive because driving lifts people’s lives,” he said.  “In my mother’s day she was just at home for us, cooking at home.  But nowadays [women] can have opportunities.  If a woman can improve herself by learning to drive she can get the same kind of opportunities as men.  If more women drive, it will empower this country.”

***

According to the Organisation for Economic Co-operation and Development Social Institutions and Gender Index (SIGI), Malawi was ranked 60 out of 102 countries in the 2009 SIGI and ranked 38 out of 86 in the 2012 SIGI.

In 2011, the Human Development Index for Malawi was 0.400, placing the country at 171 out of 187 countries.  For the Gender Inequality Index Malawi received a score of 0.594, placing the country at 120 out of 146 countries with data.  Also in 2011, the World Economic Forum ranked Malawi 65 out of 135 countries in its 2011 Global Gender Gap Report, with a score of 0.6850 where 0 represents inequality and 1 represents equality.

“Meating” halfway – The growing importance of soy in Malawi

Skewered meat sizzles on kickstand grills along the main M1 highway, a whole pig is slaughtered in an open-air butcher’s market shack, a farmer herds wealth-representative cattle down a maize-sidled byway and a “road runner” free range chicken dodges potholes and traffic – in a culture where cows have long symbolized status, slaughtered to honour guests and in the north traded as a dowry to marry off daughters, making the conscious choice to live a vegetarian lifestyle in Malawi is about as rare as an order of steak tartare.

But a Development Aid from People to People in Malawi (DAPP in Malawi) program is working to change the mindset and the menu.  In 2007, with support from the United States Department of Agriculture, the American Soya Bean Association and the World Initiative for Soy in Human Health, DAPP in Malawi began training Total Control of the Epidemic (TCE) field officers to promote soy in communities affected by HIV/AIDS.  Today over 100 of their HIV/AIDS support groups have been trained to cultivate and cook with soy in the preparation of other local foods.

Recipes promoted through the DAPP – TCE soya program include banana and soy sausage, masamba a soya (soy vegetables), khofi wa soya (soy coffee), and mkaka wa soya (soy milk), and are made available on print paper with easy-to-follow directions; “Boil 3 cups water, wash (1 cup of) soya in cold water, don’t put the soya into the hot water all at once but little by little like you do with rice,” begins the soy milk instructions.

Goliyati Village resident Mary Bilila serves up a selection of newly-mastered soy recipes during a DAPP - TCE HIV/AIDS support group meeting. Photo by Karissa Gall.

Based on the nutritional value of 1 cup of boiled soybeans, the DAPP – TCE soy milk recipe would provide about 300 calories, 28 grams of protein, 10 grams of fiber, and 20 grams of fat.  The soy milk would also provide essential vitamins and minerals, with 1 cup of boiled soybeans providing 50 percent of the recommended daily intake of iron, 40 percent of the recommended daily intake of vitamin D-balancing phosphorus, and 4 percent of the recommended daily intake of vitamin C.

According to DAPP in Malawi Partnership Officer Nozipho Tembo, the nutritional benefits of soy foods could make a substantial difference in the fight against HIV/AIDS.  The disease is known for causing micronutrient deficiencies – vitamin A, vitamin B12, vitamin C, vitamin D, carotenoids, selenium, and iron in the blood – which in turn speed the progress of the infection, and in 2006 a study conducted by Médecins sans Frontières in Malawi found that patients with mild malnutrition were twice as likely to die in the first three months of treatment, and patients with severe malnutrition were six times as likely to die as patients with a healthy body weight.

“Over the years we have learnt that soya is high in proteins which can be substituted for meat, cheese and fish, of which some people in rural areas can’t afford to have on their daily meal,” said Tembo, adding that 1 kg of soya costs MK200 (CAD0.80) compared to MK800 (CAD3.00) for 1 kg of meat.  “The DAPP – TCE project teaches the communities to adhere to a well-balanced diet and this is one way for people in rural areas to get proteins in their meals.”

To support existing programming and expand into other areas of Malawi, Tembo said DAPP in Malawi and TCE will be engaging seed companies for seed donations.

“The demand is high… the people who are (HIV) positive are living a healthier life whenever they adhere to the information given to them about soya and how to prepare it,” she said.  “Now the challenge will be to provide soya seed for the people to plant in their fields.”

Remodel to rehabilitate – The need for mental health aftercare and rehabilitation treatment in Malawi

A build or remodel is not typically what the doctor ordered to stave off chronic stress and depression; the process risks construction anxiety and expense and according to Walter A. Brakkelmans, an associate clinical professor of psychiatry at UCLA, “on a scale of 1 to 10, 10 being the death of a child and 1 a fender-bender, a remodel rates a 6 in terms of stress.”

But in Malawi there is a shortage of doctors with orders, and for Flomina Mawindo, a single mother of five in Che Mboma village, rebuilding a dilapidated house is her best shot at ensuring her own rehabilitation to home life after being discharged from Zomba Mental Hospital.

Mawindo was admitted to Zomba Mental Hospital after familial and financial stresses set off a downward spiral into anxiety, insomnia and ultimately mental illness – she struggled with a husband who, until his death in 2004, encouraged thieves to steal from her to ensure she did not have the means to divorce him, in-laws who cursed her and her children and a son who stole from other villagers and skipped town leaving her to answer to the authorities and pay outstanding debts.

She began walking the streets at night, talking to herself and became increasingly violent when her children attempted to restrain her, and after initially being turned away from the Queen Elizabeth Central Hospital primary health care facility in Blantyre was admitted to the mental hospital in November of 2011.  She was discharged in February of 2012, and is able to recall, with a shaking voice and haunted eyes, her experience at the hospital as one of “trouble and pain.”

“In the first ward, it was not good at all,” Mawindo remembers.  “There were four or five patients in one room.  The others would bite me, abuse me, and grab my food.  I could not protect myself.”

Mawindo said the problems that made the hospital “like a prison” were caused by a shortage of doctors and nurses, an issue that was confirmed by a nurse at the hospital who said “the nurses are always there, but for example today we are only two nurses, and we have got 53 patients… For one or two nurses to look after 50 patients and provide the quality of care that they need?   It’s impossible.”

Due to the shortage of doctors and nurses, psychological treatment has not been institutionalized and instead the provision of drugs takes priority.

Mawindo has been prescribed sodium valproate, a mood stabilizer which causes side effects which include fatigue, shaking and sedation and are immediately obvious in Mawindo.  She is no longer strong enough to walk to the market to do business and has not returned to work since being discharged.  Her eldest daughter Tadala absconded from primary school to care for the family until the Jacaranda School for Orphans stepped in and hired a caretaker.

Beyond the caretaker and maize meal donations provided by Jacaranda, Mawindo said she is not aware of any community-based services to help support her and her family.

 

In the absence of government-funded community-based aftercare and rehabilitation services, Mawindo said she plans to make repairs to a dilapidated house on her property and open it to renters or turn it into a chicken farm.  She said with the supplementary income she will feel less stress about paying debts and providing food for her family.

 

She derives her motivation from the time spent at the mental hospital – not from therapy and positive learning but the fear of return.

“I was going through trouble and pain at that hospital,” she said.  “I’ve decided I will never go back there again.”

***

According to Draft III of the Malawi Health Sector Strategic Plan for 2011-2016, in March of 2011 when the plan was published there were no mental health activities at community level, primary health care units did not provide mental health services, the treatment services provided by tertiary institutions were mainly for people with severe or acute mental health problems and the provision of psychological rehabilitation was limited.

The same report found that in 2011 only 1.5 percent of the national health budget was being spent on mental health and except for one or two districts, most districts spent none of their budget on mental health services apart from the procurement of drugs.

The Daily Times newsroom.

The future of press freedom in Malawi

Joyce Banda was sworn in as Malawi’s newest president on April 7 under the terms of the constitution, following two days of political uncertainty after the sudden death of the late Bingu wa Mutharika.

Having won national and international recognition for championing the education and rights of underprivileged girls, Banda’s ascension to the state house has raised hopes for a fresh start for the impoverished nation.

But in a place where a two-day national news blackout left Malawian media scrambling to ascertain the fate of the late head of state, what can be said for the future of press freedom under the new leader?

According to Daniel Nyirenda, deputy editor of The Daily Times and editor of The Business Times, it will take more than a transition of power to translate into improved media freedom.

“We are at a period now where there has been a suppression of media freedoms,” said Nyirenda, citing “bad laws” for press freedom that were enacted during Mutharika’s second term of office.

“We’ve also seen threats from the executive arm of government on the media and the banning of advertising to media that is unfriendly to government,” Nyirenda added.  “Reporters or even newspapers are afraid to publish certain stories for fear of getting a backlash from the executive arm of government.”

When asked if rights media might improve now that the executive arm of government is under Banda’s new leadership, Nyirenda said he is unsure.

“In my view, I think much won’t change because it’s the same people really, just wearing new clothes.  In Malawi, we have people who believe in controlling the media…so much won’t change.

“But, I’m hopeful that now that (Banda) has tasted life in the opposition she has learnt a lesson and she might be more flexible in the way she handles the media.”

Based on comments from The Daily Times’ current chief reporter, Charles Mpaka, Nyirenda’s hope may stand to come true.

While Mpaka said that colleagues working longer in the industry have testified that Banda was averse to criticism from the media and personally attacked journalists when serving as a minister, he added that after she was ousted from the Democratic Progressive Party (DPP) in December 2010 and started her opposition People’s Party, “she was reachable on her phones and willing to talk all the times that (he) phoned her.”

However, he added, the interviews were on issues serving her interests.

“From the experience that I have had with Malawian politicians, I would not rush to conclude that things will get easier for the media.  Politicians do change when they get the power and influence.”

When asked what needs to change to usher in a new “normal” for press freedom in Malawi, Nyirenda said that it’s not the people that need to change but the system.

“We still have a hangover of one-party dictatorship in our laws,” said Nyirenda.  “We also need to change MBC (Malawi Broadcasting Corporation) from a state-controlled institution to a public institution.

“We need to reviews these things – then there will be adequate press freedom in this country.”

This article was originally published on the Toronto Star website on May 4, 2012.

Money lending sparks new-found rights for women in Malawi

Money doesn’t grow on trees, but in Nkalo village it grows near one.

In the centre of the village a tree has become the site of new financial freedom and empowerment for local women – an outdoor Village Savings and Loan Association (VSLA) that is literally taking a grassroots approach to providing women with the opportunity to access a loan.

Women from the Nkalo village VSLA are pictured contributing and lending kwacha during one of their meetings. Photo by Karissa Gall.

Roughly 25 kilometres from the ATM queues that are characteristic of Malawi’s commercial capital of Blantyre, 10 Nkalo women meet regularly under the tree to contribute kwacha in amounts that range up to $3 depending on what they can individually afford, and lend to one another.

The microfinance project is overseen by the Centre for Alternatives for Victimised Women and Children (CAVWC) Women’s Rights Programme and based on the VSLAs first engineered by aid agency CARE International in Niger in 1991.

According to Chrissy Chibwana, one of the members of the Nkalo VSLA, the alternative micro-lending model has made her more economically independent and better equipped to care for her family.

“Before (the VSLA) I had to ask for money from my husband all the time to buy salt or sugar or pay for my children’s school fees,” said Chibwana.  “Now, I no longer have to wait for my husband to look for the money to send my children to school. I have the power to get money whenever the need arises.

Because the women are  lending to themselves, the VSLA model is not only providing women like Chibwana access to loans but also allows the women to earn interest and save.

Nkalo VSLA members Dorothy Musaya and Anne Maere said they have been able to lend money and save enough of the interest to improve their standards of living; with Musaya able to buy 24 iron sheets for her house and Maere being able to buy cement, and a mattress.

According to CAVWC executive director Joyce Phekani, such success stories are becoming more common in Malawi as VSLA membership rises each year, increasing economic independence and empowering women who would otherwise be dependent on a man.

“We were finding that women would stick to a relationship where she was being abused because she was not economically independent,” said Phekani.  “But these VSLAs are financially empowering women.

“When we first start a VSLA we find that the women are not empowered, they are really shy, inhibited and can’t see any future with their lives.  From day-to-day, we find that these women are able to survive better than in the past.  For women who were never able to save anything in their lives you can see the visible joy that they now have.”

However, challenges still exist in achieving greater gender equality through the VSLA finance model; access to financial resources alone does not automatically translate into empowerment or equality and according to Phekani some women are still being short-changed.

“We can’t rule out women who succumb to their husbands, which is a challenge for us,” she said.  “Recently we heard of a woman who had built capital by doing a small business of selling tomatoes.  When she was asked where the money she’d earned was she said she’d given it all to her husband.”

Pece Pearson of Nkalo confirmed that such challenges exist on the ground, saying that “there are some men who steal from their wives and use the money for petty things like beer.”

To address the issue of not only access but control of financial resources, Phekani said the CAVWC plans to “build the capacity of the program” through leadership, business management and training workshops.  The training will aim to address issues of power relations within the VSLA groups as well as in the family home.

Since CAVWC launched its first VLSA in 2009 a total of 326 VSLAs have been established in the Chiradzulu district in Nkalo, Kadewere and Onga.  Of them, 314 associations are exclusive to women who have been historically disadvantaged in access to material resources like credit, property and money.

This article was originally published on the Toronto Star website on April 16, 2012.

With files from The Daily Times‘ Sellina Nkowani

In Malawi when ‘Life’ gets tough, it gets banned

Saturday night in Blantyre and the drinks are flowing at Mustang Sally’s, a fluorescent bar with a swimming pool centerpiece frequented by ex-pats and a new generation of young Malawians who have money.  The laptop DJ plays LMFAO’s “Party Rock Anthem” for the eighth time of the night.

No longer under the strict censuring control of one-party-state president Hastings Kamuza Banda, Malawian airwaves have opened up to music that in the 20th century remained an unknown.  In the years following the country’s first multi-party elections in 1994, the Malawian music industry has diversified, with Malawian artists more free to perform traditional, gospel and reggae-inspired sounds, and some images and styles even being scavenged from sexually provocative, explicitly violent and drug-saturated music on  stations such as  MTV.

Today Malawians can praise any God, they can even party rock, but if you ask Lucius Banda they still can’t protest.

Lucius Banda, the first Malawian musician to use his platform to protest government. Photo submitted.

The first musician to sing openly against political oppression in Malawi during the decades of one-party rule, Banda says growing up in absolute poverty and amid systemic social injustice inspired him to “make sure there’s an alternative voice from the government.”

“Coming from a broken family living in absolute poverty, life was difficult,” remembers Banda.  “We had to go to the Catholic mission houses to clean toilets to pay for school fees.  After we’d paid that, we’d go to school, and then if the president was visiting your area you had to raise money to give him as a gift.

“We couldn’t afford that and so we wouldn’t be allowed in class, maybe for two or three weeks.  It was like getting candy from a grandchild,” he says.  “I don’t forget that.”

In the 1980s Banda began his music career singing gospel songs as part of the Alleluya Band, but eventually branched out on his own to produce music that would “sensitize people to regain their conscience.”

“I didn’t like singing love songs,” he says.  “I talked about injustices, the suffering of the people, that was my main concern.”

In 1993 Banda released his first solo album titled “Makolo”.  The single “Mabala” which means “wounds” was critical of the ruling Kamuzu Banda regime, which he said afflicted pain on those already living in absolute poverty.

In 2001 when then-UDF chairman and President Bakili Muluzi attempted a third term, Banda released the song “How Long.”

“I did a lot of songs rebuking [Muluzi],” Banda says.  “Why should we have become a friend of Mugabe and others who were clinging to power?”

In 2005 he released the album “Enemy (of the State)” where he criticized current president Bingu wa Mutharika for quitting the UDF party that had ushered him into power to seek re-election as the Democratic Progressive Party (DPP) candidate instead, and in 2006 and 2008 he released the albums “Survivor” and “Freedom” respectively with messages meant for Mutharika: “We’ll survive you” and “You will see when people realize the truth.”

But in 2011 his latest album of protest music and its title track “Life” attracted negative attention from the Malawi Censorship Board and a ban by the Malawi Broadcasting Company (MBC).  Now that his music is banned from Malawian radio stations, Banda says Section 35 of the Malawi Constitution has failed him and that without free expression the music industry is “harsh” in Malawi.

“You can’t criticize people who are in positions where you put them with your vote,” he says.  “They say, ‘Stay quiet as I’m sitting on your money’ at a time when we don’t have a strong opposition and [Malawians] are weaker than we were in terms of our reactiveness to dictatorship… The Malawians you meet today are not the Malawians of 1994.  In 1994 Malawians were aggressive.  We were patriotic.  The Malawians you meet today I’m sorry to say are desperate, everyone for himself, ‘as long as I get mine it’s OK.’  That’s why we cannot come together and fight one common enemy.”

Though he still believes Malawians who love their country should show that they’re not happy with what is happening, Banda says the MBC ban has hurt his medium.

“Because of the ban, slowly [my] music is dying, people don’t listen to it, youngsters don’t listen to it, so they [government] are succeeding,” he says.

“Today you have to censor yourself so much when an artist is supposed to be free.  If I were going into the industry now, in this environment, I wouldn’t go.”

This article was originally published on the Toronto Star website on March 8, 2012.

Listen to Banda’s song “Tikamalira” (Why We Cry) here.

Collateral damage: Police report policy delays treatment for accident victims in Malawian emergency rooms

You’ve been in an accident in Malawi – where do you go?  If you said the emergency department you could be wrong.

A few months ago my editor at Blantyre Newspapers Limited’s Sunday Times made this “mistake”, taking a small boy who had been in a traffic accident to Queen Elizabeth Central Hospital (QECH) for emergency treatment.  The boy, playing with a friend alongside of the highway, had run head-on into an oncoming SUV.  He was severely bruised, crying, and required treatment, but when they reached the hospital the staff at the registration desk turned the boy away on the basis of a policy that requires a police report before care can be administered to an accident victim.

Nurses and doctors affirmed the police report policy to the boy and the editor and it was only after they drove to the police station and were escorted by an officer back to the emergency department that the boy received treatment for the traumatic experience he had endured – nearly two hours after initially arriving to the ward.

Three weeks ago, that same editor witnessed a similar episode when a transport truck struck a small car.  At least one passenger was killed on impact, and when another bloodied passenger was brought to the hospital in hope of emergency treatment he was forced to wait in agonizing pain until a police report could be acquired.

When questioned on the policy, chief administrator of QECH Themba Mhango said a victim of a traffic collision would “definitely” be treated right away because “it is a human rights issue.”

“Now with the multi-party system, human rights came in and people started realizing their human rights.  You can’t do that to a person now – say ‘no I won’t give you treatment,’” Mhango said.

However, a subsequent visit to the hospital’s emergency room registration desk involved no mention of human rights.

In contradiction to Mhangos’s comments, a desk attendant said that while critical injuries are treated as soon as possible, “when an accident victim arrives a police report is required.”

While “there are serious cases in which you can’t do otherwise but treat the victim,” the attendant matter-of-factly said the majority of individuals who seek treatment following a collision have suffered “minor injuries” and therefore require a police report.

Southern Region Police Public Relations Officer Nicholas Gondwa also confirmed the hospital procedure of requiring a police report prior to treating injuries sustained in an accident and said the policy exists as a kind of collateral, because “hospitals fear that the person may not be an accident victim but rather a criminal who got injured while committing acts of crime.”

“It cannot be known whether the person was really involved in an accident or was injured while committing acts of crime,” he said.

The point is moot.  Under Article 16 of the African [Banjul] Charter on Human and Peoples’ Rights, which Malawi ratified in 1989, Every individual shall have the right to enjoy the best attainable state of physical and mental health” and, “States parties… shall take the necessary measures to protect the health of their people and to ensure that they receive medical attention when they are sick.”

The African Charter on the Rights and Welfare of the Child and the Universal Declaration of Human Rights contain similar clauses.

Because Malawi uses a socialized system of health care, “with the goal of providing access and basic health services to all Malawians” and to “raise the level of health status of all Malawians by reducing the incidence of illness and occurrence of death in the population,” it is the responsibility of the Ministry of Health to address this unjust policy – take necessary measures to protect the well-being of their people.

Considering the fact that it is already difficult to get necessary health care in Malawi – transportation to clinics and health centers is problematic, and when a person is able to reach a health centre or hospital it is not uncommon to find that there is no medicine – added delays to accessing appropriate care such as this hospital procedure of requiring a police report are undue, unjust and inhumane, and contradict the state of emergency for which the health department in question exists.

In the meantime, Malawians should be advised to keep a first aid kit on hand as well as a police officers’ phone number on speed dial – you will need both before you can access appropriate treatment for injuries sustained in an accident at Queen’s hospital.

With files from the Sunday Times’ Ruth Mputeni