Well Repair
July 5, July 9

Well repairs have been an integral part of Child Legacy’s mission since the Rogers brought their organization to Malawi in 2008. In its infancy Child Legacy paired with Living Water, a Houston-based organization, to repair the basic afrodare pumps present all throughout the country. Karen Rogers and her sons traveled the country in search of broken or malfunctioning wells. Now Chid Legacy employs a team of five Malawians who have been trained to effectively assess, replace/repair, and document these well repairs. The average cost to repair one well is about $1000 which, along with wages for the well repair team, is funded by donors from the U.S. The well repair was a key part of my initial interest in the CLI placement – I was very impressed that the organization integrates aspects of environmental well-being with health care. Needless to say, I was extremely excited to find out that Sabha and I would be able to join a group of American donors on several well repairs.

The Well Team:
The well team consists of a preacher, a liaison with the village headman, a photographer, a teacher, and a general repairmen. As a Christian organization, the preaching component is critical not only in discussing proper sanitation and hygiene, but also in spreading the Gospel. The team liaison gathers a standard set of information – regarding the village population and the state of the well – which is then compiled for future records. This report includes GPS coordinates, total depth of well, static level, depth of cylinder, time without functioning properly, number of people served by the well (men, women, children), alternative source of water, distance to alternative source, distance to nearest school, and problems encountered with the well. The photographer documents the entire repair to ensure that donors in the US are able to see where their money is going. The teacher’s role on the team is to instruct a responsible member of the community on the well repair process so that they can fix the well themselves should future problems arise. All of the members of the team are trained in the process and aid the general ‘repairman.’ The repair process (simplified version) consists of removing old pipes and rods; measuring the depth of the well and static level; replacing pipes, cap seals, and hanger rods, pouring chlorine as a disinfectant; and replacing the well head, etc.

I learned after the final well repair that there is another critical member of the well repair process – Child Legacy’s development director. This person’s role (at least in the nearby area) is to communicate with local headman to identify which wells are in the most need of repair. They then inform the headman 1-2 days prior to the scheduled repair date. The majority of the repair team was busy in Kasungu (northern) region of Malawi during our stay at CLI, so the repairs that we went on were led by Karen and Sho (the fifth member of the team). While we were unable to see the trained team in action, this did allow for greater participation in the actual repairs and greater interaction with the communities. To give you an idea of how much we slowed down the process – the trained team generally repairs 4 wells a day and we were only able to do 2 per day.

The parts:
Cylinder (pumps the water)
Foot valve (plastic part below cylinder)
Plunger
Rising main (pipe)
Steel rods
Pedestal
Pipe centralizers (stabilize pipe in casing)
Rod centralizers
Rope
Bush bearings
Hanger pin
Fulcrum pin
Handle
Pump head and cover
Bobbin (helps with foot valve and plunger function)
Cap seal (rubber portion around plunger)
O-ring
Other – nuts & bolts, PVC solvent cement, chlorine, cloth, hacksaw, tools (screw driver, etc.)

The Repair:
Sabha and I went on three well repairs (two July 5th and one July 9th) and there was a different root cause for each. In the first village, the rods had rusted and the pipes had been cut so short that they didn’t reach the static water level. The second village had a broken cap seal and the third village had worn bush bearings and worn pipes. Karen informed us that these are very commonly encountered problems. The length of the pipes and hanger rods is very critical. Often the pipes and hanger rods are cut so short that the plunger comes out of the cylinder, bangs on the pipe and wears away at the rubber cap seal. Worn bush bearings can also lead to many, more severe problems from metal hitting metal. When repairing wells themselves, the people often remove the pipes and then reheat instead of gluing the pipes back together. This often causes the centralizers to rub and prevents the rods from working together properly. They always replace plastic plungers with brass and always put in a new cylinder (which should last 5 years if the pump is well maintained).

The Community:
At the first village, I spent the majority of my time talking with the women and playing with the children. One woman gave me a bit of a village tour. She introduced me to her friends, showed me the kitchen where she makes nsima, and brought me to another malfunctioning well nearby. This was my first formal introduction to the full process of making nsima. The maize husks are dried in a straw hut, then the kernels are scraped off and laid out on a mat to dry. Once dry, the grain is pounded into flour and this flour is eventually cooked in pot of boiling water. The most astonishing thing to me was the lack of ventilation in her kitchen, which was a just a small brick room (separate from the living space) with a couple of pieces of wood and some old husks for fuel. She bent down over the fire and blew on the coals to get the fire going, all the while inhaling the smoke pouring out of the fire.
At the second and third villages I got the chance to participate a bit more in the well repair process. While the cause of malfunction may be different from well to well, it appeared that the repair process was pretty standardized – PVC pipes, rods, centralizers, bush bearings, and cylinders were almost always replaced. For me, the most memorable part of the well repairs occurred at the third village. The women and children all began singing and dancing as the repair came to a close. When I asked Lester (who served as the stand-in preacher) what they were singing about he told me that it was traditionally sung at wedding ceremonies as a way of welcoming new members to their family.

Sunday and Monday were filled with visitors at CLI. Dr. Oden and Dr. RRK paid a visit to CLI on Sunday and we gave them a full run-through of the site with Jeff. Although the health center is not yet up and running, there are a lot of future projects in the works at CLI and potential for future Rice interns in medical and engineering-related fields. It’s always great to see familiar faces and their interest in the site gave me a renewed sense of lucky I am to be here experiencing the start of it all.

Monday was also a big day for visitors at Child Legacy. An emergency at St. Gabriel’s prevented Mr. Ngalande from visiting, but he did send two Msundwe area HSAs to visit the site. I’m not sure whether or not I’ve given a detailed description of who HSAs are what they do. HSA stands for Health Surveillance Assistant and they are essentially government-paid community outreach workers. They are not health professionals but they do undergo community health training. Their primary responsibilities are to provides vaccinations, report health updates and outbreaks to their respective health centers, and provide health education in the communities. Harold, one of the HSAs whom we met with, is the head HSA for the greater Msundwe area and was extremely knowledgeable about the program. At this time I am still unclear as to whether or not he is affiliated with the community outreach program run through St. Gabriel’s or whether he simply knows Alex (Mr. Ngalande).

After giving the HSAs a grand tour of the site and trying to make them feel as at home as possible at CLI, we explained to them a little bit about Jeff’s goal in adding a community health worker to his well repair team – improving health not only through increased access to water but also through treatment for common illnesses such as malaria and diarrhea. Jeff is hoping to emphasize the treatment of under fives, at least initially. While Harold was extremely willing to try to establish a relationship between the Msundwe-area HSAs and Child Legacy, he emphasized that their main role is serving their own communities through routine updates and monitoring. He also mentioned that most of the HSAs would not be interested in being gone for long periods of time. Jeff also informed us that the well repair team just headed up north to the Kasungu area so there may not be an opportunity to test out this partnership in the near future.

Sabha and I were extremely grateful for the opportunity to meet with Harold and his colleague (whose name I have unfortunately forgotten) and exchanged numbers for future contact. During our meeting with Alex on Friday, he informed us that HSAs could easily be trained to use the Rice CHO backpack, but at present their training is very limited and they may not be exactly what Jeff is looking for. A better solution may be to have the well-repair team coordinate with HSAs prior to their visit so that they can organize health talks at the well repairs and/or vaccinations. I really like the idea of combining the health care with the well repair missions, but it is a little more complicated than I had originally thought because the best health care and education cannot be achieved during a quick, one-time encounter. We will have to continue to brainstorm. Once the CLI health center is operational, it should be easier to incorporate HSAs or some other community health program.

Danielle, Alexa, and Issac (from Medic Mobile) also visited us in the afternoon. It was great to give Danielle and Alexa a tour of our intern placement since they were so gracious about sharing their experience at St. Gabriel’s with us. It was also very interesting to hear more about Medic Mobile, especially because I think it could be very beneficial to Child Legacy’s health center in the future.

It seems that now is quite the season for visitors – Z will be back in Namitete on Friday and I know that she is very interested in visiting CLI, the group of 13+ donors is coming in on Saturday, and then Michael arrives on Monday, July 4th. It is looking like we will have a very busy week installing the new solar panels, and 5 KW wind turbines, and otherwise preparing for the donors’ arrival.

Market Day! – June 25, 2011

We used the second half of our Saturday to take a little break and do some shopping at the nearby town/trading center of Msundwe. Wednesdays and Saturdays are market days in Msundwe and Sabha and I were really excited to get a feel for the local market. Jeff and Karen arranged to have Lester, the sight supervisor, meet us in Msundwe and show us around a bit. The market was bustling with people buying anything from chips (aka Malawian French fries) to bananas to used clothing and chitenje (cloth warn by the local women). We spent the majority of our time going back and forth between vendors looking for the perfect cloth to make into shoulder bags. After searching and searching we took our chitenje to a tailor and he pumped out bag after bag for just 150 kwacha (about $1) each.

Other than the chitenje, the other thing that caught my eye (as it always does) was the street food. I’ve been warned against anything made in questionable oil, but I couldn’t help but look. Of course, there were tons of stands with men making chips, fried chicken, a cabbage mixture but there were also women selling different types of donuts, fish tomatoes, onions, sweet potatoes, ground nuts (peanuts), fresh breads, and of course nsima. Whenever I travel, I am always interested in eating the ‘local cuisine.’ While there are definitely local staples, I’ve come to realize that here in Malawi the people really just eat whatever they can. I see people of all ages chewing on sugar cane and making nsima because that’s what is available. I did try some of what Lester called ‘African cake.’ It tasted a bit like cornbread, but it was much more dense (and filling) and not quite as sweet.

When we were finally ready to head back to the site, we bought Lester a few gifts as a token of our appreciation – including a pair of new white shoes! He was so grateful and we knew that he would look very smart preaching in those at church the next day. Lester also showed us his house on the way back. It consisted of a courtyard area, a kitchen, and the house itself (a sitting room with a tv and radio and a bedroom). It was really great to get to see a part of Lester’s life other than what we see on the site. We met his wife and daughter, Faith, but were sadly unable to meet his son, Wonder. We made the full walk back to CLI for the first time and it took about an hour and ten minutes. A large portion of the CLI employees make that walk twice a day, in addition to their 10-hour workday. Despite this, they still manage to greet me everyday with a smile on their face. Their spirit never ceases to amaze me!

It took us nearly three weeks, but Sabha and I finally realized that our fellow BTB interns at St. Gabriel’s are just about a 30-40 minute trip down the road. We exchanged Malawi phone numbers and made two very productive trips this week. For our first visit (on Wednesday), Danielle and Alexa showed us the grounds and told us a bit about their daily routine. We were not only able to help take temperatures in the pediatric ward, but we also got the chance to see in the ins and outs of a well-established CHAM hospital (Catholic Hospital Association of Malawi – I’m not entirely sure of the acronym). The hospital staff was more than welcoming and allowed us to take photos so that we could bring as much information as possible back to Child Legacy. We made a list of laboratory equipment that Child Legacy may need to invest in if they are to effectively test for hematocrit, run urinalysis, and test for malaria. We also took into account that St. Gabriel’s is considered to be a district hospital, while Child Legacy is a ‘health center’ – one step down in scale. Child Legacy would need to add male, female, and pediatric wards in order to reach hospital status.

Danielle and Alexa shared with us a lot of valuable information health care practices in Malawi. With regards to maternal health – umbilical cords are commonly cut with string, stirrups are not used for prenatal checkups or in delivery, and instead of incubating newborns they are encouraging women to keep their children close to their chests in ‘kangaroo pouches.’ Alexa and Danielle were also quite stumped as to what the underpads (which were donated to CLI in exorbitant amounts) would be used for. At St. Gabriel’s they simply change and wash the sheets after delivery and neither had ever seen underpads used to stop excessive bleeding. CLI also received donations of patient gowns in large numbers, but apparently patients are never put in gowns at St. Gabriel’s. All of this information will be extremely useful in putting together a revamped list of needed items for Child Legacy to send to Medical Bridges and other organizations that focus of medical donations.

Today we returned to St. Gabriel’s for a meeting with Mr. Alexander Ngalande (Alex), head of the community health outreach program out of St. Gabriel’s. Jeff has expressed an interest in trying to incorporate a community health worker (CHW) into his well repair team. Of course, the level of treatment for sick patients would be limited due to the time constraints of well repair missions. Nonetheless, we thought a discussion with Mr. Ngalande would be the best place to start. While government facilities in Malawi employ Health Surveillance Assistants (HSAs) who serve a similar purpose, the CHW program out of St. Gabriel’s is unique in that they are now utilizing the Rice CHW packs and Frontline SMS (a software that allows for cellphone communication between CHWs and St. Gabriel’s). Alex was extremely welcoming and open to all of our questions about his program and how we might be able to model it at CLI.

Alex first told us that there already about 20 HSAs in Msundwe area and that they could easily be trained to use something such as the CHW pack because they have already undergone the basic HAS training. Alex also offered to recruit several male HSAs from the Msundwe to come with him to CLI on Monday to meet with Jeff and get better acquainted with the Child Legacy and its goals. It was readily apparent that Alex was willing and excited to share his successful CHW program with other areas and health facilities. He also shared some valuable information about the different types of hospitals and funding sources in Malawi – CHAM, government, and private (and sometimes combinations). It is difficult to compare CLI to St. Gabriel’s because the former will be (somewhat) government run while the latter is CHAM. Jeff is hoping to keep CLI separate from CHAM because government funded hospitals are completely free to patients. On the other hand, he also hopes to maintain some control of the clinic (in order to assure quality care) by having a say in the hiring of nurses and lab technicians.

I could go on about the other useful information that Alex shared with us – especially with regards to malaria treatment in Malawi (mostly that the nation is transitioning to LAH for numerous reasons) – but I’ll move on to the other good news of the day. When we returned from St. Gabriel’s shortly after lunch, Karen was also returning from a meeting with the Ministry of Health about the MOU (memorandum of understanding) for the health center. Given the current financial situation in the country, I was half expecting to hear that the government would not be able to provide the funding required to open in the near future. I was happily surprised to hear that the Ministry of Health agreed to the majority of the MOU’s stipulations, including: paying for 3 nurses, consumables, pharmaceuticals, and vaccinations. This is extremely good news. The head minister has also agreed to come visit the site on Monday.

Monday is looking to be a very good day for CLI. We will have the minister of health, Alex and the HSAs, and we have just confirmed that Danielle and Alexa will be visiting that day as well.

Today was a very eventful day. I was joined by one of the female workers, Lynis, on the latter half of my morning run. She lives in a village up the road and generally waves hello to me as I pass by in the morning. Today she waited for me to pass by again, flagged me down, and jogged with me all the way back. I’m sure we were quite the site to see! I really enjoy seeing all of the CLI employees in the morning and it was an extra treat to have such an eager companion.

MKANGA SCHOOL:

Sabha and I were also able to visit the nearby primary school in the morning. We have previously expressed to Jeff an interest in testing out the BTB handwashing station at the school. He mentioned said it might not be necessary because the government had recently implemented a food program and at the same time constructed several handwashing basins. Nonetheless, he said that we were more than welcome to check it out. The Mkanga School (which refers to the region in which it is located) is just about a 15 minute walk from the site and serves nearly 900 children in the area.
When Alec (the CLI driver) escorted, Sabha, myself, Brooke, Katie, and Sam to the school, we were welcomed by swarms of excited children yelling, “Azungu, azungu!” I’ve become very accustom to this greeting, but it was still startling to see such large quantities of children yelling it. Last winter (June/July), Child Legacy constructed roofs for several of the classrooms, so they have established a good relationship with the school. The headmaster was extremely welcoming – as were each of the nine teachers. We got a very thorough tour and were invited to introduce ourselves in several of the classrooms. I felt guilty because we were clearly a huge distraction.

Here are a few of the observations that stood out most to me:

• We arrived around 8:30-9 am but still saw many children walking to school. When I asked, the headmaster said that they ‘try to start at half 7’ but it was clear that the timeframe was really more of a guideline.
• The handwashing station consisted of a cement basin with a lid that the older girls filled up with buckets of water brought from the well. The students then dip a plastic cup into the basin, hang it on a tree branch, and rinse their hands from water that drips from a hole in the bottom of the cup. Today the water was especially low because women were using the well water to fill buckets for men molding bricks. An organization (I can’t remember the name, but I think it was through the government) has provided funding to build staff houses near the school so teachers won’t have to commute as far everyday. The headmaster assured us that the handwashing station is used regularly but we didn’t witness any students using it. There were two handwashing stations – one for each gender – and numerous latrines.
• Food program: As far as I could tell this is funded by the UN World Food Program and is provided at all government schools. The students are provided one meal per day (school ends at noon) and the goal is to serve food around 9-10 am. The school has a storeroom of soy beans, maize, and porridge. The food is cooked and served by 3-4 female volunteers from the community, who prepare it in a small, poorly-ventilated kitchen. One of the volunteers was sitting in the smoky room breastfeeding her own infant. Unfortunately we were unable to see the meal distributed because they were running behind schedule due to a lack of fuel (firewood). Hopefully we will be able to return because I’m very interested in what the serving procedure is – do the kids wash their hands? Do they have their own bowls for food?
• They are severely lacking in teachers. The school serves 900 students (although I doubt that many are there on any particular day), but only has 9 teachers. The headmaster himself teaches first grade because they are so understaffed. Many of the students were just running around because there are only 4 classrooms. The 8th grade class was cut because there wasn’t enough space to have a separate class for so few students.
• They teach 9 subjects: mathematics, general sciences, religion, social studies, art, English, Chichewa, and two others that I cannot remember.
• There were no desks, chairs, or books in any of the classrooms. The four inside classrooms each had a chalkboard, but four classes were taught outside. The students sat on the crowd, huddled in a semicircle. While the students in the classrooms were well-behaved, many of the younger children were running around. With such a large student to teacher ratio, it is no surprise that the school also served as a type of daycare.

TURBINES AND TRUCKS:

After lunch we watched and documented ‘engineering in practice,’ as Jeff so eloquently phrased it. One of the 3 original turbines has been out of commission for quite some time and Jeff is hoping to get it repaired while Mr. Connolly, an American electrician volunteering his time before the Mt. Kilamanjaro Clean Water Climb in July, is staying at CLI. His daughter, Sam, is one of the girls who joined us at Mkanga School in the morning. They lowered the turbine by attaching a wench to the turbine and the Rogers’ Ford and slowly releasing the turbine bit by bit. It was pretty cool to see and luckily I have it all on video. The source of the problem was apparent after just a short amount of inspection. The design of the turbine head was such that some of the moving parts required outside connection and these had become severely rusted during the rainy months of the year. While the problem was easily diagnosed, the part in question was so rusted over that it could not be removed with tools available on site.

SOLAR PANELS AND PEANUTBUTTER:

Later in the evening, around 6:30 pm, the 40×10 foot container arrived. This was the big shipment that Jeff had just sent off prior to talking with us on skype at the end of the April. I knew that container shipments were a big deal at CLI (this is the Rogers family’s eighth in total) but I was still taken aback the lengthy and hectic operation. First, we had to set up spotlights because it was too dark to see a thing. Then, Jeremy had to break the locks on the container since the keys had been left in Lilongwe. Site employees stayed overtime to help offload everything from solar panels to wind turbines to PVC pipe to Skippy peanutbutter. The highlight of the evening, however, watching Jeremy Barr (a family friend of the Rogers) drive a brand new tractor off of the container and onto a truck trailer! The whole crew called it quits at 11 pm with about half the container still left to offload.

For our second Sunday in Malawi we were lucky enough to spend some time at Lake Malawi, which is just a couple hours away from Msundwe. Jeremy, Brooke, Katie, Mr. Connolly, Sam (Mr. Connolly’s daughter), Sabha, and I piled in the Ford and headed to the Lake after breakfast. We passed through numerous small towns and windy roads and ended up at a nice resort/hotel in Salima.

The hotel has its own restaurant and beachside property that we were able to enjoy just by eating lunch at the restaurant. Luckily I brought a swim suit to Malawi (and cap and goggles, just in case) and figured it might be a good idea to bring it to the Lake, even though it was a tad overcast. Jeremy, Mr. Connolly, and I all jumped in and went for swim. The lake was absolutely beautiful – it was like the ocean without all the hassle of getting salt water in your mouth and eyes. There were significant waves and if I were a better body surfer, I’m sure they would have been even better. What’s more, the water temperature was perfect – I could have swam for hours.

For lunch I ordered one of the traditional dishes (even though they had a very tempting lentil and naan option) because we haven’t yet had a taste of the local food. I ordered the chambo (fish), which came with nsema and local vegetables. The workers at CLI have nsema for almost every meal and the consistency reminded me a bit of the fufu that I had in Ghana. It was a little plain on its own, but tasted great with the vegetables (which were kind of a mix between collared greens and kale) and a sweet tomato sauce. Sabha order chicken kawawa, which was very spicy but very tasty. Sabha and I decided to get our extra nsema in a to-go box and had quite the fiasco attempting to give it to some of the children on our way back to the site. The children seemed to be terrified of the box and didn’t want to go anywhere near it. Jeremy eventually opened it and was able to persuade some of the women standing nearby that it was good food. I think they were disappointed because the outward appearance of the box made it look at little bit like chocolate.

We finished off our second Sunday in Malawi with a delicious dinner of rice and chicken a la king (I believe), courtesy of Karen. Sabha and I were put in charge of making the rice and failed miserably. Luckily Karen’s amazing chicken concoction made up for our lack of skill (you could hardly tell that we turned the rice to mush).

P.S. Happy Father’s Day!

***Just a note before reading this post – Sabha and I purchased a Dongle and now have (very intermittent) internet access on site!! These next few blog posts will be extremely out-of-date, but I’ll be trying my best to get caught up. Unfortunately our internet connection is too slow to upload photos so I’ll have to do that when I return to the US or the next time we have a significant stay in Lilongwe.

June 15, 2011

The more time I spend here, the more impressed I am with all that CLI has accomplished and all that it has in store for the future. It seems that every time I talk with Jeff and/or Karen, they tell me about another development project they have in mind. This is the list I’ve been able to come up with thus far, but I will keep you posted as I hear more:

• RENEWABLE ENERGY: CLI currently runs almost entirely on wind and solar (they do burn wood for hot water).  They currently have 3 wind turbines (one of which they are currently trying to fix) and have 2 larger turbines coming in on the next shipment. I cannot remember exactly how large these turbines are but the concrete base that they require is at least 6’x6’x6’!  They currently have 2 sets of tracking solar panels, a roof of stationary panels (30 degrees to the north), and another set of less powerful stationary panels. The construction crew is building a roof on which to place another set of panels that should be arriving in the next shipment as well.  CLI also has a room of back-up generators, but have not had a need for them yet.
• SOLAR WATER PUMP: All of the water at CLI is groundwater that comes straight from their own well. There are numerous taps throughout the site.  Water is pumped from the well by solar power and is stored in 3 enormous tanks, the third of which is set to automatically shut of the pump when it is full.
• HEALTH CENTER: Jeff has told us that the proper term for the facility is ‘health center’ because it is larger than a clinic, but does not have the same capacity as a hospital.  The health center contains a maternity ward and an OPD ward.  The goal is to eventually have 3 nurses and 3 nurses assistants. They will be able to prescribe some medications and run some basic tests, but the majority of serious surgical cases will have to be referred to a bigger regional hospital, such as St. Gabriel’s (I believe).
• WOMEN’S SHELTER: This shelter, currently under construction, is for pregnant women to stay and rest prior to giving birth. Jeff and Karen have told us numerous stories about women giving birth on the side of the road as they walk to the nearest clinic or hospital. The idea behind this shelter is that women can walk to the health center about 10 days before their due date and have a safe place to stay and rest until they go into labor.
• EMPLOYMENT: CLI employs men and women for almost every task needed on the site. They have locals in charge of carpentry, painting, gardening, plumbing, brickmaking, and general supervising. There are regular workers on staff, but they almost always at least several people who show up just looking for several days work.  Each of the neighboring villages must also provide a certain number of workers for a specified period in order to ensure participation and investment in the project.
• WORKSHOP: Eventually there will be a workshop ‘training’ area which will serve as a type of vocational school to teach people from the surrounding communities trades, such as carpentry, brickmaking, etc. Here, Jeff hopes to makes desks and chairs for local schools.  It will be powered entirely by solar panels. This area is currently used for mixing cement, storing wood, and as a dining/break area for the workers.
• SCHOOL: CLI has a close relationship with a nearby primary school. They put up a roof over 2 of the 4 classrooms and are hoping to be able to provide more aid in the future.
• VOCATIONAL SCHOOL: Construction has not yet begun on the vocational school, but it is in the plans. My impression is that the vocational school will serve primarily to train nurses and health workers, but may be expanded to teach other trades as well.
• STAFF/VOLUNTEER HOUSING: There are 3 short-term volunteer/guest houses (one of which we are staying in) that are complete and most of the construction is complete for the nurse’s housing. They are currently working a constructing several houses for permanent staff.
• WELL-REPAIR: CLI employs a team of about four men who travel around the country and repair wells, specifically those using the afrodaire pumps. This team is extremely well-trained and generally repairs about three pumps a day.  They have been in the northern part of the country since we arrived, but should be returning to the area soon and we are excited about the opportunity to travel with them.  Jeff is also hoping to add a community health worker to the team because they encounter numerous sick children at every village they visit, but there is nobody with the expertise to treat them.  Sabha and I are hoping to talk with Alex Ngalande from St. Gabriel’s hospital about his community health outreach program and find out whether or not it would be possible to train a nurse to travel with the CLI well team.  I believe that CLI has helped repair over 1000 wells since its creation, but you will have to check their website to be sure of that statistic.
• AGRICULTURE: CLI recently purchased more land with the hopes of creating agricultural co-ops and fair trade that could stimulate economic activity in the area. Jeff emphasized that they are not seeking to take people’s land, but simply make use of land that is not being used at all.  Tobacco has traditionally been a major crop and export for Malawi, but they have recently been trying to grow it simultaneously with corn and as a result neither is selling well.  Jeff hopes to introduce citrus to the area because it is much less detrimental to the land.  Again, the main idea is to stimulate economic activity however possible.
• FLOWERS/PLANTING: Part of this will include a greenhouse in which Jeff hopes to demonstrate to the local people all of the forms in which water can be beneficially utilized – irrigation, mist, solar pumping.  Jeff also discusses plans to plant local flowers – for the benefit of visitors and as another economic project. Some of these plants shed seeds, which can be collected and sold – either as a source of income for CLI to expand or as a possible co-op for the community.

It is great to see work being done on all of the current projects and hear about all of the plans for the future.  I am also excited to see how much progress has been made when we leave at the end of July.

Sabha and I spent our first Sunday in Malawi trying to immerse ourselves in the cultural and become more familiar with the communities surrounding the CLI site. In a nutshell: I went for a run with some of the local children, went to a church service, walked around for several hours, and played soccer! A very fun-filled day!

RUNNING:

Before coming to Malawi, my plan had been to go for a run every morning as a way to both stay in shape and explore the surrounding area. Even though Sunday is technically our day to sleep in, I decided to finally get up and for a run. I was almost immediately joined by a crew of children from the nearby villages. I ran with them for about 20 minutes as they laughed and giggled beside me yelling, “Azungu, azungu,” meaning “white person, white person.” We picked up an older boy along the way who knew a fair amount of English, but I was still unable to make out his name. We eventually ran back to the edge of the CLI site where we “talked” and played for a little bit. I was shocked and extremely impressed to see that almost all of the children could count to 100 all on their own. I then started trying to teach them a few English words by spelling them out with a stick in the dirt. They had kept mentioning and motioning about a ball and the older boy knew the word, “football” so I eventually spelled out ball in the dirt for them. They immediately started pointing back down the road and motioning like they wanted to play football. We had passed a group of children with a small ball on the way, so I thought we were going to join them. They took me to a somewhat empty looking field, which I then thought was where they played football.  Eventually another boy, who knew even better English, came over and told me that they wanted me to go to town and get them a ball.

My heart dropped a little bit.

I had run around blissfully with the children – making them thirsty and out of breath – and then couldn’t provide them with any water to quench their thirst (I wasn’t exactly sure about the CLI policy). I wish that I could’ve driven to town and bought them a nice ball to play with, but I had no vehicle. Situations like this really make me think about the disparities in quality of life. Sabha and I came to Malawi knowing that it is one of the least developed countries in the world, but thus far we have lived rather comfortably and we know that it is only because we are American visitors. I don’t want to be intrusive, but I am hoping that we will be able to experience more of the “native life” before we leave. I am very interested to see the cooking stoves and living conditions. Thus far, I only know what I have been able to see from the truck and from the main dirt road as I ran by.

CHURCH:

Lester, one of the men who works at the CLI site, is also a pastor for different churches in the nearby communities. He holds a service every Sunday in the clinic’s courtyard. He then travels to other nearby areas and holds more services throughout the day. Unfortunately, there isn’t a single space large enough for him to hold just one service. As I was talking with the children after my run, I saw some people arriving in their Sunday best, but didn’t really know where it was they were going (because there isn’t an actual church on site). It wasn’t until later that I realized they weren’t just passing through. Some of the children that I spoke/played with came back for the service changed and cleaned up a bit. I’m pretty sure that all of the white people standing the back watching the service were a major distraction, but I’m very glad that Lester and the other pastors were willing to humor us. They even translated the sermon into English for us.

Watching the church service was an amazing experience – listening to the harmonies of the children, women, and men. Although I couldn’t even make out everything that Lester said in English, I could tell that he was extremely passionate – he spoke a lot about giving without expecting anything in return and about being a good husband, wife, and child. The sermon was very powerful and it was incredible to see people who have so little, go up to the front and make donations to the church. This was something I also noticed during the Catholic service I attended in Guatemala – the people were extremely willing to give.

At one point, some of the children who had run with me earlier in the morning got up to get water from one of the spigots and I felt bad for not giving them water when they had asked before. I will have to be sure to check with Mr. Rogers about the ‘policy’ for giving out water from the CLI site.

WALKING AND PLAYING SOCCER:

Katie, Russell (two family friends of the Rogers), Sabha and I went for a walk later in the afternoon – the opposite direction from early this morning. There was a community/village literally feet from the edge of the CLI property and many of the women were sitting out. We passed by pigs and goats and several other villages. The children were always amused to see us and we eventually passed by a much larger church, at which Lester was also leading the sermon. There is no one church that is large enough to serve the entire area, so he splits them up and travels group by group. The children spotted us over a hundred yards away and broke out in a run almost immediately. They giggled and laughed as we approached and start following at a safe distance. Katie and Russell would turn around and pretend to chase after them and they would run away giggling. This group of kids had a “ball” made of a bunch of plastic bags wrapped and tied together. We played with them for awhile and then continued to the ‘pond’ further down the road. It seemed that every village or community that we passed by, a new group of children would follow us at a distance. It generally took them awhile to open up and approach us. The one thing that always got their attention, however, was the camera. As soon as Sabha and I took out our cameras they rushed over and started dancing and posing. They were still slightly more hesitant to pose with us but eventually gave in.

SPEAKING CHICHEWA:

I have made it one of my goals to learn as much of the local language, Chichewa, as possible. But, I must admit that I have been a very slow learner thus far and I seem to have the memory span of a fly when it comes to learning to languages. Sabha and I generally ask Isaac, the cook, and Lloyd, for help because they have very good English and pronounce words very slowly and deliberately for our benefit. We have also started talking a lot with a group of women who work at the site everyday. They’ve been busy teaching us the standard greetings for different times of day. As soon as we think we’ve got it down, they seem to say something different and we’ve got to start over again. The women definitely get a good laugh about it – as do Sabha and I!

It is really great chat (or try to chat) with the local people in Chichewa because I think they really appreciate the effort that we’re making – no matter how slow our progress.

 

Sabha and I spent our first week outfitting CLI’s health clinic with donated medical supplies that have come over on recent container shipments. While the construction of the clinic was complete when we were given a brief tour Wednesday afternoon, the rooms were empty except for several storerooms piled high with boxes of donated materials. After sleeping in quite a bit Wednesday morning, Sabha and I got busy organizing and inventorying the boxes.  The plan is to get the clinic prepared for inspection by the Ministry of Health in early July. Mr. Rogers informed us that the Ministry generally pays for most consumables, vaccinations, and nurses, who are hired by, trained by, and report to the organization and then reimbursed by the government.  This enables CLI and other NGOs to maintain their own standards and the nurses feel that they are employed by the organization and not the government.  Unfortunately, the Ministry went broke last year and although they have approved a budget, CLI has had to work for donations and may not be provided with the supplies promised.  Completing this inventory will be extremely important in determining what medicines, consumables, and devices are still necessary to obtain.

As of now (Friday evening) we have almost completely finished going through the boxes in the two storerooms and will continue tomorrow (here the workweek includes Saturday morning) by going through the boxes in the maternity ward storeroom. After emptying out the rooms and separating the boxes, we proceeded to reorganize the storerooms with excess items or items that we felt would not be needed in the respective examination, treatment, and laboratory rooms. We set up several metals shelves for one of the storerooms and have spoken with Jeff about getting built-in shelving in the other and shelves above the sinks in each of the treatment and examination rooms.

On Thursday we got the opportunity to speak with some of the women working at the project and practice our Chichewa (which is coming along slowly).  They had been cleaning the hospital beds and brought them up to the clinic to be placed in the rooms. The women had spent nearly the entire day scrubbing and moving the extremely heavy beds. Unfortunately we will have to wait to put them in all of the rooms because we didn’t realize at first that they were too wide for the doorways and we’ll have to get some help from the men to rotate and carry them in sideways. Next week, we hope to start stocking the individual rooms with consumables that will need to be readily accessible. Hopefully the shelving will be ready so that we can finish organizing and finally be rid of all of the boxes that have occupied the hallway of the clinic since we started working! We have also talked with Mr. Rogers about meeting with a local RN who may be able to help us hone in on exactly what we are missing and things that may be better suited for the larger regional hospitals.

The well repair men are currently out of the area, but they should be back within a week or so and Mr. Rogers has told us that we should be able to join them on several of the repairs. Once we get the opportunity to speak with a nurse or physician we will also be able to ask whether or not it might be possible to incorporate a health aspect to the repair missions. More specifically we can ask whether or not our health packs would be useful on such missions.

THE CLINIC:

Here’s a basic description of the clinic itself. The clinic has two wards – a maternity ward and a general outpatient ward. They are connected by a small courtyard area that will serve as the waiting area when it is operational. The general outpatient ward has two storerooms, a secretarial room, 3 treatment rooms, an examination room, a holding room, a laboratory, a pharmacy, a staff toilet, and a sluice room. The maternity ward as a large prenatal room (with 5 beds), 2 postnatal rooms (with one bed each), a delivery room (with 2 beds), a sluice room, several toilets (3), a storeroom, and a nurse’s station.

Hello all! Sorry these posts may be somewhat after-the-fact, but I’ll do my best to keep this blog updated whenever we can get to Lilongwe and use the internet!

ARRIVAL

After 36 hours of travel we were thrilled to arrive in the Lilongwe airport. Just before deplaning we met a woman from Seattle, who came with a group of nurses traveling to different areas training community health outreach workers. I couldn’t believe that the first person I met upon landing in Lilongwe was actually from my hometown. It was crazy to meet someone from so Seattle so far away from home. And it also made me realize that there were plenty of people who had been traveling much longer than us!

Even more amazing than meeting someone from Seattle, was the ease with which we were able to pass through passport control and customs. I had been so worried about not being able to enter the country for one reason or another or having trouble getting the health technologies through customs. We were greeted by Jason, a nice Malawian man, who held up a sign with our names and escorted us through the long passport control line.  He then helped us get our bags and proceeded to escort us through the customs line, where we met up with Jeff Rogers’ son, Jeremy.  It was a huge relief and a welcomed surprise to have such an easy time during the final leg of our journey.

After stopping briefly at the Rogers’ home in Lilongwe, we loaded up our luggage and some necessary supplies and made our way to the Child Legacy International (CLI) site about 45 minutes to an hour away.  The road that we drove along in Lilongwe reminded somewhat of the main road in Cape Coast, Ghana but seemed to have more businesses and government buildings because it is the capital city. Unfortunately I will have to make better observations if we make the drive again because I was so exhausted that I couldn’t help but fall asleep for a portion of the drive. After exiting what must have been the “city limits” we drove along a somewhat rougher road and passed through several small villages in the Msundwe area (note this could be a complete misspelling of the name). The children all waved and smiled and some of them chased after us for a bit. It reminded me somewhat of my experience in Ghana last summer. I am extremely excited for the opportunity to really get to know the people and the area to a much greater extent than was possible during the 3 short weeks I spent in Ghana.

When we arrived at the CLI site around 3 pm, I was surprised to see just how many Malawians and local people the organization employs. There were carpenters working on cabinets for the new guest kitchen, painters, plumbers, gardeners, men paving, women washing and moving dirt, men making and moving bricks, and every other sort of job you could imagine. They got us set up in one of the guest houses – with a nice closet, bathroom and beds for each of us. We then got to help out with a few things right from the start – setting up chairs and tables for the new visitor kitchen.

The entire project is run by Mr. Jeff Rogers and his wife Karen. Their two sons, Jeremy and Caleb, spend their summers helping out and working at the site as well. It is easy to see that this is very much a family affair – by which I mean, every member of the family is invested in seeing the project grow and develop. Sabha and I have felt nothing but welcome in the few short hours that we’ve been in Malawi.