Debriefing & Farewell dinner 9/10 – Departing thoughts as we leave Malawi 9/11

On Friday four of us from the GAIA-US and three from the GAIA-Malawi office spent most of the day de-briefing and going over next steps, questions small and large and discussing our intervention strategies. In short, our current areas of emphasis are enabling us to impact thousands of the poorest of the poor in remote rural areas unserved by other NGOs. Our signature Village program is empowering women in desperately poor villages to help others in the community as caregivers for HIV+ villagers and the many, many orphans who have been left as a result of the extensive number of deaths in the current parental age group. The training and education provided by GAIA has become a vital part of the villages. We saw this so clearly when the hundreds of villagers showed up to greet us singing GAIA gratitude songs and speaking of their specific reasons for appreciation. Whether for having been tested for HIV, receiving care themselves or for the orphans they care for in the form of kits, school fees etc., being trained in a skill or as part of a village health committee etc., etc., these villagers see GAIA as a God-send for helping them take steps toward health and hope for well being in the future. At the same time, the three mobile health clinics we now deploy in the Mulange district are serving more than 125,000 patient visits. In this meeting we all computed our cost to be approximately $2/visit for patients who otherwise would have to walk many, many miles to district government clinics which we have been told are often short of necessary medicines. Women in neighboring districts whom we met at CBOs we visited asked us when we would bring mobile clinics to their areas while others at different CBOs wondered the same about their villages within the Mulange district.

The difference GAIA is making in the Malawi healthcare structure with it’s nursing scholarships which boost the nursing force in the country is significant and will be even more so as we roll out the USAID grant which has recently been approved to provide even more scholarships, HIV training, BEmONC training and triage in conjunction with UCSF School of Nursing. This major program expansion along with the clear room for growth in GAIA’s existing Villages program and Mobile Health Clinics makes clear the need for our continued push to find the resources required. Similarly, the capable and hard-working GAIA staff is continuing to see areas for improvement and development which make our programs even more effective and responsive the the specific needs seen in the villages. It is also clear that here is considerable expansion capability in the densely populated areas contingent to our current villages, not to speak of needs which could conceivably be addressed in other districts down the road. With funding, the demand for addition Mobile Health Clinics, costing roughly $375,000 each, all-in for 5 years of service, would justify a multifold expansion of the current clinic program. On so many fronts there is so much we can do.

I awoke for the last time this trip to the Muslim call to prayer from a nearby mosque, the neighboring roosters and the smell of gum tree fires burning along every roadside and from kitchens everywhere in the area other than the relative few that have electric stoves. We thank the dear Malawians who run our guest house and head to the airport. Relatively well-off neighborhoods distinguished by their walled homes and security guards give way to less affluent but still urban clusters of homes down long dirt roads off the paved road to the airport. Then the communities along the road begin to look more like the rural villages where there is no electricity or running water and simple dirt floors. Even in Blantyre, we experienced electrical outages and most of one day without water. The farewell dinner we held for staff at the nicest hotel in town on the last night was missing 6 of the invited staff from Mulange who could not come because there is fuel shortage in all of Southern Malawi this weekend due to road problems which have reduced normal traffic to a trickle…

We take off toward Johannesburg looking through skies thickened by smoke from open fires burning wood, so much wood that the landscape below seems mostly to be dry, red soil – deforestation is evident and will have further impact on the country’s ecosystem. I feel sad to be leaving despite being excited to get home to see my wonderful husband and family whom I have been missing. There is maybe a sense that you can help these people who have so many basic needs if you are here in the country but leaving is turning your back on them. It is, of course, not the case but still I feel a pang. We have met so many people who opened their homes and hearts to us and greeted us with such joy and hope despite their own person pain on so many levels. These fine people love and care and work hard to help each other in their communities. How much we can learn from them and how much we can help. Even the smallest effort is a blessing begun which can expand to who knows what ultimate benefit.

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