Place of little hope with Amref Health Africa hand

by Amref Health Africa

By Chachacha Munthali, Malawi

The sun is staring down unforgivingly. The Department of Climate Change and Meteorological Services had forecast minimum temperatures of 18 degrees Celsius and a maximum of 36 Celsius for Ngabu, Chikwawa. About 20km away at Nchalo, it feels like 100 degrees Celsius, yet it is only 11am.

We are on a mission, this stuffy and unbearable Wednesday, to Mgwinya Island about 10km south east of Nchalo.

We branch off the main road and traverse through Nchalo Sugar Estate to emerge on the other side of thevast fields of sugarcane. We cross a stream and pass by a village called Ndirande. It shares a lot in common with its namesake in Blantyre. It bears the same scene of chaotic beauty, decay and poverty despite the riches within reach across the stream.

We chug down the rugged road, past cheery faces of children who wave at us oblivious to the chastising heat of the sun. Goats and chickens scamper at our approach. We rumble past some grass thatched houses and iron-roofed houses, some of which were reduced to a heap by Cyclone Idai in March. Order and destruction co-exist here.

We pass some fields and emerge by the bank of the Shire River. The river is flowing serenely and only the shifting position of twigs as they sail downstream suggests movement.

Five canoes are moored to a metal pole and gently nudge each other as the water laps against them. Close by, two donkeys are browsing with the contentment one can only find in abundance.

Some distance away, scores of bicycles are parked in an upended fashion. The owners, I learn, have crossed over to the other side of the Shire River where they have gardens.

There is bustle of activity on the other side of the river as three canoes are scrambled to take us across to Mgwinya Island in the area of Traditional Authority (T/A) Makhuwira.

We are on a medical mission and as soon as the canoes beach, a multitude of hands help us to load various medical supplies into the canoes and soon we start our journey across the river.

The three oarsmen paddle up stream with the graceful patience of people attuned to this sort of work. Slowly and gently we get to the other side of the river bank, on the island.

The medical supplies are offloaded and before long, three local women with children strapped onto their backs welcome us and help carry the supplies from the dock.

Such has been the routine every week for the past three months for officers from Chikwawa District Health Office and Amref Health Africa.

A German organisation, Sternstundene.V., has been funding Chikwawa DHO, through Amref, to carry out outreach clinics in three areas that were ravaged by Cyclone Idai in March 2019.

The outreach clinics take place on Jombo Village in the T/A Ngabuon Tuesdays, Mafale 2 in T/ALunduon Thursdays and Mgwinya Island on Wednesdays.

Darkson Matchado, Amref’s Emergency Response Coordinator for Chikwawa, says the outreach clinics have reduced the distance that child bearing women travel to receive family planning and antenatal services.

“They have also reduced the pressure on OPD services at Nchalo Health Centre as some are getting services in their communities,” Matchado says.

Having unloaded and picked up everything, our walk to the interior begins. Amos Watchman, the Health Surveillance Assistant (HSA) for the area, tells me the distance to the venue for the outreach clinic is about 7km. Or eight.

Travel on Mgwinya Island is not for the fainthearted. The place has no cars. I saw a few motorcycles and bicycles, but one needs to have signed up to an experience of a sore back to even countenance riding on one. The footpaths are a rugged mess of broken clay and uneven surfaces.

While I huff and puff as I try to keep up with the frenetic pace of the team (there are 13 of us), our women helpers don’t even break sweat as they dexterously balance the items on their heads.

As we walk up, Watchman recounts what happened in March when Cyclone Idai laid the island to waste. His house was destroyed, too, so he had to relocate to the ‘mainland’. Other people stayed put.

Looking around me, I cannot help but notice that the lush foliage on the island belies the cries of hunger elsewhere in the district.

A day before, I had been to Nyasa Village in T/A Ngabuin the same district where the pervasive outcry had been about hunger.

When Cyclone Idai swept across Chikwawa, many crop fields were damaged, rendering most people destitute and in need of food.In the wake of the disaster, Chikwawa DHO regularly conducts cooking demonstrations in order to improve the nutritional uptake among the people and build their resilience.

With funding from Sternstundene.V., the office has been holding cooking demonstration in communities that were laid to waste by the floods for them to prudently use commonly available crops such as sweet potatoes. Nyasa Village is one of the areas that was bereft of food crops and the cooking demonstration could not have come at a better time.

Mgwinya Island may not have such fears.It has food aplenty. Green fields of maize give way to green fields of sugarcane. Green fields of sugarcane give way to green fields of maize inter cropped with creepers. It is an endless, breath-taking carpet of green.

Here and there we passa homestead. Here and there we meet someone tending to their crops.Here and there, birds break the monotony of our weary silence as we walk along the rugged surface.

Around 1:30pm, the purring sound of a diesel maize mill rises above the excited sound of children and the contented chattering of birds as if performing a chorus of welcome. We had finally reached our destination.

We soon emerge into a cluster of houses, which I learn is roughly the centre of this island. Under a huge Indian jujube (masau) tree, hundreds of children, women and men, are waiting expectantly for us.

We have no time to waste, so the outreach clinicsstart as soon as we arrive. There are three clinics taking place simultaneously. There is an outpatients section being held under the tree. Under-five children are being attended to at another jujube. The women who had assisted us are attending this clinic as well.

The ‘maternity wing’ is out by itself behind the house fronting the huge Indian jujube tree. Pregnant women are being weighted under a tree, but consultations are taking place in an unfinished house that offers little, if anything, by way of privacy. In fact, none of the clinics here does.

As I go about capturing the scenes, I overhear one young man telling a clinician he has had stomach ache for three days. He looks weak. I doubt he would have made the distance to the dock, let alone walk for another 10km to the nearest healthy facility at St Montfort Mission Hospital or Nchalo Health Centre at Nchalo, Chikwawa.

Mgwinya Island could be a place of no hope. Its population of 10,500 people is served by two HSAs, but it has no clinic. Its only school ends at standard five and has two volunteers for teachers.

It has no borehole and no running water. People draw water from unprotected wells.It is a similar refrain in the area of Group Village Headman Mzangaya, in T/A Ngabuon the mainland, where sanitary facilities were swept away and their reliable sources of water (boreholes) were also damaged.

Mzangaya community is picking up the pieces by rebuilding their sanitary facilities, but provision of water remains a major challenge. The community uses a damaged borehole and a shallow well, which raises fears of waterborne diseases.

Amref Health Africa, with funding from Sternstundene.V., is providing chlorine to the communities in Mzangaya and on Mgwinya Island, but they need a sustainable option. The island has its own unique challenge of transporting drilling equipment.

The clinics ends at 4pm. The sun has turned the Shire River into a canvass of shimmering gold by the time we return to catch the canoe.

As we sail across the river, I am left reflecting wondering whether Mgwinya Island is a place of no hope. But there is hope, however little of it, that reflects itself in small gestures of volunteerism by people and the abundance of food on the island.

Article first published on

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