MAY 2006 - I WAS REALLY LOOKING FORWARD TO MY EXPERIENCE IN MALAWI AND TO SEE FOR MYSELF THE PROBLEMS, BUT AWARE THAT I WAS GOING TO BE A VISITOR IN A VERY PRIVATE ENVIRONMENT.
Bottom Hospital is a government run hospital for the very poor which is the social status for the majority of the population in Malawi delivering around 11,500 women per year which is almost double the number who deliver in Simpson's.
When first walking into Bottom Hospital you are aware of the horrendous smell. I can't really describe it, I have never smelt anything like it before and I have smelt some smells. The grounds around the building have pregnant women, children and guardians (these are the women who come with the expectant mother and help her during the early stages of labour and post delivery) camping, cooking and lying around, waiting. The hospital has dark corridors, with women queuing to be seen standing or lying on the ground. Iain and I met with the staff who knew we were coming and we talked about what we could do while we were there for two weeks.
Iain painted the special care nursery and replaced 22 strip lights. I helped paint and assisted in labour ward. That was an eye opener!
There is no pain relief in labour and sometimes no pethidine for post caesarean section patients. The women deliver on a bed with no sheets, pillows, towels, no hot water, nappies or sanitary products and very little if any privacy or dignity. They lie on a plastic sheet the same as our black bin bags with a piece of brightly coloured cotton material (chitenjes) on top. That is all there is to absorb body fluids, clean themselves and to dry and wrap babies. Gloves are worn permanently remembering that 40% of Malawians are H.I.V. positive.
The midwife I helped was from America and could speak a little of the language Chichewa. It was wonderful to watch her work so independently, performing kiwi extractions and just getting on with very little basic equipment. We take so much for granted here, paper towels and swabs at the ready!
I bought a fridge for the stillbirths. They were usually kept on racks in the sluice. We became quite used to seeing dead babies, often a daily occurrence.
I also bought a new kettle for the staff with the Mums Recipe money, their one had broken and it would cost two weeks wages for someone to buy.
It was great to be there and see the problems and the logistics of helping directly. We have now got contacts and with the help of email, I never thought I would be able to use a computer, we can keep in touch.