Water and Soap

I felt like Dr. Snow – the British physician who pushed for removal of the handle from an offendingwater pump in London in order to stem the course of the 1854 Cholera outbreak.Except I was lugging metal stands and pails of water to thirteen different points on Nkhoma’s hospital campus in an attempt to prevent the invasion and spread of coronavirus.Ironically enough, these pails were originally designated for use in Malawi’s cholera outbreaks over the last two decades, but fortunately they had been released by management to assist our efforts now.And I wasn’t alone. Half a dozen groundskeepers and maintenance workers at the hospital helped carry the stands, distribute buckets, and fill them with water.But getting buy-in from each hospital ward, equipping the gate guards, and setting up a system for maintaining each station was an all-day process. I suppose it was good that I already turned over all my other responsibilities for these weeks since I expected to be traveling and at a conference.With flights canceled and borders on lockdown, I was free to work internally focusing on disaster preparedness.And that was good. Because our entire 250-bed hospital had only 12 bars of soap left.The pharmacist had plans to make hand sanitizer, and the senior administrative officer had an order of soap on the way, but a few days without soap in the meantime could be disastrous in terms of infection prevention.Then I realized that the money donated by our last group of medical student volunteers – the ones who left less than a week after arriving due to pandemic concerns – was exactly the amount needed to equip the hospital with the needed amounts of soap for a month.Praise God.After arranging for that procurement, we received news of additional funding opening up.I worked with the projects coordinator and the rest of our committee to put together a grant outline which would provide for the supplies, soap, and extra staffing needed to increase our capacity for the next 3 months.I wonder how different the world, and the public health scene here will look after that time.It will be cold season by then, and the potential for devastation is grim.We pray that the virus will not hit us hard, but we still prepare as best we can.

Bracing Ourselves

There’s no Coronavirus in Malawi - at least not today. That might change by tomorrow. Or later tonight. We pray that it will not come at all, but we know that is asking for a miracle. With only a handful of ventilators and a few dozen oxygen machines for millions of people, it would hit us hard. Our communities are already struggling from malnutrition, from parasites, and from viruses that compromise immune systems. And our healthcare providers were few to begin with – less than one doctor for tens of thousands of individuals. So we pray for this global pandemic to miraculously pass us by. And we prepare. Last week my teammates looked at me strangely when I didn’t want to shake their hands or when I begged sniffling nursing students to return home. The hospital wasn’t ready for a talk on Coronavirus this time last week. Now we have a Disaster Preparedness Committee with dozens of action points for moving forward. The pharmacist has plans to make our own hand sanitizers and put them on every ward. Our Environmental Health Officer is formulating a plan to educate our staff and surrounding community members. Nurses compromised with logistics personnel to determine oversight for handwashing stations at every hospital entrance and triage staff just inside. Our charge nurse, faithful and organized, will make sure that everyone does their designated tasks in a timely manner. We don’t have a room to isolate patients. We don’t have a ventilator. We don’t even have medications to treat severe complications. But we have a bit of time to prepare, and we’re working together efficiently, which is impressive considering all the other things on each of my teammates’ plates. We still pray that we will be spared. I think about the church I attend here, and how optimistic outcomes from an outbreak could mean a dozen members of our Sunday congregation dead. I praise God that we can do something while there is still time. We have no idea what the future will hold for us, but at least we can say that we tried to do our best to contain this.

As we hear stories from friends and family on the other side of the world, we are laying prayers before God for you often. Please join us in prayers:

- For those who are isolated and lonely due to quarantine measures around the world

- That Coronavirus will not cause death or destruction in Malawi

- That Greg and I can travel just enough to keep our visas valid and get back to Nkhoma safely

- That I have energy and balance to keep serving until other missionaries come and join me

Thank you for your prayers and support, Greg and Christina

Alinafe

When the rain came today I was so excited. It had been seven days since the last rain, a sign that wet season was waning. The maize already climbs above my head, ensuring a good harvest either way, but as someone who grew up in the desert, I already missed the daily rains. About fifty meters down the dirt road toward the village, however, that joy at a nice rain turned into a bit of dread. We cautiously followed the minibus ahead of us, taking note where it hit the puddles deepest. The uncomfortable slipping and gliding sideways and backwards on the road introduced just enough discomfort to quicken our prayers. Then came the turn-off in the road. We watched the minibus ahead of us stall in the mud and we didn’t even try. We parked just off the main road, asked a local to watch our car, and began the final trek to the village on foot. I have worn brown shoes all season, but today that wasn’t enough. The mud, a sticky clay, caked to our feet layer after layer. It was good resistance training, but no fun in my long skirt. Halfway there and half of us gave, took off our shoes, and simply waded through the mud and water. We arrived at the village with mud stuck thick from soles to ankles, even squishing up between our toes. We rinsed off at the house of the pastor’s wife when we arrived, not an easy task.

But we barely touched the threshold, barely contemplated putting back on those shoes, when we were up again, going to see the village demonstration garden. The elders in this village had trouble getting food, especially in the season between planting and harvest. In the past, they begged food from other villagers, and most of the community simply waited for them to die. Now, they led their community with year-around vegetable gardens, which not only provided nutritious food right outside the houses, but also provided a source of income when there was excess. They didn’t have a watering can so they carried borehole water in a bucket and sprinkled it on the plants by the bowlful in dry season. They also layered straw under the vegetable plants to retain moisture. We made our way to the front of the village and sat down. The slightly drier mud on my bare feet matched the feet of five dozen elderly women who came out to greet us. There were ninety-five in this village group, starting at 65 and going up to 92, working together for health and hope. Each of them planted a new tree this season, and they gathered up the plastic litter from around the village and brought it to us in big bags to show us. They could use the bags of rubbish as seats or mattresses in the future to help ease their aches, and the plastics wouldn’t leach into the environment. They stood up and clapped out a song. “Your grandma prays, why don’t you?” They chanted. Elders in this community now had a place of honor. They help support themselves and started to teach the younger generation. They used fabric and yarn and old maize bags to create crafts to teach children their alphabet. They care for goats donated to the community, and whenever one gives offspring, they pass it on to another member of the group. The added protein from the milk helps both young and old alike. As we began the program, the chief preached a sermon from Matthew 5. “Some people think chiefs don’t pray” he said, and then proceded to talk about the salt of the earth. How appropriate for this program where we will be giving a bit of maize to each elder community member, and a bit of salt, something they can’t produce locally for themselves, but “useful for making everything tasty” as the chief said. He went on to talk about a city on a hill, which cannot be hidden, and I wondered whether this village would serve as a beacon of light and hope for others.

Hunger season was difficult this year, especially in this village. “But we didn’t go to beg” the group chairperson said. Gifts of maize flour distributed at critical times this season preserved strength and life, it was acknowledged. Today a bit over 100 kg of maize was given as well as an extra goat and about $30 cash which could be a transformative amount for some of these projects, equal to a month’s wages for a young healthy person. But the bigger intervention could be found in the organization and empowerment of these grandmas. These elder people who were considered a drain on society now have programs and projects of their own. They plant trees their grandchildren will enjoy and teach them how to keep their village clean, how to cultivate gardens year-around. It’s a new beginning, a young group of older people. They are still learning to do for themselves things that outsiders used to provide. But it is such a blessing to see. When Jesus said that loving widows was a sign of his followers, I wonder if he pictured thriving communities like this? What a better way to give, rather than handing out little bits at a time to beggars at the door? To build capacity and sustainability and dignity within communities. I can’t help thinking how much stronger this village will be now that their elders are standing in their proper place of influence.

We begin the trek back to the car. It is astounding how the mud from hours ago is already converted to soil and sand. Most of it at least. But there is still enough to cake my feet as I walk. I’m surrounded by beautiful mountains, so different from our Nkhoma peak even though it is just a couple miles down the road. It’s a nice perspective, a fresh hope. I think about how Greg and I can begin to partner with this community, and others like it. Maybe I can help with community health, maybe Greg can bring some teachings. The program is appropriately named Alinafe Communities of Hope – it means God with us. And today we saw just a beginning of that hope. We pray that we’ll be up to the task to trudge through the difficulty, so that we can be part of lasting change instead of quick drive-by fixes.