Spring 2017 Trip Report

This year we traveled to Malawi from April 8-April 23, 2017.  Our group totaled 16 at maximum and consisted of doctors Brian Lisse; Don Hangen; and Sanjay Ram (an infectious disease specialist new to BTM this year); Trina Carroll, RN; Jen Hardy (IT teacher at Worcester Technical High School and point person in charge of laptop/tablet donation to Malawi secondary schools); Naomi Lisse (chemical engineer and Jen Hardy’s educating sidekick);  Ellie von Wellsheim  and Phoebe Nabwami (our Mooncatcher Project experts); and high school students Hallie Hangen , Helen Crosby, Melissa Buck, Kaitlyn Libby, Samantha Cirillo, Samantha McLaughlin, Megan Haberle, and Kelsea Blair.

What a fantastic trip!  With the exception of our waterwheel project, still in its infancy, I can gladly report that all of our projects have been extremely successful.  And we’re only just getting started!

The first and most wonderful thing about the trip was what a marvelous group of excited, energetic, and enthusiastic high school students we had this year. All women!  All team players!  All indefatigable! Bridges to Malawi began as a combination medical mission trip/high school and medical student experience and each year I’m struck by how powerfully rewarding it is to see some of our future leaders, the ones who are going to help solve the world’s problems, cutting their teeth on global health and international development while working with us in the Mtunthama area  and know that we are a small part of the change they will someday bring to a suffering humanity.  You can’t top this as one of the world’s best experiences; it should be on everyone’s bucket list.

The next wonderful (sorry about all the superlatives, but what can I say?) trip aspect I experienced this year was that Malawi wasn’t brown and withered, it was verdant!  I started going to Malawi in 2012 seeing everything through the eyes of the doctor I am, but now, after 2 years of devastating drought and consequent famine, on this trip I felt more like a farmer, marveling in delight at how tall and healthy the maize (corn) was this year.  Know what that means?  Healthier people and that means less disease! 

Oh yes, there were still lots of people in the hospital both at St. Andrews and Kasungu District, but we saw only a few children with kwashiorkor or marasmus  (protein and carbohydrate malnutrition respectively) this year, unlike the last two.  As usual, we saw far too many children with malaria, some of whom tragically died from it, but what was different was  that none of these cases came from the 9 villages (25,000 people) currently being protected by the Rotary IRS (Indoor Residual Spraying) grant (with the exception of a few households that had refused IRS).  We, as usual, participated in rural outreach clinics in two different villages, both non-IRS, and found malaria rates of 52% and 61% respectively.  Unfortunately, these are typical numbers in this area without IRS.

As part of our time in the hospital, our students got to help as we, working with our Malawian colleagues, treated patients with pneumonia, asthma, dysentery, and seizures among other illnesses.  Some of our EMT high school students also got to watch Trina deliver a few babies and a few even saw a C-section.  Hard to beat an experience like that; still one of my favorite parts of medical practice!  All of the students had a chance to spend time at Kasungu District Hospital as Don worked with outpatient orthopedic and trauma cases.  Our students also had a chance to work in the lab, pharmacy, dental, nutritional, and HIV clinics as well.  As always, many of our group donated blood and had the opportunity to meet the patient (usually a child with malaria) whose life they had helped save as a consequence. 

Overall, it’s easy to say that the hospital and rural clinic experiences are life-changing for so many of our students.  Frequently, those who were considering a career as a healthcare professional will really catch fire in Malawi and know that they’ve definitely picked the right calling.  Occasionally, some students will be converted from “can’t see it” to “oh, yeah I want to be a nurse (or doctor)!”  Less often are those who are more interested in the development, cultural, or journalistic aspects of our trips.  They usually come home certain that medicine/nursing is not for them, but find they want to alter their life goals to include changing the world for the better.  As I said earlier, in so many ways, the high school students are the best part of the trip for me!

Since the last trip report, Bridges to Malawi has significantly expanded its development operations.  This was a direct response to the ongoing famine and the belief that good medical practice starts with prevention.  Wipe out poverty and malnutrition and you have a good start eliminating some diseases and significantly mitigating the effects of many others.  This is particularly true in a place like Malawi where 80% of the population survives on subsistence farming, barely making it when it rains and starving when it doesn’t. 

So we started a goat pass-on program, and a microcredit bank, and our Land Lease program, and cows and ploughs program, and irrigation projects.  Peter Minjale, who makes all things BTM happen when we’re not in the country (and most when we are)took us to meet beneficiaries of these various programs, and wow!! was it wonderful to see how we (YOU!!)  could make such a huge difference in the lives of the hard working impoverished farmers of the Kasungu East District.  We drove through villages teeming with goats and were told that this was a result of our pass-on program.  We met one women who had started with 1 goat in 2014 (given her by K2 TASO our Malawian partner, not us) and now had 8, which made it possible for her to help feed an extended family of 30 people (or more…I lost count), including her 101 year old mother . 

We met 5 women, typical of the 230 recipients of an initial microloan of $10 who had gone from subsistence farming to thriving business as a consequence.  One had started a restaurant, another a tea shop and bakery, the other 3 each had opened a small grocery business. All had paid off their initial loans ($10!) and some had enhanced their business with a second ($15) loan, also paid off in the case of the women we met.  In fact, Peter told us that 100% of the first loans given out had been paid back while 88% of the second loans had as well, with an expectation that the remainder would be paid back soon.   These women each had powerful stories of poverty and need before they got these loans and then told us about now: children’s school fees afforded, medical bills for sick children payable, solar panels bought, a pig purchased, better nutrition for all, and best of all, hope for the future!  $10. $25.  Imagine how easy it is to spend that in the US on so little; in Malawi it was life changing.  Remember too that the average Malawian family consists of 7 people.  230 x 7 is a lot of people whose lives we’ve changed!  We were overwhelmed and right there and then agreed to double the bank’s capitalization.

Peter took us to meet “Brian” and “Cindy” the cows, part of our “Cows and Ploughs” project.  They are both pregnant but had been used to plow a field before this was known.  I had expected to have a bull named after me, but I realized how much more useful a pregnant cow is, so I’ve decided it’s an honor.  Peter took us to the plowed field, and introduced us to the very grateful farmers who had not had to break their backs cultivating with hoes, like all of their neighbors. These farmers were also delighted to meet “the Brian” for whom their cow was named.  They were disappointed that Cindy (my wife and fellow BTM board member) couldn’t travel to Malawi (bad back), but were equally excited to see a picture of her which I had in my wallet and left behind with them.  As a result of this BTM gift to them, they hope to plant 3 successive crops this year, not just the usual single planting.  In addition, he pointed out that this field had been irrigated with one of our treadle pumps last year and produced a good crop despite the drought.  Thus far we have donated 8 cows and 4 plows to groups of 180 farmers each, and also donated 8 treadle pumps for irrigation purposes, again to large groups of farmers who then share them. 

Finally, with regard to development, Peter took me to a Land Lease Project.  13 of the poorest farmers in the village of Chiwela (about 2 hours from Mtunthama over a string of potholes that passes for a road) had pooled the money we donated to cultivate a ¾ acre field donated by a local chief.  These guys did cultivate with hoes.  They dammed up a spring to provide year round water, even during drought, and had raised 8,000 tomato plants from seed.  They had also grown onions, mustard greens, and  “chinese cabbage” from seed.  They had even constructed 6 inch high thatched structures to protect the seedlings after initial transplant.  The day we visited, we brought them watering cans made entirely by hand in Kasungu town from the remnants of automobile bodies (cost $2.50 each).  They sang songs of welcome,  joy, and gratitude just to me, Peter, and Patrick (K2 TASO’s microloan and Land Lease expert) since we represented the entire group.  Peter explained to me that the average tomato plant yields a minimum of 20 tomatoes and that 4 tomatoes go for about 150 kwacha (20 US cents) in the market.  Assuming that all 8,000 plants survive (I was told this was very likely) and that the sudden large number of available tomatoes doesn’t depress the market, this means that these 13 farmers are likely to make, at a minimum, from this one crop alone, about  $615 apiece.  The average per capita income in Malawi in 2013 according to WHO was $750.  One crop, $615!  This will make a huge difference in the lives of these people.

We did go to the Bua River where Peter was thinking of siting our first waterwheel.  It was clear that it wouldn’t work in the place he chose because the wheel would have had to pump water uphill, something it can’t do. Peter seemed to think that two other rivers nearby would be better candidates but we didn’t have time to check them out while there. He promised to take this up with William Kamkwamba when he arrives in Malawi next month.

Speaking of William, we also went to his house and met his dad, Trywell, and his cousin, Geoffrey, who had partially built our first waterwheel in Malawi.  He didn’t have a chance to finish it while we were there, but it looks like it will work, given the right site.  At William’s house, we inaugurated the “William Kamkwamba Museum of Science (or whatever he wants to call it) by donating posters (in English and Chewa) explaining the workings of the internal combustion engine, electricity generating windmill, and typical Malawi water pump along with a plastic model of the “visible engine”, and a cut-in-half real auto engine as exhibits.  We also carried William’s original windmill (no longer in operation) and placed it as an exhibit inside the museum along with everything else. It was a great start; who knows where it will end up, but the idea is to provide a learning opportunity for Malawi children that they wouldn’t have had otherwise.

Then there was Ellie and Phoebe and the Mooncatcher Project.  In the developing world, girls and young women often miss school once a month because they have no access to underwear and menstrual pads or tampons.  The mooncatcher project is designed to help a group of interested women start a small business by providing them with sewing machines and training in their use.  The women are then provided with materials necessary for producing the “mooncatcher,” a reusable washable menstrual pad.  They are expected to make a certain amount every month with the material provided.  All of the mooncatchers are then donated for free to needy girls.  In return for their free labor, the women can then use the sewing machines for their own purposes; thus they provide an amazing free service and they get to start a small business on the side.  So far, the mooncatchers are produced during “moonbees” in the US and also by groups of women in Kenya and Uganda.  Ellie and Phoebe agreed to come to Malawi to initiate a mooncatcher program with the help of BTM and K2 TASO.  They were amazing!  With only about a week to accomplish anything, they spent every day teaching, training, working.  It was such a pleasure to walk into the big K2 TASO headquarters conference room and find it filled with a busy group of women having a wonderful time as they learned their trade.  By the time we left, they were successfully making mooncatchers without difficulty!  Ellie and Phoebe both plan to return sometime in the next year to help grow the project.

Meanwhile, Jen Hardy and Naomi Lisse were busy every day with our laptop/tablet donation project.  BTM donated laptops to the All Saints School secondary school in Mtunthama (which has electricity most of the time) and the secondary school in the village of Chikanda, which has no electricity(where we donated a solar powered tablet system).  Both computers and tablet system were so filled with educational software as well as microsoft office, that they enabled the user to “access the internet” without actually being able to do so.  Jen and Nao spent every day teaching faculty and students at one school or the other.  Nao told me that in Chikanda the students had never seen a computer before, and they loved them!  At this school they had over 60 students show up to learn.  At All Saints, students and faculty came in to learn on Easter Monday, even though they were on break.  Jen and Nao left already planning next year’s trip.  They exchanged contact info with the faculties of both schools so that they could continue support throughout the year.  In addition, they befriended a local Mtunthama internet café IT expert to help continue the project in their absence.  They both plan to return next year to keep the project going and help it expand.

I can’t produce a trip report without mentioning that everyone spent a lot of time at the AMAO orphanage in the Anglican compound which also contains St. Andrews Hospital and our living quarters.  The over 70 orphans love it when we come to town.  They are all so cuddily and they quickly adopt their own special members of our group.  Most of our high school kids and Trina carried a small child on their back, Malawi style and, thank goodness, nobody dropped anyone! Don brought a lightweight projector and we had movie night.  He also organized an Easter egg hunt.  Both events were certainly a novelty for these kids and everyone had a blast.

As a reward, the group went to the Salima craft market after tearful goodbyes on the last day in Mtunthama.  From there we swam in Lake Malawi and spent the night on the lake.  The next day we returned to Lilongwe and the airport and flew home.

Sorry this report was so long, but we did so much it was impossible to make it any shorter.  If you want to see pictures to go with this narrative, please check out our facebook page (I haven’t figured out how to get the pictures on this website yet).  Thanks again for your interest and support!  Brian


February 2017: The rains have finally started and are persisting!  Peter Minjale says that there is hope for early crop harvest, thanks to our irrigation projects!