World Mission - Malawi

Malawi
Dr Malcolm and Dr Liz Molyneux working in medical aid and malaria research in Malawi

Pictures from Malawi

• March 2005 (new ward)
• March 2005 (official opening of the new ward)
• August 2004 (building the new ward)
• July 2003 (work in the ward)
• January 2003 (in the ward)

Link person: Eric Linford

Making Better Health in Malawi (added May 2009)

May 2009
October 2008
January 2008
January 2007
January 2006
December 2005
January 2005
August 2004
July 2003
March 2003
February 2003
August 2002 (b)
August 2002 (a)
February 2002

May 2009 - Malawi

Our enormous thanks to St Luke's for all your interest and continuing support. Liz and I have entered a new(ish) phase of our lives, in that we both technically 'retired' on 1 January 2009. However life is not noticeably different - we are still doing much the same things, full-time. We each now have a 40% contract with the College of Medicine, while continuing research and other activities (which seems to add up to 110% as usual), and of course we receive pensions based on our previous employments.

Liz continues research on meningitis and child cancers, and has general clinical duties in the paediatric wards. She is in considerable demand for giving instruction on the emergency management of sick children, and has been twice to Ethiopia this year, as well as to Edinburgh, and she is lined up to go to Afghanistan probably in July, and to Florence in September. Liz has worked hard to shepherd in the new Malnutrition Block, which is now completed and in full use. Staffing for Paeds continues to be a challenge, and the 'FOSC' (Friends of Sick Children) funds to which you have contributed help enormously to alleviate the shortfalls.

For me, the research on severe malaria in children continues, and I also do clinical work and teaching in adult medicine in the Department of Medicine. Here HIV predominates, with its huge burden of infective complications, but all the usual non-communicable diseases (diabetes, stroke, hypertension etc) are just as prevalent as anywhere else in the world (although we have a conspicuous near-absence of coronary artery disease and heart attacks). We are all pleased that The Wellcome Trust of London has provided money to build a new Adult A&E unit, on which work will start in July and which will greatly improve the care provided for adults. I'm going to meetings in Dakar, Cambridge and Nairobi over the next few months.

The bell at St Luke's Nkolokoti is well situated in its tower and rings out clearly to the local community. I am sorry not to have got hold of any pictures or recordings of it in-situ yet - will try to do so. It is greatly appreciated and unique in peri-urban Blantyre, except for one Catholic church in Chilomoni, which I understand is not a bell at all, but an electronically generated chime!

Our love to you all
Malcolm

October 2008 - Malawi

The Children's Department Queen Elizabeth Central Hospital

The number of children in our ward at any one time depends on the season. Children’s health and well being is closely tied to the weather, the harvest, the availability of clean water, warmth, light and protection from ills.

This year the rains were heavy - good for the harvest but not so good for malaria. The mosquito larvae breed in static water and there was a lot of that around. Malaria has become increasingly resistant to what was our first line treatment and so in December last year the national policy changed and treatment now requires 3 days of a newer combination medicine rather than the older one-off treatment. The drug is good, the practicality of getting children to swallow it is another story all together, and that may be why we had so many children admitted with malaria last rainy season. Mosquito nets have been distributed free to children less than 5 years of age. But the distribution was too late for the last malaria season. Lets hope it makes a difference this rainy season.

The HIV/AIDS epidemic in children has not peaked yet and despite efforts to prevent mother to child transmission of the disease there are numerous children newly infected with HIV. The Government has embraced a policy of treating children as early as possible. This is a good idea but a huge task of identifying and following up all these children. This is a life long commitment and numbers will inevitable increase with time. At the same time children who are receiving treatment for HIV are being admitted on numerous occasions for infections or complications of one sort or another. It has changed the nature of paediatric health care.

Acute infections, injuries and premature babies etc continue to abound and keep us busy. The cancer ward has been especially busy this year. Last month (August) there were 20 new children admitted.

For many years with your great support we have provided extra staff for the department. There are nurses, clinical officers (equivalent nurse practitioners), clerks and cleaners, home craft workers and patient attendants. Their help is invaluable but slowly their numbers have increased and our annual outgoings are more now than our income. This week we are having to interview everyone and will have to tell about half of them that we can no longer manage to employ them. For some this will be a great blow as many are widows supporting grandchildren etc, but it has to be.

The Church

With your help the church (St Paul’s) managed to complete an office block that had been in the process of completion for several (?4) years. It is now rented out in the hope that it will bring some income to the diocese. With your help the toilet block of the church hall was rebuild. (it was in dire need of it).

Our Bishop Tenga-tenga had a tenth anniversary celebration of his commemoration as a bishop which was a splendid and happy occasion. The ladies group has been active in fund raising and other ways; I find it a great source of Christian friendship.

This year no one has come forward to train for the priesthood and we need your prayers about this.

On a happier note the youth group are active, participatory and enliven our Sunday Service with beautiful music.

We are always grateful to you all at St Luke's for your warm welcome of us on our infrequent visits; for your faithful concern and generous giving for the sick children in our care, and the church, and for your prayers.

Thank you
Zikomo
Liz and Malcolm Molyneux
22 September 2008

January 2008 - Malawi

Greetings and news from Malawi

The rains have come early and are heavy this year. This bodes well for the crops, for which we are grateful, but they have brought the mosquitoes out in force and the wards are very busy with malaria. Over the Christmas period we had 165-189 children in the 52 bedded special care ward. (This is the ward that you raised money to refurbish and rebuild). The on-call team of doctors and nurses would not have coped without the good will of colleagues who came in over the holiday period to help with treatments and with seeing all these children. Remember that is only one ward - there are 7 others, though it is, without doubt the busiest of them. Our resuscitation room in A&E has 2 beds and we have regularly had 7 or 8 children in at any one time, many of them anaemic or convulsing. Every day brings its own challenges.

There have been lots of good things happen this year. The Kangaroo care ward was completed (finally - it took 14 months instead of 3 to build!) and it has been full ever since I opened its doors. It has room for 17 mothers and their tiny infants. Having this ward has taken some of the pressure off SCIBU where the sick newborns are looked after, and allowed the nurses a little more time and space for the sickest of neonates.

We have used some of your generous donations to paint and try to make major repairs to the entire department. This has really raised people's morale. Another morale raiser was to give prizes to the best nurse of the year and the best cleaner. We kept the idea of prizes a secret and declared them at the Christmas party. It was a resounding success and we hope to continue to be able to offer such incentives to our hard working staff. The malnutrition ward has about 50 children in it. This is much better than a couple of years ago when there were over 100 children in there. This reflects last year's good harvest and we pray that it is as good this year.

In 2008 we hope to refurbish the malnutrition unit which is rather dark and dismal and quite a difficult place to work in. We will continue to support extra nurses and ancillary staff in the department to be able to provide care to the children and will continue to buy necessary drugs and equipment which are out of stock. Our odd job man continues to unblock the drains that keep blocking and keep one step ahead of all the plumbing disasters we seem to have.

On a personal note, Malcolm has stepped down as Director of the Wellcome Research Laboratories but is staying on to head up the malaria studies for at least a year. I continue to run paediatrics.

Thank you for your prayers, your generosity and your continued interest in Malawi. We wish you all a happy, peaceful and healthy 2008.
Liz Molyneux

January 2007 - Malawi

The hospital is not as busy yet as usual for this time of year — perhaps because of a good harvest last year so that the children are healthier to face the rainy 'hungry' season. The malaria season is just beginning.

The extension to the Kangaroo Care unit is slowly being built. We have a KC unit which has 9 beds and it is proving too small. The new place will have 18 beds. Kangaroo Care has been a great success and frees up the nurses to look after the sick and very, very low birth weight infants. We have introduced a simple 'hot cot' which is a locally made incubator. It is heated by 4 electric bulbs under the cot, is very effective and the mums and nurses really like it. It costs about 50 pounds to make (by a local carpenter and electrician) rather than 3000 pounds for a commercial one — which then often go wrong and we cannot repair them.

We anticipate some staffing problems next year. We may know that the medical training scheme in UK is changing and all the trainees feel understandably insecure about finding jobs. It all seems pretty incomprehensible from this far away but it does mean that young doctors who have come out and helped us enthusiastically (and gained a great deal of experience themselves) do not feel free to come. We await our Malawian postgrads to finish training and come home.

The Anglican church here is in some turmoil. An English bishop designate to the central region has not been welcomed by everyone (because of his lack of objection to homosexuality) and feelings have run high. Then a retired UMCA priest was found dead in his house and the question of poisoning has been raised. He may have had an acute gastric perforation or such) but it is not good for the image of the church. It needs our prayers.

January 2006 - Malawi

More Christmas Greetings from Liz and Malcolm Molyneux

Happy Christmas and a joyful New Year Thank you for your email with Christmas greetings - and indeed telling us of further gifts for Malawi. I never cease to be amazed at people's generosity and God's provision. At Christmas lots of people get bonuses etc, but our staff do not. So this Christmas I decided to give them all K2000 each. (That's about £10), enough for a good family celebration. The staff list seemed inordinately long - I didn't know we had so many cleaners(!) - but everyone was very happy and they thank you all for it.

One of my Dutch colleagues who was here for a year about 9 months ago and planned to come back and volunteer for 3 months was diagnosed with pancreatic cancer 2 weeks before he was due to come back. He died within 3 weeks of the diagnosis. His wife is still reeling from the shock and speed of it all. They had so little time to come to terms with it and to say what one wants to say. We had 5 wonderful days with Sassy Al and little Moli in early December. Moli is just 2 and adding words to her vocabulary at every turn. She is absorbed by animals and loves giraffes!

Sassy is well, she is due in early March and the family will return to Liverpool from mid January until after the baby is born. Alun is doing a Master's in Education and has to be in the UK for one of the modules so it suites them both well. I was on duty for Christmas eve, day and tomorrow. It has been as busy as ever with many children coming in desperately anaemic from malaria. We have been transfusing 10-12 children every night. The blood transfusion team were stars over the holiday period and I have just given them a basket of peanuts as a thank you from the children's unit! I hope you and yours are well. I hope 2006 brings us all joy and peace.

Love
Liz and Malcolm

December 2005 - Malawi

Christmas Greetings from Liz and Malcolm Molyneux

Dear Friends

Christmas proverbs

The rich tradition of proverbs in Chichewa provide material to illustrate our family’s year, 2005.

Kuchuluka nkwabwino koma kuipira kethetsa mchere. ‘It’s great to have a big family, but it sure uses up the essential stores (such as salt)’. Sassy and Alun will need to heed this as baby no. 2 is on the way.

Kalulu adatuma njobvu. ‘The rabbit dominated the elephant’ – ie size isn’t everything.  Moli (2 this month) has clearly understood this instinctively from birth.

Kugona pakati nkoyambirira. ‘To sleep in the middle (the nice warm part of the hut) is for the first to arrive’. Mat and Eleanor secured about the best place in Italy for a wedding, by arranging it 11 months ahead. Now we all look forward to the event, in June 2006.

Kuona maso ankhono nkudekha. ‘If you want to glimpse the eyes of the snail you’ve got to be very patient’. Ben has persisted over several years until rewarded this month with an Australian right of residence.   If he decides to live there for 2 years he can become a citizen.

Chapita chapita, dazi liribe mankhwala. ‘What’s gone is gone, there’s no cure for baldness’. Sam has lost the title ‘Doctor’ after having held on to it for only 3 years. This accident was due to his passing the MRCS last week. Hey, Mister! Sorry for that.

Nzimbe sadyera kutalika koma kutsekemera. ‘We don’t eat sugar-cane because it’s long, but because it’s sweet’. Liz’s Inaugural Professorial Lecture in October was appreciated for its simple and interesting content, not because it went on for 40 minutes.

Walira mvula walira matope. ‘If you pray for rain, your praying also for mud’. Malcolm got a new grant, but there’s an awful lot to do to use it properly. 

WISHING YOU A WONDERFUL CHRISTMAS AND THE BEST FOR 2006.

With love from
Liz & Malcolm in Malawi

January 2005 - Malawi

Liz wrote on 29 January.

We had the official opening of the ward on 10 January. Philip and Lyn Clarke
were the offical guests as was the Minister of Health.

It was a very special occasion with the nurses, cleaners, clinical officers
all genuinely delighted. They put on a play about what the ward was like
before and after the changes. They sang to us all. A mother who had been in
with her child when it was old and now new also spoke and thanked everyone.
Philip spoke well and the Minister was very gracious. There was a minute's
silence for Phillipa Clarke, and I know that for the Clarkes it was a
difficult, emotional, but important ocassion.

For us it was a wonderful opportunity to thank those (including St Luke's of
course) who have been so generous in the funding of the building.

My 60th birthday came immediately after the opening.

Liz has sent us this account of the whole affair, and the text of her speech at the opening of the new children's ward at the Queen Elizabeth Central Hospital in Blantyre.

August 2004 - Malawi

Yes, time flies and we seem to be chasing our tails! The building is coming on very well. The building is costing £50,000. How the price climbs to such heights I don't know, though I do know that the price of cement has tripled in less than a year. This is probably true of all imported things. With your previous gifts and Phillipa's family's gifts we have that much, but certainly need to equip the ward. The cost of the building includes the beds but we will need stools for mums to sit on, some bedside shelves/lockers, oxygen concentrators, suction machine etc.

There are some pictures of the building work here.

July 2003 - Malawi

Liz wrote again on 30 July.

I think we may have met our target. The architect has handed the plans to the quantity surveyor who is discussing it with the contractor. It all seems to take longer than one had hoped, but I trust the contractor and that is important. So I have to sit on my hands and try not to fuss too much!

Liz wrote with the latest news on 8 July.

The wards are quieter now that the cold weather is upon us. In fact it is jolly chilly tonight, and I am huddled over a small blow heater. The trouble is the electricity keeps going off and then we sit in candle light but the heater dies!

The architect has completed the drawings for the extension to the special care ward. I am anxious that we get on and start before it is too late and the wards start to fill up and overflow again because we will need to house everyone in another ward while some of the building is done. Some construction can be done without disturbing the ward too much. It will be wonderful when it is finally built. I am waiting with bated breath to hear what the contractor will say that the final cost will be.

Malawi has probably been in the news with al-Qaeda suspects being whisked off from the country. That led to riots in the Muslim areas with some churches damaged. I do not know quite what the crowds were agitated about, as their main complaint seemed to be that the Muslim Association had not done enough to protect Muslims!

It was Independence Day a couple of days ago and so in preparation the City cleared the street outside the hospital of vendors. The (illegal) shelters were uprooted and bulldozed. We came to work in the morning to find a very angry stone-throwing crowd. Fortunately it calmed down fairly quickly and did not spread.

Our bible study is small but active. We have decided to try and do something for the prisoners. Many do not have a blanket in this cold weather and sleep on the bare concrete. Most prison cells (which house 16 or more people) have no buckets and people are locked in from 4 pm till morning. Malcolm went and took in some buckets with lids, and blankets have been bought. When you think about the problems of Malawi and the hospital and poverty and illness you always find somebody or bodies worse off.

Thank you for your prayers, your support and your consistent interest. We really are enormously grateful. I will try to attach a few photos which I received today from a chap who took them when visiting.

Our love and best wishes to you and others in St Luke's.
Liz.

Liz also sent some photos that a visitor took; see them here.

March 2003 - Malawi

Hospital Extension

Liz has written with details of the extension being planned for the children's department of the Queen Elizabeth Central Hospital in Blantyre which St Luke's is supporting.

The children's department of the Queen Elizabeth Central Hospital in Blantyre, Malawi admits 12,000 children a year and treats 90,000 children in the outpatient accident and emergency unit.

The inpatient wards are several - a ward for babies less than 6 months of age, a Malnutrition ward, a Cancer ward, a Surgical ward, an Orthopaedic ward and a Special Care ward. This last ward called 'Serious' by the local people is for all the very sick ill or injured children who need more intensive observation and nursing care. The Queen Elizabeth Central Hospital (QECH) is a referral and teaching core hospital for the whole of the southern part of Malawi.

The Special Care Ward has 28 beds, one small isolation bay and 2 small procedure rooms. In the rainy season, November to May, there are 90 to 110 children in this ward. These patients are accompanied by at least one guardian (usually mother or grandmother) and often a young breast feeding sibling, who cannot be left at home. Some mothers hold their children in their arms all night. Into this melee of people come medical students (this is a teaching hospital), and doctors, nurses and nursing pupils and clinical officers. In this crowded ward nurses try to deliver good care. It is a hard uphill task.

More space would be an immense improvement. Sometimes it is difficult to do procedures surrounded by mothers and other children on a bed that is shared by 2 or 3 children and cannot be moved away from the wall, or a corner with little light.

The ward would be enlarged. There is a space on one side of the ward that could have an extension which would help make the ward more user friendly, less liable to encourage cross-infection and much, much more comfortable for patients and their mothers.

The cost of this extension is approximately £25,000. The size of the extension would be about 10m by 10m. This simple extension would allow for about 20 more beds.

February 2003 - Malawi

A letter from Liz, 28 January 2003

Thank you for your thoughts and prayers this month.

We have a lot to be grateful for - the rains have come and the maize is looking good. Please pray for a good harvest. Many churches, NGOs and others have been giving maize flour to the most vulnerable groups while they wait for the new harvest.

But with the rains has come our annual flood of malaria cases. This is despite a drive to ask people to use bednets. On top of that there are many in the malnutrition ward and the number with AIDS has not peaked.

I think our nurses, support staff and medical staff need your prayers as they struggle to help.

Malcolm needs your prayers. His staff (better paid than most) seem dissatisfied and want still more and think it is in his province to be able to give it.

The church is really trying to take a political, moral and social stand for what is thought to be right. It is not easy.

Thank you for your prayers, your practical support and your friendship and optimism in Christ.

May God bless you all.
Liz

Africa/Crosby

This month we give thanks to God for a young doctor, Dan Wootton, who lived in Coronation Drive Crosby, and his partner Rebbeca Sinfield who have gone out to Malawi for a year. Dan is working with Malcolm doing a malaria research study and Rebecca is working in Liz's department. Isn't it a small world?

With the rains and the prospect of a good harvest, comes malaria and an influx of new cases in an already overcrowded hospital with an overworked staff in the poorest of conditions. Please pray for Liz and her staff at the hospital.

Liz (in her spare time) is working on a building project to extend one of the wards in the hospital which at present has 28 beds. Last week it had 106 children (patients) plus 106 guardians, some siblings and various other hangers-on. This is typical of most of the hospitals in Africa today, where relatives have to feed, clean and generally take care of the patients.

Liz is trying all the embassies to try to raise some financial support. She says she is greatly encouraged by the support they get from St Luke's and thanks everybody for their generosity and love for the people of Malawi.

The estimated cost of the ward extension is £25,000. So far Liz has £5000, including a recent donation of £3000 from St Luke's.

To help Liz doings God's work in Malawi, take a box from the back of church, fill and return it, or carry on supporting as you do now. Every penny counts. Thank you and God bless you.

August 2002 (b) - Malawi

Here's another e-mail from Liz Molyneux.

I have returned today (10 August) from a week in Kampala at a meeting on improving quality of health care in referral hospitals throughout Africa. And who should I bump into but David Trollope! We were both as surprised as each other.

You ask for prayer items:

I think the food shortage in the country is one that needs our prayers. We need to pray not only for sustenance for those in need during this crisis, but for some actions that have a lasting and sustainable improvement in the provision of food and harvest yields.

We need prayers for the increasing number of people with AIDS and those who are looking after orphans, and sick relatives. Those who are finding their extended families a huge financial responsibility.

We need prayers for the Church - that it is seen to show compassion to the sick and the burdened both with practical help and in real brother love.

And our little patients and their families, who put up with so much discomfort and hardship with a dignity and fortitude which is truly humbling.

Love,
Liz and Malcolm

August 2002 (a) - Malawi

The latest letter from Liz Molyneux

It has been an odd few months. On the one hand the NGOs have been here and the Western press, to look into the poor harvest and impending food crisis which is expected in about October, when what harvest there was this year has been consumed. On the other hand we have just had Colonel Gaddafi here. He arrived in 4 large planes with his entourage of 600 people, numerous ?40 vehicles and much to say that is not very complimentary about Westerners in Africa. He visited the hospital but would not enter the wards, and then promised a new hospital, Libyan doctors and lots of maize. He has been going all around Africa making promises. We wait and see... It would be very difficult to staff anything new and would much prefer proper maintenance and repair of what we have.

The malaria season has subsided and in a way that exposes the chronic diseases from which our children suffer and we are seeing more and more AIDS related problems. There are so many orphans in society and so many sick adults trying to care for sick children that we have become almost used to it. It is such a delight when a nice fat juicy baby is admitted in the wards who gets better quickly, because he is unusual We tend to purr at him!!

The EU finished our malnutrition ward building last year but the promised furnishings for there or the Casualty department have not materialized. I keep sending enquiring (and I hope polite) chitties to all and sundry but 'all and sundry' do not reply.

The doctor who has been looking after the Accident and Emergency department for 18 months is leaving to go back to UK - in fact to Liverpool. We shall miss her.

We have just painted the nurses' rest room. It was a dismal place. We have painted it in bright blue (their choice!), managed to get some chairs, a fridge, kettle and hot plate. I hope it makes them feel appreciated. They deserve it.

Thank you for your support. It means a great deal to all of us - children, parents and staff alike.

May God bless you.
Liz and Malcolm

February 2002 - Malawi

At this time we welcome Malcolm back home even if it is only for a short while. We pray that he and Liz are well and look forward to his lecture at The School of Tropical Medicine in Liverpool on Monday 11 February.

Malawi is a landlocked country located in south-eastern Africa. It is bordered in the north and east by Tanzania, on the east, south and southwest by Mozambique and to the west by Zambia.

The country lies within the great African Rift Valley system. Lake Malawi, a body of water some 360 miles long and about 1500 feet above sea level, is its most prominent physical feature. Much of the land surface is plateau between 900 and 1220 metres (3000 and 4000 feet) above sea level. Elevations rise to over 2440 metres (8000 feet) in the Nyika Plateau in the north and in the regions of Mt Mulanje 3050 metres (10,000 feet) and Mt Zomba 2135 metres (7000 feet). The Shire highlands in the south are lower with elevations from 610 metres (2000 feet) to 900 metres (3000 feet).

To the north there are rugged highlands with rolling hills in the Nyika and Vwanza plateaux, whilst in the south, traversing the escarpment that forms part of the Great African Rift Valley, lie the lowlands of the Shire Valley.

Lake Malawi is the county's centrepiece. Like an inland sea it has endless palm-fringed beaches, enclosed by sheer mountains, making it undeniably the focal point for Malawi's tourists. Unfortunately, where there is water there are mosquitoes and they can carry malaria, the scourge of Africa, the very reason for Malcolm's research, and his being there.

Update from Liz 29 January 2002

Dear Friends

We thank you so very much for your prayers and generous support. Without them we would really be in a bad way.

Here it is the height of the Malaria season and we are inundated with admissions to Hospital. We have had admitted 135 children in one day, 21 of whom required blood transfusions, an all time record for the Hospital. It was a nightmare; how two nurses coped with that influx I do not know. We ran out of quinine for the third time this month and I used some of the money you sent out to buy some more in the town. We also ran out of Gentamicin, a basic and essential antibiotic especially for new-borns. Again your gifts are put to good use.

This month nobody is getting paid at the Hospital; we are told that the computer is down, I hope that is the only problem. We are praying that the rains will come when they should, that the sun will shine when it should and we shall have a good maize harvest. Until then maize is in short supply, and the price is three times what it was last season.

Our bible study continues to meet on Wednesday evenings. We are looking at various people in the Bible, having become bogged down in such books as Revelation and Lamentations recently. It is a lively and enjoyable meeting for all.

Until we meet, God Bless you all.
Liz and Malcolm

this page was last modified on 4 August 2003