PO Box 45 Mulanje. We welcome back Mark Kalimbuka who was in Kenya for the past 2

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1 Newsletter Volume 15 issue 3 December 2014 CCAP Blantyre Synod PO Box 45 Mulanje Malawi director@mmh.mw National Bank of Malawi P.O. Box 945 Blantyre Hospital accounts: ($) ( ) ( ) SWIFT CODE: NBMAMWMW Keep up to date with all the news from MMH. MMH website is regularly updated Visit our site at Please send feedback to info@mmh.mw Editorial Comment It is Christmas time again! We would like to wish you a Merry Christmas and a successful New Year as you are reading our newsletter. Winds of change keep blowing across, staff moving out and new staff joining us, medical students from various countries come and go, patients with challenging diseases keep coming for treatment, some staff take up new responsibilities, donors and partners continue assisting us;; and we are still here and going strong. We welcome back Mark Kalimbuka who was in Kenya for the past 2 Back to MMH The journey that started in September 2012 comes to end with the successful completion of Bachelors in Clinical Medicine and Community Health. Many thanks and appreciation should go to management and its partners for successfully supporting my studies in Kenya. It was a journey that began with lots of hurdles and uncertainty yet hope and faith in the Lord made all things possible. The programme has equipped me with in-depth knowledge of almost every aspect of medicine from preventive, curative and palliative to forensics. With this vast knowledge, I am ready to serve the community with greater confidence and safety. I am also delighted to have my career nurtured to this level at and this has set another level of career Sam Matandala years furthering his studies, welcome brother to the fold. We are looking forward to great years of working with you. Still on a happy note we would like to congratulate Mrs Tabu Gonani on her new appointment as our Matron. This is a huge responsibility but we know she will perform very well because of her track record of hard work and dedication to the nursing profession. We wish her all the very best as she takes up this challenging post. We thank you all for your faithful support of MMH and look forward to seeing you again in Mark Kalimbuka ambitions. I have the hope that this next level shall be at Mulanje Mission Hospital too. I shall endeavour to maintain discipline, encourage and foster team work for the benefit of our clients and ourselves at Mulanje Mission Hospital. I know that personal career development is a very important agenda, that and her partners have fostered more than any other Christian institution in Malawi over the years. Therefore, this must be rewarded with loyalty and hard work. Last but not least, may I thank my wife, Ndaziona and our son, Roni for their support and resilience whilst I was away. Finally, PRAISE BE TO THE LORD OUR GOD AND BLESS YOU ALL.

Sunday s Child appeal, run by Edinburgh Medical Missionary Society, will support the establishment of a degree course in Palliative Care here in Blantyre.

2 Medical Director s desk Dr. Ruth Shakespeare This year Mulanje Mission has decided not to run our usual Christmas appeal. Instead we would like to encourage our friends and partners to consider making a Christmas donation for the development of palliative care services in Malawi. Sunday s Child appeal, run by Edinburgh Medical Missionary Society, will support the establishment of a degree course in Palliative Care here in Blantyre. is very much involved in this development, which will enable MMH to improve the standard of palliative care offered in Mulanje, and see MMH participating in the training of future palliative care staff for the whole country. The UK government will match every pound given to this appeal in December 2014 and January 2015, doubling the value of your donation! For more information: Sponsor a hospital bed A CHRISTMAS BLESSING God grant you the light of Christmas, which is faith;; the warmth of Christmas, which is purity;; the righteousness of Christmas, which is justice;; the belief in Christmas, which is truth;; the all of Christmas, which is Christ director@mmh.mw From all of us at Mulanje Mission, we wish you a truly happy Christmas and a peaceful and blessed New Year

3 Nursing profession essential to health care team Healthcare institutions are comprised of people from different professions.we have the pharmacists, laboratory technicians, clinicians, nurses and others. It is usually said that nursing is an autonomous profession. However, looking carefully at the nature of the hospital setting, we come to realise that there is nothing like a completely autonomous profession in health care settings. We all need each other! A nurse cannot work alone without a clinician, pharmacist, laboratory technicians or radiographer. To provide efficient care to our patients all these departments need to work together as a team. Team work is a tool for success and in a hospital setting, team work can help to save lives. It is essential therefore for nurses to recognise the role of teams in the hospital setting. Nurses should strive to initiate and maintain a good working relationship with colleagues. The question can be how important is team work in the nursing profession? Promoting teamwork and good communication among health professionals can dramatically improve healthcare delivery, resulting in much better outcomes for our patients. For team work to be possible, nurses and other health care workers need to appreciate the importance of team work and team decision. The work environment should allow mutual trust among workers and respect the fact that every health care member is important, no matter what their role is and MMH staff, volunteer doctors from the UK & medical students from South Africa & The Netherlands posing for a staff team photo in November they need to be respected as such. There should also be mutual trust, shared vision and openness to feed back. It is said that no man is smarter than all of us, meaning that we are more intelligent and perform better if we make collective decisions and work together. I therefore urge all nurses to work as part of our nursing team. Work with support staff as well as technical staff to enhance patient care. Build good working relationships and maintain professionalism in our interactions with one another and other members of the health care team. It is only when we hold hands that quality patient care can be achieved. by Tabu Gonani - Matron Remember that nurses are an important part of the health care delivery system as they spend 24 hours with the patient and team work amongst nurses can lead to proper handovers and collaborative practice. In addition nurses enjoy work more when the working environment is friendly and peaceful. Let me take this opportunity to congratulate the ART clinic team for maintaining excellence in their department. This is evidenced by the recent Ministry of Health supervision where the department scored 99%. This is a product of team work among the clinic staff. CONGRATULATIONS!!! Let me also take this opportunity to thank all companies and organisations who responded to the hospital s call for help. Paediatric ward looks very nice with the beautiful beds from Mike s Trading. Our nursery has moved a step ahead with an oxygen concentrator from Malawi Savings Bank and a radiant warmer from Telecom Networks Malawi. I would like to finish by welcoming all nurses who have just joined our nursing team. You are all very welcome and I urge you to be active players in our team. Bring in new suggestions to improve nursing care, we are ready to learn from you.

News from Mulanje Mission Youth Centre Mulanje Mission Youth Centre (MMYC) has been in existence for nine years providing comprehensive sexual and reproductive health services in a youth friendly

4 News from Mulanje Mission Youth Centre Mulanje Mission Youth Centre (MMYC) has been in existence for nine years providing comprehensive sexual and reproductive health services in a youth friendly environment regardless of gender, religion colour or disability. MMYC has been conducting life skills sessions in secondary schools and primary schools across the catchment area of the hospital supported by MMH PHC department. When designing programs for youth, it is important to understand skills that contribute to healthy development. Youth need opportunities and support from their communities to develop these important personal and social assets in order to become competent, contributing adult Wema Chilomo is aged 60 years and comes from Mwanamvula village, Tradition Authority Mkanda in Mulanje district. She has been married to Nelio Chilomo for 25 years. Wema and Nelio Chilomo have been active volunteer members of MMH for more than 13 years. Wema and Nelio come from the same village, but her husband used to spend most of his time at beer drinking places. They were housed in a dilapidated grass thatched house, and life was very hard, since the woman had responsibility for orphans left by her husband s elder brother. Wema had a big housing problem - she forced herself to live in her parents house. Despite being married, she could not continue to stay in the house which was full of cockroaches, ants and spiders and not well roofed. Wema was in dire poverty - as if she was not married. members of society. Youth do not need to possess all of the skills to thrive;; however, having more skills is better than having a few. For young men and women, growing up marks a time filled with changes and choices. They must establish relationships with peers of the same and opposite sex and maintain loving relationships with their family members while becoming independent. Young people must also learn to manage their developing sexuality, both physical and emotional, as they prepare to make their own decisions about reproduction and parenthood, as well as dealing with their challenges. Life Skills is one such programme. It focuses on three of the most important tasks young people face: dealing Livestock beneficiary pass-on project In 2008 MMH, in collaboration with small scale livestock promotion (S.S.L.P) project, introduced a pass on project to beneficiaries working on the food security program, Wema was identified to be the first beneficiary to receive dairy goats as well as materials to construct a livestock kraal.. She was very excited to be among the beneficiaries and during the training on livestock management she tried her best to attend all the lessons and later on constructed a good livestock kraal together with other beneficiaries. After a year Wema managed to pass the goat offspring to another beneficiary as agreed in the project proposal and after six years, she has sold six male goats at a price of MK 150,000 equivalent of USD1000 in She used the money to build her house. by Wise Ndawa Some of the youths who underwent life skills training. with day to day life situations and challenges, dealing with their sexual and reproductive development, and preparing for the world of employment. During life skills in schools 2,445 youths were reached: 1222 boys and 1,225 girls. The most challenging situation right now is the drop out of some of the youth peer educators;; many of them have graduated from youth work. by Felix Mkwate Later on her husband was sick for a month due to alcohol and when he was discharged from hospital he stopped his bad practice of excessive beer drinking. He assisted Wema to build a house, and she was able to procure all building materials required for the house and it was built. The family is also using livestock droppings as manure instead of applying fertilizer. Wema did not hide her happiness when asked how the house has changed her life. She has moved from her parent s house and lives in her own house roofed with new iron sheets. The family is happy, because they have managed to pay back agreed off spring to other beneficiaries and they have managed to build their own house.

MMH Food Security Programme Many in Malawi are facing food shortage with a high percentage of households having very limited access to food for considerable periods of the year, particularly the

5 MMH Food Security Programme Many in Malawi are facing food shortage with a high percentage of households having very limited access to food for considerable periods of the year, particularly the months prior to harvest, September to April. Smallholder farming is based on customary land which is primarily subsistence and provides 85% of domestic food production. The chronic food deficit and the current exacerbated food crisis in Malawi results from many constraints faced by small scale farmers. Most of these have been well documented in the past, but have not yet been solved, like land tenure and access to land, limited access to agricultural extension messages, limited access to loans, poor rural feeder roads, inadequate market infrastructure and market intelligence, poor pricing of farm produce, high price of farm inputs, over dependence on rain to grow crops, labour availability, adverse legislation on the production and marketing of some crops, environmental degradation and others. Knowing the impact that sufficient and balanced diet can have on children s development and health as well as on sick people s ability to cope with their disease, MMH supports home gardening projects aiming at linking food security, nutrition and health. Currently, the food security project has assisted 6,500 families through agriculture kits like water canes, different varieties of vegetable seeds, hoes, treadle pumps and fertilizer. After the CHAM supported project phased out in April 2006, Blacksburg Presbyterian Church took over the project at MMH. Participants learning new skills The aim of the project is to reduce and treat malnutrition in our catchment area by focusing on sustainable food security activities at community level and the goal is to develop sustainable activities that will enable members of the community to improve their livelihoods. The project has three main objectives: to improve the general health and nutrition status of orphans, PLWAs and the community within the catchment area, promote self-reliance among members in the catchment area and enhance household food security. The project targets guardians of children admitted at N.R.U, orphans and vulnerable children and their guardians, People living with HIV/Aids (PLWA) and Volunteers. We identify beneficiaries through the nutrition rehabilitation unit and orphan care training center, Outreach clinics, PLWA and PMTCT clinics and Chiefs in liaison with volunteers. There are so many achievements that have been realized in this project: establishment of a model functional vegetable garden and orchard at N.R.U and 10 community gardens. 80% of people who received training on food security by Tikondwe Katumbi and Felix Mkwate have started or improved their vegetable gardens. 60% of the trained families are implementing one or more food storage and preservation techniques. The number of trained families who are making compost manure has increased by 50%. The number of children readmitted at the N.R.Us has dropped tremendously during the lean period of January to April Other benefits include 9 support groups who have received 22 pigs, 40 volunteers who received 40 dairy goats and one traditional birth attendant who received a dairy cow. A fish pond was constructed at Tambala village and beneficiaries are able to use the pond in different ways apart from fishing e.g. domestic use, and irrigation of their crops. Four students had school fees at Chambe Day Secondary school paid. Four beneficiaries from Mwanamvula and Misanjo have built houses roofed with new iron sheets and two beneficiaries from Mponda and Demula village have managed to buy bicycles after selling their male dairy goats. We would like to thank the entire staff of - without their support things would not have worked out the way they have. We would also like to thank CHAM, Dan Church Aid and F.A.O for initial support to the project, as well as Blacksburg Presbyterian Church, EMMS, PWSD and other donors for current support.

Rapid care Analysis. Toolbox of exercise - Texting in Bangladesh. Oxfam Bangladesh. Oxfam Bangladesh. Oxfam Bangladesh

Rapid care Analysis. Toolbox of exercise - Texting in Bangladesh. Oxfam Bangladesh. Oxfam Bangladesh. Oxfam Bangladesh Rapid care Analysis Toolbox of exercise - Texting in Bangladesh Oxfam Bangladesh Oxfam Bangladesh Oxfam Bangladesh Women in Bangladesh work on average 16 hours a day are involved in various unpaid housework.