To start a new week we arrived at Devlin’s office to confirm our plans for the day. Devlin had travelled to Blantyre on Friday night (a 10 hour bus journey) to facilitate a 2-hour parenting workshop on Saturday before travelling back to Mzuzu the same day. He spoke about how this had been positively received and he hoped that further input would be requested in the future. This reminded us of the scarcity of psychological resources in the country, with Devlin being one of only 3 psychologists here.
We discussed our developing thoughts about how we might support and collaborate on research with the agogo projects. We asked about the training that staff currently receive; Devlin explained that the projects are led by social workers who will receive some education around older adults and associated issues during their training. The projects rely on volunteers; we later found out through talking to several volunteers that they come from the local communities who are supported by the projects. There is also someone within each village who is identified by the village chief to liaise with SJOG if they have any concerns about agogos in their village. Currently there are not many opportunities for these volunteers to access training or specialist knowledge as part of their role.
We decided that the best use of our day would be to travel to Massasssa, the second agogo project. We were kindly driven to the village and enjoyed the meandering road through local markets up to the agogo service. The service is in the hills and has a wonderful view that allowed us to truly appreciate how far the agogos travel to arrive. They were keen to point out the direction of their home villages – the picture below is taken from the agogo centre; one gentleman told us that his house was a two hour walk in this direction!
We were warmly welcomed by the agogos and staff, who explained that there are two groups of agogos who rotate attendance each week due to the large numbers of local agogos in need. This is in addition to the agogos who are visited at home due to being unable to access the agogo centre. The staff shared that the traditions of these agogos are different from those at Towilane due to descending from a different tribe. Part of this difference includes their traditional songs and dances which they demonstrated throughout the day. They would often burst into spontaneous song in the middle of a group conversation, often to acknowledge or celebrate the important things being spoken about. Following tea and bread (which they wanted us to share) there was a facilitated discussion around health issues. This initially focused on possible contributing factors to having a high or low blood pressure. There was some acknowledgement from the agogos of psychological factors e.g. worry about their children, but the discussion largely focused on diet and exercise. The agogos explained that without this ongoing psychoeducation they had been unaware of these facts. This had allowed them to make changes to their lifestyles and they had noticed improved health as a result of this.
We were then invited to contribute to a more general discussion around health issues and we took this opportunity to explain the purpose of our visit and gain their ideas of how we could support the projects, the agogos and their communities. There was a lot of energy in the room when we spoke about memory and people asked us lots of insightful questions about dementia as well as providing examples of difficulties that they were experiencing. Examples included questions around whether dementia can kill you, if dementia exists in all countries around the world, how do we identify dementia in the UK and whether there are treatments for dementia. We did our best to address these questions but recognised that this could form a much bigger piece of work in the future. We explicitly asked the agogos whether it would be helpful to learn more about dementia and to find ways of assessing for dementia which are culturally sensitive. The response to this was loud cheering, shouting and traditional vocalisations. We double checked the meaning of this and staff explained that the agogos felt very positively about this idea. Staff and volunteers expressed their own keenness to learn more and develop their skills. We wondered whether these projects would be a lovely opportunity to work with staff, the agogos, their families, and local community representatives.
Following a shared lunch we took time to sit and rest outside with the agogos; we had taken some handcream and soon had a queue of women wanting a hand massage. They explained that moisturiser is very expensive in Malawi so this was a luxury in many ways. The agogos kindly gave consent for us to take pictures and asked that we share these in the UK, as well as bringing them back to show them next time we visit. We then joined them for an afternoon of ‘motivational talks’ where the agogos shared their life stories with each other. We noticed the prevalence of traumatic life events within these stories e.g. early loss of parents, witnessing physical violence and injuries. They tended to focus on the theme of overcoming these difficulties and thanking God for this. We reflected that in the UK such discussions might be more structured if in a therapeutic setting due to the potential of this causing further distress.
Our wonderful day with the agogos ended with a literal bucket of tea – they prepare tea in a large bucket and then serve individual cups to each of the 53 agogos. Some of them poured their milky tea into bottles for the journey home. Each agogo came to say goodbye as they left for the day and expressed a hope that we would visit them again.
On our return home we had planned to have a cooking lesson from one of the chefs at St John of God, Edward. He demonstrated how to cook nsima (a staple food made from cornflour) and groundnut vegetables. Edward was very much in teacher mode and had a great catchphrase of ‘have you seen it?!’ when he wanted us to really pay attention!
Before we could bake our African Cake the power went off in our accommodation so we ate by torchlight and finished cooking in the main SJOG kitchen. It was a lovely meal to share with someone who has become a friend over the years and for those of us who we see in person, you can look forward to a truly Malawian meal on our return!