Drug Shortages in Malawi Continue

Two months ago, the government of Malawi assured citizens that drug availability in hospitals was becoming normalized. This assurance however, was false hope. Studies are revealing that only 15 percent of essential drugs have been produced. In May, Catherine Gotani Hara, the country’s Minister of Health addressed reporters saying that the drug shortage was normalizing following the delivery of 80 percent of medicine and pharmaceuticals produced by the Central Medical Stores Trust (CMST). However, recent information from the CMST indicates that the company has only managed to produce 15 percent of the essential drugs. (Nyasa Times)

Six months prior, CMST released information stating Malawi was running dangerously low on essential drug and medical supplies with a 95 percent stock-out. The stock-out is now currently around 80 percent and the country awaits drugs that are being shipped in from countries such as Mozambique. When asked why the drugs were taking so long to arrive, CMST Executive Director Fred Mzoma blamed the delay on logistical hiccups in the shipment process. (Nyasa Times)

The serious essential drug shortage is affecting hospitals throughout the country. Doctors at Kamuzu Central Hospital (KCH) in Lilongwe sent a letter to President Joyce Banda asking her to help stop public hospitals from becoming "waiting rooms for death". At KCH, along with many other public hospitals, patients are being turned away and told to find treatment at private health facilities. The Health Ministries Principal Secretary, Charles Mwansambo, blamed the shortage on drug theft from warehouses by medical workers. However the Ministry is now assuring that there will be no more cases of drug theft because all remaining loopholes have been sealed.

In related news, President Joyce Banda has said her administration is making a point that health facilities with adequate standards will be available to all in Malawi at reasonable distances. Banda recognizes that the measure of a country’s development is based on the health of the people. President Banda spoke at a development rally after laying the foundation stone for the construction of Luvwere Health Center in Mzimbia West constituency. She said a country can’t develop without proper health facilities. (Nyasa Times)

Banda included in her speech that health facilities not only had to be close by, but also equipped with adequate resources. The Luvwere Health Center is among the first Health Centers of its kind being built under the standards and supervision of President Banda. This new health facility will address problems currently facing people in surrounding areas.

During her administration alone, President Banda plans to make sure at least 15 new health centers are constructed throughout the country.

Alum Alex Carstensen uses Chichewa to study linguistics

We love to feature blog posts that highlight former volunteers' ongoing work in development and Malawi.

Alex Carstensen, a 2009 volunteer, is studying psychology at the University of California, Berkeley, with a focus on linguistics and cognition. Much of her research has included Chichewa speakers and the structure of the Chewa language, so we thought it would be great to share more with you about what she's up to! Some of the material is a little complex - but we've tried to break it down for the layperson (WC staff included!). It's really intriguing if you have even a bit of interest in the relationship between language and thought.

In a nutshell, Alex is looking into whether language shapes the way we think about space. Different languages vary in the amount of detail involved in spacial descriptions. Some languages are closer to
each other in this area while others are quite different. Do these words people use to explain space (say,
"over" or "on") shape the way we perceive the world? To some extent, yes, but Alex's research suggests that speakers of different languages may still think similarly, even when they talk about the world in different ways.

Alex sent World Camp the following abstract of some research she will be presenting this summer:

"Languages partition the world in different ways — for example, the categories named by spatial terms
vary substantially across languages. Yet beneath this linguistic variation there may lie universal
cognitive tendencies. Khetarpal et al. (2010) found that speakers of Dutch and English, despite
differences in their linguistic spatial systems, sorted spatial scenes similarly — and more like
the finer-grained language, Dutch. We asked whether this preference for fine-grained sorting extends
to two new languages: Máíhɨki, a language of Peruvian Amazonia, with a fine-grained spatial system,
and Chichewa, a Bantu language of southeast Africa, with a coarse-grained spatial system. Despite the
great range in spatial naming represented across these languages — both in the granularity and the shape
of their spatial categories — we found that speakers of all four languages sorted finely, and thus
similarly to the finer-grained languages, Máíhɨki and Dutch. These results suggest that spatial

cognition, unlike spatial language, is universally fine-grained."

Let's unpack that a bit!

Languages use different prepositions to explain the location of something. Perhaps in English we say
"around the neck" and "in a fishbowl" while a Chichewa speaker uses the same word for both locations.
In this case, English is the more "fine-grained" language because it's describes differences in location
more thoroughly.

When subjects were asked to group objects without using words, they grouped them in ways that were closer to the classifications of the finer-grained languages in the study. In fact, their non-verbal
classifications were even more fine-grained than any of the languages. This was true of subjects across languages.

This observation has led Alex and some of her fellow researchers toward the hypothesis that people think
about space with similar "granularity" regardless of the detail conveyed in their language.

Isn't that cool? And don't you feel a little bit smarter for working through those ideas? I think we
often wonder if people see the world in the same way that we do. This is some evidence that we might all be seeing the world in a similar way - at least spatially!

Baker's Back! World Camp is Planning a Medical Mission Trip for 2014

It has been almost two years since I last saw Malawi. Having been accustomed to visiting "the warm heart of Africa" two to three times a year prior to starting my surgical residency, it was quite shocking to see how many changes have occurred in this small - land locked country. The streets are busy with tiny  import vehicles, such as a Japanese version of a Ford Fiesta, only  in this case filled with 6-8 Africans. Several large new buildings have arisen, most with empty stores. I was discouraged to find that over the past several months the kwacha (Malawian currency) has lost what little value it had two years ago. However, just as usual, the people are as friendly and optimistic as I remember in spite of the discouraging state of their nation; this is a country that continues to live up to its nickname.

This trip to Malawi is a short but important one for me. During the summer of 2014, we plan on running what will be the first of hopefully many medical/surgical missions with US based doctors, nurses and other volunteers here in Malawi. According to the medical council of Malawi (I myself have counted,) there are 37 practicing surgeons total, either foreign or domestic, in Malawi; consider this number in the context of a population of 16 million! One of my goals on this visit is to establish a new project for World Camp. I have just visited several rural hospitals with semi-functioning operating rooms that have no surgeon...or any physician for that matter! The fact is that everyday, an untold number of Malawians needlessly die because they do not have access to the most basic medical care. Wouldn't it be exciting if we could fill a small part of this void?  

Please follow our journey, support our cause, volunteer, and help Malawians get the medical care they need and deserve. I believe that if the first World  can consider access to healthcare a basic right, so should the citizens of Malawi. I thank you in advance for your support.

Women and Girls' Empowerment and Education

In the beginning of 2013, President Joyce Banda challenged professional women in Malawi to mentor young girls and women in leadership. This empowering partnership was intended to encourage women to seek roles in leadership throughout their lives. President Banda claims that women are not truly leaders if they are not mentoring, inspiring, and preparing other women for the responsibilities that follow leadership. She hopes that women in leadership positions will move into the future together and ensure opportunities for women.

Following this request, the United Nations published findings that add weight to this desire to afford women space to effectively participate in society and to have leadership within their communities. According to the 2013 Human Development Report compiled by the United Nations Development Programme, Malawi ranks 124^th in gender inequality, an index based on three main factors: reproductive health, empowerment, and labor force. To break down some of these figures, women in Malawi comprise 22.3 percent of seats in their Parliament and the percentage of women with secondary education is 10.4 percent, while the percentage of males with secondary education is almost double that of women, at 20.4 percent.

Despite these statistics, it seems as though the women of Karonga, in the northern region of Malawi, have taken Banda’s plea to heart and are working to create a safer environment for girls and women. The lobbyist group Karonga Women’s Forum launched a campaign to promote the end of violence against women that has plagued the lakeshore district. Joyce Nyondo, the Forum’s Coordinator, says the organization wants to empower women to break the culture of silence, understand their rights, and uplift their social status within society in the process.

This campaign in Karonga specifically urges women to report all cases of abuse to authorities and other rights oriented institutions. Nyondo explains that, “violence does not only affect women but also the social-economic development of their own households and that of the country as a whole.”(Nyasa Times)

The Karonga District has also received praised for another initiative that encourages female enrollment within school systems. The Forum for African Women Educationalist in Malawi’s (FAWEMA) initiative is known as Gender Responsive Pedagogy. This initiative was created in 2009 to promote gender equity and more specifically, equality in school system by promoting related legislation and opportunities for girls to thrive within the educational sector.

Since the start of this project, education and government officials alike, have noticed the increase in female enrollment and their success rates in school have been significantly improving. Classes are registering more girls that boys and in the past year, and girls have filled the top five spots for Standard Eight students within the district.

In response to this initiative, women groups have been created in Karonga to sensitize the community to the benefits of educating girls and while there had been some initial resistance, members of these communities have begun to embrace the importance of educating girls as well as boys. In fact, 75 percent of night students in Karonga are married women who have felt empowered to education themselves.(Nyasa Times)

Education in Malawi Today

There has been a lot in the Malawian news this week about education. Check out our roundup here of some of the most pressing issues in Malawian education!

Curtailing inappropriate relationships between teachers and students

Malawi’s government has sought to take a harsher stance on inappropriate relationships between male teachers and their students. This push came as a result of a recent case from January where a primary school teacher impregnated a fourteen year-old student.

Osborne Kamisi, Rumphi District Education Manager (DEM), expressed the problematic nature of these relationships and the results of teachers taking advantage of students, often leading girls to “shunning [their] classes.” The DEM believes teachers are expected to take on a parental role with these students and instead are creating a feeling of insecurity and threatening the learning environment.

Currently, the teacher from the January incident is suspended from teaching and will most likely be removed from teaching in the school system.

British Development Department to donate funds to Keep Girls In School 

While Malawi’s government is pursuing ways to create safer environments for girls in Education, the British Department for International Development (DfID) is preparing to launch a new program to assist girls in Malawi and around the world to complete primary and secondary education. The Keep Girls in School (KGIS) program seeks to address many factors that thwart female matriculation up through secondary programs including dropout rates, early pregnancy and marriage, violence, and lack of sanitary facilities for girls.

The head of DfID Malawi, Sarah Sanyahumbi, is excited at the development assistance and potential for Malawi under this program. Currently one in four girls completes primary school and two in five participate in secondary programs. This program in Malawi is worth MK22.5 billion (over 50 million USD), the biggest single investment in female education to date.

Malawian curriculum criticized by religious groups 

While the DfID program is aimed at improving female education in Malawi, it also addresses several issues raised a few ago earlier when a slew of church-based NGOs publicized a joint complaint. Their concern is that Malawi’s education curriculum is not sufficient in addressing the needs of Malawians today because it lacks needed education of survival and entrepreneurial skills. 

The Catholic Commission for Justice and Peace held an open debate entitled, “Is Malawi’s Education System Doing Enough to Shape the Future.” Significant concern was raised over the need to mirror the aspirations of Malawi within the curriculum and ensure the curriculum addresses related skills and knowledge.

Many organizations in the debate agreed that more consideration towards the needs of the country must to be included in the curriculum and also urged the government to allow more participation in creating educational standards, because the current standards demanded of school systems keep teachers “pinned to the desk and not teaching.” 

 

The Catholic Education Commission National Secretary, Cleopas Mastara, is quoted in an article by Nyasa Times saying that the involvement of communities in the education system can have a profound influence in addressing tardiness, dropout rates, fundraising, and early pregnancy and marriage.

 Ministry of Education botches school calendar, shortens Easter Break by two weeks  

An example of how this lack of communication between schools and Malawi people can create negative outcomes, is the recent announcement that school holidays are going to be shortened by two weeks. The announcement was made within a month of the change being implemented nationwide. Not only did many people express their anger towards these changes, but many also expressed concern on the pressure it puts on their resources and budgeting.

During a debate hosted by Zodiak Broadcasting Station, one opponent felt this change not only put pressure on teachers and their curriculum, but also affects the families and students, and shows a lack of seriousness by the government in creating a meaningful education system.

These sentiments were echoed by others in protest, including James Mhone, a parent of three from Lilongwe saying:

“I have three children in boarding school in Kasungu, Salima and Mzuzu. Imagine now I have to look for money to take care of their school needs when I had already planned my small salary on other issues that would make me raise enough money for the same should the schools have opened as were indicated earlier. This is outrageous and the ministry has not thought about our plight as parents and guardians.”

These changes have been implemented to all schools, public and private, in Malawi to create more uniformity within the system.