Category Archives: Malawi

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.

Understanding the link between gender and climate change

A common sight in Malawi: Young girls carry heavy loads of firewood. Photo by Desiree Buitenbos

When I met 16-year-old Chikondi Phiri, she was struggling to lift a weighty load of firewood on top of her head. I offered her a helping hand, and initiated a conversation about why she was carrying the wood in the first place.

“It’s for my family,” she said proudly.

I could hardly hide the perplexity on my face. Chikondi’s slender frame and youthful appearance had me questioning what sort of family would make such a slight girl perform such a laborious mission?

Sweat poured from Chikondi’s brow as we attempted to lift a heavy bunch of branches in scorching heat, and when the task was completed, she walked off with the balance of a high-wire artist, and said, “See you”.

In Malawi, I see girls like Chikondi all the time. They’re usually either collecting water from a polluted river or carrying wood with babies bouncing on their backs.

According to the United Nations, women in sub-Saharan Africa spend 40 billion hours every year collecting water and up to 9 hours a day collecting firewood. Not only do the latter play a huge role in contributing to the 41 million girls’ worldwide not attending school; but also it is one of the many reasons why African women will likely be hardest hit by the impact of climate change.

My interest in understanding the link between gender and climate change in Malawi took me from Lilongwe to Kasungu, a northern rural town, where rainfalls have become increasingly far apart. In 2002, over 100 residents died in a famine brought on by drought, and the community has been picking up the pieces ever since.

On a visit to Nkhamenya Girls Secondary School,  I spoke to a group of students about their daily “female” chores and what they knew about climate change. Many said the temperatures continued to drop over the years, forcing more girls out in search of wood to heat up their homes. Others said they knew children who had died due to smoke inhalation. In fact, worldwide, pollution in homes caused by burning wood kills about two million women and children a year.

Sitting there, listening to these stories, I couldn’t help but feel an overwhelming sense of guilt when one girl asked me, “What is causing this climate change?”

I took a second to gather my thoughts before saying,

“Well, climate change is caused by human action, more specifically, the burning of fossil fuels which contribute to global warming – the heating of the Earth’s temperature.”

They just stared blankly. I knew I had to define it on more simple terms.

“You know those big cars that people drive here in Malawi?” I said, “Those cars burn poisonous gases which make the Earth hotter. You know those big factories with black smoke coming out of them? It’s the same thing.”

I further expanded on the greenhouse effect, and they seemed to get it. But trying to define climate change to Malawian school girls was like trying to paint a picture of hyper-industrialization in a country where vast, barren landscapes and an indigenous way of life are the norm.

Climate change is a condition not of Malawi’s creation – less than 0.1 metric tons per capita of carbon emissions, while Canada contributes 16.3 metric tons. Yet there are NGO’s working in Malawi who are promoting an idea that locals are somehow responsible. They implement projects to plants trees, and raise awareness about the issue. But where are the solutions?

The NGO focus on climate change in developing countries should not be on deflecting the problem, but rather figuring out ways for locals to cope with the change.  Farmers will benefit more from learning to adapt to the temperamental weather, while girls would benefit from a cleaner energy source which would not involve collecting firewood.

As I left the school, I realized the weight and the importance of my visit.

To see a different perspective is the very reason we travel, we explore, and meet people like Chikondi who inspire us to comprehend a new outlook of the places we come from and the things we do.

Queuing for treatment: “In Malawi if you’re diagnosed with cancer, you die”

Being one of the 24 countries with no radiotherapy machine and limited access to medications, Malawi’s health care system has very little to offer to patients battling with Cancer.

“In Malawi if you’re diagnosed with Cancer, you die,” says Yohannie Mlombe, hematologist at Malawi’s College of Medicine in Blantyre.

The Ministry of health external follow budget allows public hospitals to request transfer of cases that cannot be treated in Malawi to the neighboring countries.

“These patients who are referred to other countries are benefiting a full package from the government to sponsors all the requirements for the external trip,” explains Chifundo Chogawana, chairperson at the Cancer association of Malawi.

Unfortunately, these demands have to be submitted to a committee and patients are most likely to end up on the government’s waiting list.

“All the patients I had put on the list eventually died,” explains Mlombe.

At 24 years old Peter Kaunyolo was one out of too many of Dr. Mlombe’s Cancer patient to be placed on the government’s external follow list for several months in hope to be treated for Acute Leukemia.

“In the past, patients who have benefited quickly from the external follow allocation are the ones who have been backed up by someone who is highly respected in Malawi like politicians. If you have no backing, you could be on the waiting list forever,” admits Thumba Mhango, Chief Administrator at QECH.

The now deceased young man lost his battle on March 10, 2012 after his family was asked by Queen Elizabeth’s Central Hospital (QECH) to contribute half of his 2.4 million Kwacha treatment fees in order to put in place an intensive care self-contained room, even though Malawi’s health care system is to be entirely funded by the government.

“Health system in Malawi is public and funded 100%. It is free on paper and everyone should get basic drugs but this health treatment is too expensive,” says Mlombe.

Even though Malawi’s Cancer association conducts various awareness campaigns they do not possess the necessary funding to proceed with a national data collection which means that most Cancer victims in Malawi are unaware of their health situation. But screening for Cancer is not priority since the country has no treatment to offer.

“If we screen and realize the patient has Cancer what can we do about it? People don’t know what’s happening but even if we catch them in an early phase we have nothing to offer,” concludes Mlombe.

According to him, approximately 2000 Malawians die every year from this disease but the Cancer association of Malawi was not able to confirm these numbers.

Many developing Cancers in Malawi are HIV related. It is the case for Kaposi’s sarcoma which is one of the four most common Cancers in the country.

Firsthand research and experience with the Malawian health care system

“Take a deep breath. Another one, and one more…”

Those were the last words I heard before I couldn’t fight the anesthetic anymore and I was fast asleep.

I recall questioning whether this was really happening. It was just a couple weeks prior that I began working on an article that explored the capacity of Malawian hospitals to accommodate serious illness and medical procedures. So far my findings had not been encouraging, so I had the worst of thoughts running through my head as I was being rolled into the operating room.

In one particular interview with a medical intern, I was told that it is not common for most hospitals to have back up generators. If a power outage occurs, there is a chance that patients who rely on the use of power-driven machinery may not be able to survive. Knowing this alongside my other worries, I was deeply afraid of how successful the surgery would be.

When I woke up, the pain in my torso hit me immediately, as the nurses told me it would. It was so widespread I couldn’t detect the precise location of the incision.

I knew one thing was for sure: my appendix was no longer inside me. It was sitting in a jar, in front of me, labeled “Mara Silvestri, Room 9A” as if it was considered just another body part by those who removed it. For me, it was monumental.

Just hours before, I learned I had appendicitis. Within a five hour span, I was diagnosed and under the knife, without much time to consider my health care options because appendicitis needs to be treated immediately in order to avoid a burst appendix.

As someone who squirms at the thought of blood or needles, I had faced my biggest fear by undergoing an emergency appendectomy. The appendix that sat in front of me symbolized a triumph.

Lying in the hospital bed with my expat crew surrounding me, the first thing I wanted to do was look down to see the size of my scar, but even with remnants of anesthesia clouding my judgment, I knew I wasn’t brave enough to see it.

I couldn’t help being curious. Despite the tears flowing down my face pre-surgery, the doctor was candid with me and refrained from sugar-coating the situation.

“If the appendix has perforated and caused internal problems, we will need to operate further. I’m going to make the scar below your belly button instead of to the side so we can expand it upward accordingly, in case we open you up and find internal problems,” he said  as he motioned his hand up his chest and to his chin.

All I could imagine before surgery was coming out with a scar that spanned the length of my upper body.

I was lucky, I had the appendectomy before any serious complications occurred and the scar is only two inches long, I’m told (I still haven’t looked beneath the bandage).

Prior to that day I had met with multiple doctors who all told me the problem was my kidney. At that point, kidney complications seemed like a relief to liver, gall bladder or appendix complications. After asking around to gain knowledge of who the more experienced doctors in town were, I sought another medical opinion. I was told the problem was indeed my appendix, but by that point the diagnosis was becoming easier to make as the pain I was experiencing was increasing and I was in agony.

“Don’t worry, God is with you” I was told over and over again by doctors, radiologists and fellow patients.

How could I not be worried? My family was tens of thousands of miles away and I have a history of breaking into tears at the slightest of medical worries. I bawled when my dentist informed me I needed my wisdom teeth taken out- and that was at a clinic that was fully equipped, being performed by a doctor I had known since my adult teeth first grew in.

To sit in a hospital bed under a malaria net, with some of Malawi’s most common critters under the covers with me (cockroaches), being served a meal that I am sure consisted of chicken feet, caused me to be very concerned about how my recovery would progress. At one point, the nurse spotted the critter that was crawling about my bed and said “looks like you are not alone!” but this wasn’t the company I envisioned at my bed side.

Furthermore, the hospital I was in does not possess an internal communication system between rooms. There was no button for me to click in order to notify the nurses I needed their attention. The only thing remotely close to that was the radio behind my bed, which fell out of the wall when we tried to use it. This is one of the reasons I was so grateful to have friends I had made here by my bedside.

My stay in the hospital, and my experience with the Malawian health care system made me appreciate the access that patients in countries such as Canada have to a variety of specialists, surgeons, general practitioners and medical facilities.

The hospital I was at was a private hospital in Blantyre, yet it was still under staffed. There were times when I needed my IV changed, required assistance getting out of my bed, or needed another painkiller injection, but nurses told me they were busy with other patients.

I had a great support system to care for me in the days leading up to my dad’s arrival, but I was very happy to have a comfort of home at my bedside as my father walked into my recovery room and greeted me by telling me that he was there to care for me for the next week.

This experience marked an extreme moment in my internship that was already defined by extraordinary moments. Some may call me crazy for not racing back to the comforts of home at a time like this, but even in my post-op state, I’m eager to recover quicker so I can walk around Blantyre again and hear “hey sister” being yelled in my direction on my way to work. I’m also looking forward to once again hearing the sounds of my coworkers greeting me good morning at the beginning of another adventurous work day. It is all part of Malawi’s charm.

And with this, I can safely say that when in Malawi, expect the unexpected.

Fighting for the front page: The challenges of environmental reporting in Malawi

In Malawi, parliamentary proceedings and political scandals dominate the headlines and radio waves.  Whether it is a mere press conference or cabinet reshuffling, journalists jump at the chance to report on governmental affairs. The prevalence of political coverage, however, means that other issues are sidelined.

The country’s state of underdevelopment, coupled with intermittent electricity and water shortages, serve as a constant reminder that there is a long way to go in the creation of even the most basic infrastructure.

Undoubtedly, sustainable energy and water management are worthy topics of discussion. Furthermore, clear-cutting in Malawi’s northern region has left large tracks of land barren, and poaching has devastated animal populations in the country’s national parks and game reserves. Nevertheless, such pressing environmental issues remain largely ignored by the mainstream media.

In recent years, a multilateral effort to encourage journalists to cover environmental issues has been underway. Various organizations under the United Nations (UN) banner, including the United Nations Environment Programme (UNEP) and the United Nations Fund for Population Activities (UNFPA), are behind this push driven by global objectives – namely the Millennium Development Goals (MDGs).

For the past two years, MIJ FM reporter Anthony Masamba has been a regular participant in environmental reporting workshops.

Masamba explained that at these workshops, journalists are trained to understand the linkages between climate change and a range of issues, from agriculture and health, to transport. Through these sessions “journalists have been imparted with skills that allow them to write good stories from an informed perspective, as most of these journalists have not been trained to report on environmental issues,” he said. While “most of them have knowledge in journalism – they know how to write,” Masamba explained that many journalists have yet to grasp the technical languages and jargon of environment and climate change.

For this reason, the Malawi Institute of Journalism (MIJ) offers an Environmental Reporting class for certificate and diploma-level students. The course aims to equip students with knowledge on major environmental issues facing the contemporary world, as well as stimulate interest in the topic. The curriculum encompasses environmental issues, ethics, policies and legislation, as well as the idea of sustainable development.

MIJ student Patrick Botha believes that workshops and coursework are a valuable means by which to encourage journalists and journalism students to work to ensure a sustainable environment. “[Journalists] have a role to play and it is their duty to inform the masses and expose issues. There is a need to engage these journalists to create an interest in them to report on such issues,” Botha said.

Undoubtedly, journalists play a crucial role in information dissemination, knowledge acquisition and overall awareness. While media houses are a useful outlet for the promotion of sustainable development and campaigning for social change, clear challenges remain.

“Here in Malawi, if a newspaper is to sell, it must have a political story on the front page,” Masamba explained. “No one will buy a paper with a headline that reads climate change impacts development – Malawians want to read about politics. If a paper has politics on the front page, it will sell like hot cakes,” he added.

At the same time, further challenges arise as a result of the hierarchical newsroom structure. Masamba outlined a typical scenario: “I can have an idea for a story. I write my letter seeking financial support but if my request is not approved, what do I do? I just sit because I cannot support myself to go that far to do just a story.”

Botha explained that for journalists concerned with nabbing a front-page byline, there is even less motivation to report on environmental issues. With such an article, “they will probably make the third, fourth, or twentieth-something page.” According to Botha, another deterrent “is the belief that the majority of people will not bother to read [an environmental story] unless they have nothing better to do.”

Despite the workshops and other efforts, Masamba attests that the impact has not been realized due to a lack of political will. “At the moment in Malawi we do not have a climate change policy. This is a policy that would provide guidelines through which climate change issues can best be addressed or integrated into various programs,” he explained.

Masamba believes that the Malawian government’s failure to implement such a policy is unacceptable. “How do they handle climate change issues without having a climate change policy? This is a policy that would provide guidelines, but they don’t have it,” he explained. “We as journalists have our own challenges, but the government, on their part, must show political will,” Masamba said.

As for the future of environmental reporting in Malawi, Masamba has high hopes. His optimism stems from the country’s new leadership, which has already outlined a way forward. For instance, in place of the Ministry of Energy, Natural Resources and Environment the Joyce Banda administration has established the Ministry of Environment and Climate Change. “In coming up with this ministry, I think this government has shown political will towards addressing issues to do with climate change,” Masamba said.

How Malawi will remember late president Bingu Wa Mutharika

Bingu Mutharika passed away after suffering cardiac arrest on April 05, 2012

Bingu Wa Mutharika, former president of Malawi, died after suffering cardiac arrest on April 5, 2012. Photo by Desiree Buitenbos

The flag flies at half mast outside Malawi’s parliament building where thousands of civilians have braved long line-ups in smoldering hot sunshine to view the body of late president, Bingu Wa Mutharika, who died after suffering cardiac arrest on April 5, 2012.

To an outsider, this seems like a country truly mourning the loss of their beloved leader. Radio stations and newspapers are bombarded with messages of condolence, while government offices have shut down for the next 30 days.

And though some might argue that the sheer turnout to see Mutharika’s body is evidence of his vast popularity, there are others who say that nothing could be farther from the truth.

Precious Gondwe, 34, has been waiting in a queue to enter parliament for nearly two hours, and her determination to view Mutharika’s embalmed body is fuelled by a desire for closure rather than respect.

“I came here to see with my own eyes that our president is no longer with us,” says Gondwe, “It’s funny that we are lining up to see him when he is the reason we line up for essentials like petrol and sugar.”

Gondwe’s views are not uncommon.

According to Chijere Chirwa, a politics professor at Malawi’s Chancellor College, the lack of mourning among some Malawians can be characterized as “strange” but not unexpected considering the recent failures of Mutharika’s regime to uphold democratic ideals and improve the living conditions for the 74 per cent of the population who survive on less than a $1.25 per day.

“A lot of the critical minds would regard the current economic, social and political situation as developments closely connected with the president,” says Chirwa.

For the past two years, Mutharika, once hailed by the World Bank for his successful fertilizer subsidy program, steered Malawi’s economy into steep decline by telling foreign donors who contribute 40 per cent of the annual budget to “go to hell”.

His dismissal of aid catapulted the government into the adoption of a zero deficit budget which subsequently affirmed that the small landlocked country couldn’t self-sustain with limited resources.

More than 80 per cent of Malawians rely on agriculture for their livelihoods, and tobacco is the country’s main crop, as well as its primary generator of foreign currency. But since 2011, sales of the golden leaf have plummeted by a dismal 57 per cent resulting in reduced finances to purchase fuel from suppliers like Saudi Arabia. This scarcity coupled with a fixed exchange rate has increased consumer inflation to a staggering 10.9 per cent.

According to Voice Mhone, chairperson for the Malawian Civil Society Organizations, the months leading up to Mutharika’s death were overshadowed by rampant dissatisfaction.

“I think the political landscape, as well as the economic situation in Malawi kept on deteriorating,” says Mhone.

“Staying in a queue for fuel is now part of our daily life, and if you look at the price of sugar and other essential commodities they have all skyrocketed.”

On July 20, 2011, the anger and frustration surrounding the country’s economic crisis culminated in mass demonstrations calling for the president’s resignation. These peaceful protests soon turned into bloody riots when police opened fire on innocent crowds leaving 19 people dead and scores of others injured.

But Mutharika didn’t accept blame for the deaths, nor did he take the public criticism to heart; instead he began a vigorous campaign to clampdown on critics, media and opposition leaders.

Reverend Macdonald Sembereka, a civil and human rights activist who played an instrumental role in organizing the protests, had his home petrol bombed by suspected government youth cadets last September. But he says that while the nation has gone through a turbulent time, he has no hard feelings towards Mutharika.

“He did contribute what he could contribute. If he failed that would be part of human nature,” says Sembereka. “I’ll remember him as a person who stuck to his guns. When he wanted to do something, he would stick to it, even though the whole world would stand on the opposite side.”

At Mutharika’s funeral in the southern region of Thyolo, recently inaugurated president, Joyce Banda summed up his life with the sentiment of the nation, saying, “He was not an angel, he made mistakes”.

For Banda, Malawi’s first female president, the road ahead is littered with the legacy of those mistakes, and the latter has prompted her government to resume donor talks with the International Monetary Fund, and the World Bank.

Children in Malawi run away due to lack of food

Tikhala Chilembwe - former street kid turned aspiring doctor

Tikhala Chilembwe used to be one of many street children in Malawi, but he has since returned to school. Photo by Desiree Buitenbos

Co-written with Sibongele Zgambo from Zodiak Broadcasting Station 

Its 10 p.m. in Malawi’s capital, Lilongwe, and the nighttime vultures that characterize the city at night are out in full force.

Prostitutes prey on drunk men stumbling out of dimly lit bars, while stray dogs are on the hunt for scraps leftover from the hustle and bustle of daylight hours. These desolate streets are no place for a child to grow up, yet many often do.

A 10-year-old boy who didn’t want to give his name says he has been sleeping in a gutter outside a popular grocery store for the past three years. He says poverty pushed him into the streets after he lost both his parents to AIDS.

“Most of the time, I beg for money to buy food because I have no one to look after me,” he says. “The problem is some men at night will beat us up and take all that we have sourced throughout the day, leaving us with nothing at all”

Chimwemwe, 12, also left home with dreams of finding a better life in the big city, but his experience has been more comparable to a recurring nightmare.

“Some men rape us night,” he says “Others beat us and tell us to go away saying that we are thieves in town”

According to UNICEF, there are approximately 8,000 children living on the streets in Malawi’s major urban centers. Most of them are boys, and 80 per cent are AIDS orphans. These youngsters are often labelled by locals as purse-snatching, thugs, but the reality is that many of them have suffered unimaginable physical and sexual abuses.

Dr. Joseph Bandawe, a clinical psychologist at the Malawi College of Medicine, says that homelessness disrupts the sense of safety and security that children need, and as a result, they wander through life lacking self-confidence and being wary of adults.

“The trust and confidence that good things will happen to them is not there,” Bandawe says.

“This affects their social interactions – defining the way they’re able to relate to other people, and the boundaries of what is acceptable and what is not.”

Bandawe’s explanation might explain why many of Malawi’s street kids are tempted by a life of crime, but he also suggests that building trust and restoring family ties is imperative when returning troubled kids to school.

Chisomo Childrens Club is a local non-profit working on child poverty issues, and their main mission is to integrate youth back into an ordinary way of life. According to Irene Ngumano, a senior social worker for Chisomo, the biggest challenge in terms of rehabilitation is working with families who were willing to let their children go in the first place.

“Many families that we are working with are poverty stricken families who typically don’t have three meals a day,” says Ngumano.

With Malawi’s escalating economic problems, inflation now stands at a staggering 10.9 per cent, causing the prices of essential commodities like bread and sugar to skyrocket. This implies one thing: the number of street children is set to increase unless there is radical policy change.

But Ngumano adds that if families are facing financial difficulties, Chisomo provides monetary assistance which enables them, at the very least, to feed their dependents.

Such was the case with 17-year-old Tikhala Chilembwe who ran away from home in Grade 3. He slept under a bridge for years, until he was discovered by Chisomo social workers who reunited him with his legal guardians and resumed his education.

“My life is okay right now,” says Tikhala, with a smile. “When I’m finished school, I want to become a doctor and I am going to work hard to achieve my goals.”

Malawi’s fisherman more likely to catch HIV: Reports

Malawian Fishermen

Lake Chilwa’s fishermen lead risky lifestyles that increase their chances of contracting and spreading HIV. Photo by Desiree Buitenbos

Ronald Gomo, 37, is a fisherman who would rather live alone than associate with the other fishermen who reside on the shorelines of Malawi’s Lake Chilwa.

“Before, when I was living over there [with the other men], I spent all my earnings on having sex with prostitutes.”He says, “Now, that I stay here, I am able to keep my money.”

Gomo has been living in relative isolation for the past seven years in a floating house he built himself. There is no running water, electricity or formal toilet.

He chooses to live under these conditions because it prevents his self-described “womanizing ways”.

Like many of Malawi’s 50,000 fishermen, Gomo is married. In fact, he has two wives. However, that never stopped him from hiring prostitutes when the catch was good, and the alcohol was flowing.

“It was too easy,” he laughs, “some women there were even willing to give sex for fish”

If Gomo knows one thing, it’s that he doesn’t want to return to his former ways. But it’s what he doesn’t know that’s cause for concern. Gomo has never undergone an HIV test which is worrying considering 17 per cent of the population surrounding Lake Chilwa is infected.

According to the United Nations Food and Agriculture Organization, fisherman in developing countries suffer from a high HIV prevalence, often five-to-ten times higher than the general population.

Their vulnerability to the virus can be attributed to numerous factors, including their mobile lifestyles, long months spent away from home, access to daily cash income, readily available commercial sex, and the hyper-masculine fishing subculture which promotes risky behaviours such as unprotected sex and substance abuse.

Little research has been done on just how many fishermen at Lake Chilwa are HIV positive, but some academic papers have studied the correlation between the lake’s high water levels during the rainy season and an increase in reported infections.

When water levels are low, fish are harder to find which results in a food shortage for small pockets of the surrounding population. It’s during these times that women will offer themselves in return for the catch of the day.

However, when the levels are stable, the fishermen recover from a short-term economic slump and earn massive profits. Ultimately, they become icons of prosperity in their impoverished communities. This allows them to frequent prostitutes and have several wives or girlfriends, but it also implies that they’re playing key roles in spreading the infection.

According to Clement Mwazumbumba, Lake Chilwa’s District AIDS Coordinator, many of the men don’t know their HIV status because access to clinics is limited due to the very nature of the fishing industry.

“Fishing is a daily engagement, and everything you do depends on your catch” He says, “It would take a lot of planning for someone to abandon their work, go to the shore and travel some kilometers away just to undergo a test.”

Mwazumbumba adds that entering the secluded pockets where fisherman work is a challenge.

“We have tried to penetrate the lakeshore area with services, but it’s expensive to a mount mobile clinic,” he says “I think if we had very aggressive focus on the area, maybe more people would know their status.”

Malawi recognizes World Malaria Day

It’s April 25 and 12 year old Blessings Phiri traveled, by foot for hours from his village to sit in the waiting room of Kamuzu Central Hospital in Lilongwe, Malawi. This time around, malaria has hit him hard.

Blessings experiences the typical symptoms – nausea, headache, high fevers, periodic chills and sweats, muscle aches and a loss in appetite.

“I think that dying is sometimes better than going through this,” said Phiri.

Malawi’s Ministry of Health reports that malaria remains to be one of the key health problems facing the nation. Currently, up to 325 people in every 1,000 Malawian suffer from the illness every year according to last year’s figures.

“It’s the worst feeling in the world,” said Phiri, who sits with his hands covering his face.

Coincidentally enough, April 25 was World Malaria Day. It marked the height of global efforts to build awareness of the mosquito-borne parasitic disease. During this day, the Ministry of Health specifically emphasized to Malawian on the need of using insecticide treated nets to prevent being bitten by malaria-laden mosquitoes.

“I don’t have a mosquito net for my bed. No one in my family does,” said Phiri.

According to UNICEF, many children do not sleep under insecticide-treated nets. If malaria is recognized early, it can be cured, however, UNICEF stated that many Malawians are not able to access treatment within 24 hours of onset of symptoms.

Although malaria is both preventable and treatable, many people in Malawi cannot afford the treatments due to poverty.

The Ministry of Health said that support from development-partners remains a significant resource to ensure access to life-saving and cost-effective malaria interventions.

“Continued investment in malaria control will propel Malawi, a malaria-endemic country along the path to achieve the 2015 Millennium Development Goals, especially those relating to improving child survival, maternal health, eradicating extreme poverty and expanding access to education,” according to the press statement released April 25 by the Ministry of Health.

Millions of lives depend on the strong support and the Ministry of Health is optimistic that living a malaria-free life is an attainable goal.

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.