Volunteer nurse, Carol, has written a story about her time volunteering with us. Throughout her four-week placemet she covered all clinics. Read her full story.
Arriving in Malawi as a recently retired nurse volunteering with Ripple Africa I wondered, What exactly would I do?, Would I be useful?, How would I manage the language issues?
Arriving at the airport we were met by Shem Junior, Ripple Africa’s go to taxi driver, with his Dad Shem. Both speak amazing English and we learnt that in Malawi secondary education is in English and so many people speak really good English.
Dan and Kaitlin planned our induction, sadly curtailed a bit by torrential rain due to the extended rainy season, and this introduced us to the hospital and the local clinics. Everyone uses WhatsApp so we could make contact and arrange our timetable. As a primary care nurse I fairly quickly realised the inpatient wards were not for me. My skill set, and that of my fellow traveller Liz, were much better suited to the under 5s clinics, the clinics and the community projects.
Whilst at the hospital I took part in the non-communicable disease clinics. These were mainly for diabetics and patients with hypertension ( high blood pressure). There was very limited access to modern drugs and there was no access to the most basic of lab tests.
The HIV clinic was much better resourced with computerised records and rigorous follow up. Throughout my experience in Malawi I was quite shocked by the extremely liberal use of antibiotics.
Things did, as promised, just fall into place. We met Maston who runs the fruit tree project and did an amazing session with him at a local village focussing on nutrition and eating a variety of foods – the traditional Malawian diet is very heavy on Cassava. I ended up sharing videos of my greenhouse with the Chief and other locals though I’m not sure they got the concept of English cold weather! The women of the village cooked the sweet potato and tomatoes Maston had brought together with chicken and rice and gave us we lunch after the training.
Another day we did an outreach under 5s clinic which involved an eight mile round trip on foot carrying vaccines followed by a visit to the villages hot springs. There is no electricity up there and it’s a four mile walk to the nearest medical care.
We also spent some time with the sexual health team, Watson and Rebecca. We had some amazing discussions with the ladies (and one chap) in their local women’s group and devised a couple of games to aid learning. One involved demonstrating how to protect yourself against HPV and HIV. This was done using an umbrella to represent a condom and a bottle of water labelled with a brightly coloured virus. Hopefully it was a fun and visual way to get the point across.
We had been able to get a box of condoms from the hospital pharmacy and Watson and Rebecca distributed them. The chap who had volunteered to help with our demonstration got an extra supply.
Liz and I were constantly struck by how well meaning acts could backfire. An example of this is condoms. Rather than use them for their intended purpose, they often were blown up to use as makeshift footballs. Mosquito nets, vital for reducing malaria spread, were used as fishing nets. The very narrow mesh caught baby fish as well as adult fish thereby depleting future supplies.
As a medical volunteer we didn’t get to see the fish projects but you pick up on the Ripple Africa projects over dinner particularly as lots of the UK team were out with us.
The other amazing work we were fortunate enough to help with was the disability project. Ripple Africa employs a full time physio, Loveness, who has 180 children on her books. As nurses we went to children with pressure sores to dress their wounds.
We met Innocent, a four-year-old with spina bifida – there is no preventative folic acid in Malawi. He had nasty pressure sores on his bottom and on the top of his foot. We dressed his wounds but more importantly, through Loveness, discussed the need to keep pressure off the broken areas, the importance of protein (lots of people keep chickens), and vitamin C in wound healing. Later Liz and I spent a morning making a cushion for Innocent. When we took it back the next week they were delighted – his wounds had also improved a little. Annis (the wife of Laurence the Ripple Africa driver) helped by sewing the cushion covers.
The more we spoke with the Ripple Africa team the more we realised that the problems are huge and as a short term volunteer all we could hope to do was to help the person in front of you. Phillip was another child under Loveness’ care. He was learning to walk with the help of parallel bars attached to a tree. The bars had been set up a bit high for him so we all pitched in to move them. The six nails were careful straightened and reused. There were no replacements.
Throughout our medical volunteering placement the recurring themes were What is the least worst option? and Just help the person in front of you. This was personally rewarding and needed creativity and resilience but we also came away with some bigger thoughts.
Why is there no renal function testing at Chintheche? There’s a courier that goes to Nkhata Bay Hospital daily who could transport the vials to test. Why isn’t soap funded for the hospitals? And probably the biggest of all, why is there very little anti-microbial stewardship. This is work for the future…
Ripple Africa provided me with just the right amount of support. Going back to Mwaya beach at the end of each day, I really appreciated the relative luxury! I’m enormously proud of the small wins and of the relationships I made in my month with Ripple Africa. We also saw some amazing scenery and animals!
If you want to find out more about volunteering with Ripple Africa, click here.