Tuesday, August 12, 2008

Rocky Road to Dambe

Just back from three hours on bumpy, dusty roads into the hills right on the border with Mozambique. What a blast and am I ever glad I don’t have to do that every day! We packed into the back of an ambulance with Matilda Nyambo and her team from Neno District Hospital and climbed up a rocky, dusty road to the hillside village of Chilimbonde in the Dambe Traditional Authority. (More on Neno and the Ministry of Health's partnership with two international organizations in a future post.)

We followed the ridge most of the way and so had a good view of Mozambique to one side of the vehicle and Malawi to the other. In fact, because the road forms the border for part of the way, I was riding in Malawi on the way out and came back through Mozambique!

Seems every nurse who goes on a mobile clinic is part actress—and Matilda is no exception. I enjoyed watching her engage the group of 100-plus women and children and listen to them laugh at some of her pantomines.

Of course every good act needs an opener; there was singing and a lecture on the use of bed nets to prevent the transmission of malaria. Because the bednets are donated they can only be given to mothers with children under the age of a year. And yet, everyone seems to want them.

And so another odd complication. When the bednets were for sale, anyone could buy them but no one could afford them. Now that they’re free, they are limited to pregnant women and mothers with children under the age of one.

(For a while they were given to pregnant women and those with children under the age of five—the highest risk groups—but everywhere I’ve been in Malawi, I’m told the target now is pregnant women and kids under the age of one.)

But a number of people on the ground are trying to get bed nets for everyone--including adults with HIV, who seem particularly vulnerable to malaria.

NB: In the original version of this post, I said we had traveled to the village of Dambe. I learned afterwards that we traveled to Chilimbondo, which is in the Dambe Traditional Authority. We did not go to the village of Dambe, which is the chief's headquarters.


Anonymous said...

Hi Christine, I came across your blog at random and am thrilled and intrigued to read it! I thought I'd mention that our organization, VillageReach, is working to start up a pharmacy assistant training program with the Malawi College of Health Sciences. It will provide a cohort of 100 students with a 24-month program including significant field rotations in rural health centers. Pharmacy assistants in rural health centers will, in theory, allow the regular health workers to focus on patient care, while the PA focuses on drug distribution, maintaining the medical stores, and other back-end functions. www.villagereach.org for additional details. I hope this isn't seen as an advertisement; the goal is to share what else is going on that could potentially impact the nurses in Malawi. The program is modeled after a Clinton Foundation program to train lab assistants for medical work.

Christine Gorman said...

Have found lots of plans everywhere I have gone. The trick, as always and everywhere, is implementation. Good luck.

Anonymous said...

It may well be a Rocky Road to Dambe but looking at the photo - it looks so worth while