It's been a while!

I have been meaning to blog for a couple of weeks now, to update on all that has been happening since I last wrote a month ago, but have let life get in the way too many times! A mixture of getting caught up in other goings-on plus a running out of internet time at the opportune moment has kept me at bay.

I have been carrying on as normal with my work, Maula training on Monday, Kachere raining on Wednesday, Kachere support group on Thursday and meetings, prep work etc in between.

The training in Maula is more informal and is coming to an end next week with the presence of Theatre for a Change, who are coming to the female section to do a drama workshop on MTCT (Mother-to-child-transmission) and also a piece of work on stigma and discrimination. We are going to get them to act out a story of themselves too, with their backgrounds, how they came to be in prison, and how to move forward positively once they leave with a particular emphasis on self-protection from HIV and STI’s. It should be a good session, and a nice way to wrap up the period of time I have been present there. I hope that the women will all seek HTC (HIV Testing and Counselling) at the end of the session and for the coming days/weeks once I leave. They have access to free HTC within the prison from the trained medical officers, so it’s the ideal opportunity to find out their status and receive the necessary treatment if necessary. The is a strong need for more education in the adult prison, particularly the male section where there are over 2000 men in very small confines. There is a 25% prevalence rate of HIV there. If there should be more funding from the Scottish Government after I finish, I would hope that the next Health Promotion worker would try to tackle this area, and increase awareness and reduce risks which are so high in prison. The risks are using razors and sharing tattoo equipment, but also MSM (men who have sex with men) is sure to be an issue, although the medical officers and staff believe it not to be. In my opinion, it is ignored or brushed under the carpet because homosexuality is illegal in Malawi, and goes against their deep rooted religious beliefs. A tricky topic, I have tried to address with prison staff on a number of occasions but it just hits the brick wall, even with our Regional HIV Coordinator that has done numerous diplomas and certs in HIV education.

In Kachere, the rates are low, as I may have previously stated. There has been one additional inmate diagnosed since last month, and also a member of staff. These low rates are perfect for the potential future success of my work, as my Peer Educators are educating for prevention of infection of HIV, rather than dealing with being positive. Of course that too is something that they can help with the 8 boys who are positive, particularly in dealing with stigma from other uneducated boys. But I believe that these peer educators will be very successful at passing on the message to the others once I leave, and there will be some evidence of sustainability from the work that we have done with them. Officer Thom and Tom Sanderson of Venture Trust will endeavour to monitor their progress, and with his passion and the boys knowledge I have no doubt that it will be well disseminated.

I have just two training sessions left with these boys, and I will give them a Waverley care tshirt and certificate on the final day. Tom of VT conducts his own sessions on Behaviour Change on Thursday afternoons, and he happens to be on the section where we look at healthy lifestyles. Next week will be his session on HIV and sexual health, so I will take that opportunity to get the peer educators their first gig,  in introducing themselves to the rest of the boys and telling them what they have been doing and what they aim to achieve by being in the role that they are. They will help Tom conduct his session, and hopefully it will be a good interaction between the inmates. I also believe that a few of the positive boys are wanting to come out and disclose to all the boys about their status and work together with non positive boys on tackling discrimination within the prison.

We had a meeting with Baylor Grassroots Soccor and Teen Club workers last week, and Tom Greg and I showed them around the prison. They really meshed well with the boys and did some fun group exercises involving a lot of shouting and beats. Baylor work with positive youth, and are interested in doing a period of sessions with the positive boys, and also the rest of the boys in the prison, starting in April. I’m delighted with this as I feel the good work will continue and get better and better as long as these relationships blossom between Venture Trust and other NGOs. Tom is a really capable worker and has been very proactive in getting these partnerships flowing.

Of course, things aren’t always so rosy in the prisons, and about three weeks ago we had a very saddening and unwarranted death of one of the inmates. He had been transferred from another youth prison to Kachere, to be closer to a hospital, as he had suffered a hit to the back of his head (hadn’t disclosed how but we imagine from being beaten by prison guards due to the area of the head he endured the blow). Tom saw he was after falling into a coma, and he had not been eating or drinking for a couple of days. He was transported by taxi to the hospital immediately and died a couple of hours later. We had no contacts for his family , and he was due to be released a couple of weeks later, and it was just so sad. Early intervention would have saved him, the leakage of fluid from his brain could have been taken under control. But the general inability of medical staff to cop these things, and also the complete lack of First Aid training among the boys and the staff causes many unnecessary issues to become serious problems.

I wanted to get First Aid training for all the staff at least and a couple of boys in each cell, but unfortunately time is running out for me. I have been trying to impart knowledge to officers about what to do with all the things in the First Aid box, but it’s not nearly enough.

All else is well though, and I will update again at the end of the two weeks I have left in the prisons. I’m going to be very upset to leave, but I will be content in what has been achieved in my time here, and I will look forward to re-visiting the place in the future.

Mayendo Bwino (take care)

Dee x

maswela bwanji!

I'm spending this Tuesday morning working from home where the internet is trusty! I have a portable dongle that is more temperamental than Scottish weather so I am taking the initiative to use the WiFi instead. An oppertune moment to update this blog!
Lots has been happening since I last posted in work and out of it. I met with the women from Maula and they were delighted to have an outsider come in and speak with the about HIV. Myself and Peter (Regional HIV Coordinator for Prison Service) did a true/false flash card round on HIV and found their basic knowledge to be quite good, but the more intricate issues they really lacked knowledge. One woman thought ARVs were the equivalent of panadol, and used them for headaches. They asked so many questions about mother to child transmission and what to do about newly infected partners etc. I was happy to be able to give them the true and correct information around each of their queries. They asked for us to come back every Monday and so Myself and Peter went back yesterday to do a session on Risky behaviours and methods of self protection from HIV. Last Monday I couldn't go to Maula, as there were riots on the city centre streets.
The vendors who sell illegally on the streets, as the markets are full, were given 7 days to evacuate from their spots and find a new place to go. Last Monday was the 8th day, and we had presumed correctly that there would be clashes between the desperate vendors and the police force.
It took 5 hours of teargas and army charging to clear the rioters out from city centre and back into their neighbourhoods. I live 2 km out from the place it happened, and myself and Tom were in the garden listening to the shouting, and had to run inside because of the teargas stinging our eyes and burning our throats! We knew we were safe in our compound so it wasnt scary for us, just rather interesting! There has been no more unrest since, and it has been 8 days now, but the army remain patroling the streets to make sure the vendors dont resume trading. The hotspot is the road down to Kachere prison, and it has been very calm since.

In terms of my Kachere work, the peer programme was delayed the week before last as myself and Thom thought it more pressing to deal with the scabies outbreak that was taking over. 15 boys were taken to hospital for suspected STIs but we found out that it was genital scabies. They were in agony with the itching, plus many more boys with scabies on arms and legs. As there is no Medical Officer in Kachere, Thom and myself decided to command the situation. ( other Officers have no interest at all)
We reported it to the DOH and a very competant woman dealt with the situation right the next day! I was amazed! Africa time didn't apply for once!
We had to mass treat all 200 boys with a lotion, and then over the following 4 days, wash every blanket, mattress, and item of clothing in boiling water. An incredibly difficult task to do when the boys have no access to running water, except by burning wood to make fire to boil in a single 50 litre steel pot. Whilst in between using the pot to cook the nsima for the day. However they got it done in time for mass treatment number two the following Monday. Now hopefully the problem is eradicated and will not reoccur. I have asked the prison officers to test any new inmates before they enter the prison for scabies. Which they probably wont do but here's to hoping!!
The peer programme is going well though, and we should get it finished by the time I am due to leave. The officers are being very proactive and translating hand outs into Chichewa etc, and I truely believe this work will be continued by them once I leave which is a very satisfying thing to know.
I had a meeting with Baylor Malawi last Thursday to see how they can feed into my cirriculum, since it is mainly their own one from Botswana that I use. They were very helpful and will provide some sessions towards the end of my stint on how to impart knowledge of HIV from peer to peer for internalised behaviour change. Tom from VT is also going to work with them around organising a day for inmates to go and play soccer in the local stadium and Baylor's Teen Club coordinators will provide workshops in between on HIV prevention, and living positively with HIV.
This week's session I will conduct will concentrate on removing any myths around HIV transmission, and looking into the cultural practices that aid the spread of HIV. I am doing some research with Thom on what misconceptions there are here in Malawi.
On Thursday I will meet the 9 positive boys and we are going to show them how to make a power drink to boost their immune systems made of garlic, lemon, ginger and honey. This will empower them to look after themselves after they leave the prison. There is a miseducation around what nutrition should be provided to the prisoners with HIV. They get rice eggs and cooking oil.. which provides them basically with more of the same nutrients, yet still none of the immune boosting minerals and vitamins that you get from fruit and vegetables. So this session we will effort to educate the boys on the importance of other food groups.

Theatre for a Change in association with Waverley Care provided a training day for the Prisoners Officers and their spouses on Saturday, in which 20 were given a morning of discussions and drama role plays. At the end ten people went for testing of which 1 was positive. That person has yet to disclose to Thom, Tom, Peter or I, but is seeking treatment and post test counselling according to the nurse who did the test.

All in all, keeping very busy and having a great time in my free time too! I made my first trip out of Lilongwe this weekend down to the beautiful Cape Maclear. We had a bunch of 15 people and we had such a wonderful time. island hopping and snorkeling with the beautiful lake fish. Some of the good friends I have made are leaving over the next two weeks, so that is disappointing, but I'm sure more will pop up as i go along! The typical ex-pat lifestyle!

Cheerio for now
Dee :)

Work update :)

Three weeks and three days here in beautiful Lilongwe. Time is flying already and I know the three months will go too fast before my eyes, hopefully I will have achieved the objectives of my work and my purpose here by the end of March as planned!

I began training with the boys in Kachere last Wednesday afternoon.. they are good attentive students, so that makes life a whole lot more enjoyable! They get a break from the cramped courtyard that is shared by the 200 inmates, and there's a coca cola at the end of class as a treat, so its not a bad deal! I have ten boys who Venture trust identified as good peer mentor potential. They are split between the five cells, two in each. Their day starts at 6 am and ends at 4pm, so they have a lot of time to burn in the cells before sleep. The Peer mentors will disseminate accurate information to the rest of the boys in their cells after lock up- that is the aim of the project. Upon release, we hope these boys have instilled what their respected peer has taught them about positive behaviour, and self protection from HIV and STIs.
I am using resources from a variety of organisations that have been tried and tested in Sub Saharan African, resource poor settings. I am working with the HIV Coordinating Officer in the prison, Thom, in getting the  training just right, and involving games, role plays and discussion groups.
Thom is fantastic, and even though it is difficult for him to be seen to be working with the muzungus/white people (the other officers think he receives monetary favours) he ignores it and shows his passion to help the boys and their futures.
Im also working with the Regional Prison Coordinator, who has taken me on a trip to the adult prison Maula Prison. We had a meeting with the Medical Officers there, where they showed me the clinic they use to treat the 2000 or so inmates. Conditions are poor but not horrific. They prisoners receive their ARVs and porridge with extra nutrients. 480 have HIV, of which 90 take ARVs (approx). What I found interesting, was they estimated a persons need to go on ARV's by symptoms only.. no viral load or CD4 checks. This is to do with blood testing services being to diffficult to carry out on a regular basis.
I have been invited to do a piece of work with the women in Maula. Today I will go and meet with them, and introduce myself, and get an idea of their knowledge around HIV and of their back grounds. Based on that I will devise a number of training sessions, with the help of Peter the Regional Officer and his translations skills (Im not yet fluent in Chichewa!!)
On a final note about work, I have been to a meeting with the wonderful Theatre for a Change, and they are providing a day for the Kachere Officers and their spouses to encourage HIV testing and to do some prevention education through song and dance. The prison officers shy away from testing when it is provided to the boys, so this is an opportunity for them to do so away from workplace, and with confidentiality of results. And all staff will hopefully take the opportunity..and there's safety in numbers!!
This will be on the 11th of Feb. Pictures to follow!

Things have been volatile lately with the President being hugely unpopular, and a couple of riots on the streets nearby the prison. Huge fuel shortages, no Forex, and depleting resources for a growing population is starting to show its cracks on locals. However, in general, people still have a smile on their face, and safety is no problem for me I feel. I stay in a security guarded compound also just FYI.

On a easier, breezier note, I went to a reggae gig yesterday with a few friends and it was very very fun. Nice to see Malawians there having a good time, singing at the top of their voices, praise the lord etc etc!
Weather was perfectly sunny 28 degrees and the local beer Kuche Kuche resting on ice- bliss!

I will post again soon with more news, and hopefully a few photos of life here in Malawi.

Dee :)

12 full days

Malawi... arriving in to the country I thought to myself, this really looks like home with rolling green fields and trees dotted across the landscape. However, once I stepped off the plane, I knew it was a far cry from Ireland! It took me a couple of days to relax into the way of the Malawians. I know people tell you about culture shock, but I really was in shock at how friendly and open and talkative the locals were. Until you understand that they mean no harm, you realise that your own culture back home is too paranoid and closed off! Lilongwe is my base for the next three months. I am working for on behalf of Waverley Care with funding from the Scottish Government, to carry out HIV prevention and empowerment work with the prison minority group. I have linked up with two brilliant guys who work for a Scottish based charity- The Venture Trust, both of whom work here with the young offenders at Kachere prison. They provide a peer-mentoring programme around healthy living and life skills which I will feed into around the area of HIV for my short stint here.

Life in the last 12 days has gone from extreme panic and doubt on Day 1 to absolute happiness by day 6 and harmony right now on day 12. The people living here are so up for getting to know new people, and that has been brilliant for me as I came out here solo.

I think life here in Malawi is going to be an amazing experience for me, even with all the poverty and hardship you see every minute of the day, there is some sort of strange but beautiful calm and serene flip side to these people. Possibly because they haven't been ruined by the ideals of the Western world just yet..