Home sweet (second) home!

Home sweet (second) home!

Thirty hours, two taxis, three trains, two fights and a beautiful drive later – we are back in Mzuzu!


Despite it being over a year since we last visited, we’ve felt a wave of familiarity and comfort ever since landing in the Warm Heart of Africa. We’ve felt warmly welcomed back by new and familiar friends 😊

En-route to Mzuzu we were able to stop off at the Lilongwe Hospital and see the amazing building progress that’s been made over the last year.  More from there next week! During our drive we learned more about the agogo project for the elderly which also seems to have grown in scope since we were last here. Our driver, Happy, spoke of the positivity that the development of these services has been met with by local communities. We acknowledged that other adults in the UK and Malawi can often feel lonely and isolated, and Happy noted that locals have been really enthusiastic about finding ways of responding to this need.

We had a brief and welcome break during our journey to stop at a local market – the picture below can’t begin to capture the vibrancy of life in this hive of activity!


We arrived at our accommodation to find that a fecliois dinner had been left out for us – very welcome after a succession of meals in the air! Planning an early night so that we can start the day bright as early in the morning!


Tionenengo machero (see you tomorrow!)

(Update – we have only been able to post this today; we did indeed have a very early night (9pm) and early morning (6.30)!) 

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“My time will come”

“My time will come”

We have delivered our last training workshop at the House of Hospitality on ‘understanding the origins of mental wellbeing’. The aim was to promote psychological understandings of distress and to encourage staff to think beyond diagnostic labels.  In discussions with the team, it seems that this was something that had already been introduced previously and today’s session was an opportunity to consolidate their knowledge.  Again, the baked goods went down a treat!  After the session, we said our goodbye’s to staff and clients, which was much harder than anticipated.  We’ve reflected that this could be down to the time we have spent getting to know the service users and staff and the relationships we have built.

This morning, we were invited to another older adult day centre in Masasa. As we mentioned before, this is a fantastic service and is accessible to all over the age of 65.  The service offers an integration of different services and promotes physical and psychological wellbeing.  We were lucky enough to attend their weekly dance/music session and saw the older adults act out scenes of bewitchment and abuse to raise awareness in their local community through dramatization.  The photo below is of the ‘agogos’ doing a traditional dance.

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On Saturday, we heard a moving story from a lady we have come to know at the Centre. She spoke about how her decisions in life have been influenced/driven by financial motives and she has compromised her ambitions to meet the needs of her children and wider family.  Despite many challenges, she told us of her belief that things would get better and spoke of her unrelenting faith that her “time will come” (either in this life or the next). We have spent time reflecting on the power of faith and spiritual beliefs in the midst of struggles and challenges encountered by the people of Malawi.

Over the next few days, we will be spending time with the children at the Child Development Centre and hope to attend an outreach service for street children. We are aware that we w don’t have much time left in Malawi so we are using every opportunity to soak up new learning and spending time with friends we have made here.

We will endeavour to keep you updated!

Kelly & Hayley

 

 

 

A reality check

A reality check

The last couple of days have been quite emotionally challenging for us. While every day we are aware of and acknowledge discrimination and poverty, on Wednesday evening we were confronted with this is in a more explicit way.  Up until then, it didn’t feel as though we had truly processed the extent of poverty and struggles faced by many.

A young gentleman who is studying to become a clinician (and who we have come to know quite well in the compound where we are staying) described challenging circumstances in accessing education and the financial toll this has taken on him and his family.  He described how difficult it is for him being away from home and the financial struggles he encounters. As we mentioned previously, the shame people experience as a result of financial struggle appears to feature heavily.  Despite this, everyone has maintained a high level of integrity and respect towards us.

Being confronted with this overt discrimination and poverty has been difficult in the context of our privilege and got us thinking about our role and how we can possibly begin to influence change through the relationships we have developed with clinicians in Malawi.

Yesterday, we spent the morning at a Day Centre set up for adults over the age of 65 (who are referred to as ‘agogos’). We are told that this was initiated following concerns for the wellbeing of the aging population.  They are often excluded and ostracised from their communities as there is a common belief that aging adults are ‘witches’ and a burden to society and their families.  We spoke to many of the service users who described abuse, bullying and loneliness as a result.  We heard how much they value a forum to build skills and share experiences with other older adults.  We were serenaded by attendees who wished to share their gratitude for the service and how much they value it.

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The centre also offers education as part of an outreach service to the community in an attempt to reduce abuse to older adults.  All the staff we spoke to described how important they felt it was to nurture, respect and care for older adults in society.

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While we were there we helped in the preparation of lunch, by chopping vegetables and making nsima.  We’re pleased to say it was a success!

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In the afternoon, we were again drawn to attend the music lesson with the Street Children Project and again were struck by the power of music and dance in uniting children and teachers and the influence of this on psychological wellbeing.

Today, we delivered our third workshop to staff and clients who access the Institute of Vocational Training. Oswald, the co-ordinator, asked us to present on ‘self esteem’.  With the aid of staff as translators, we discussed the importance of being true to one’s values and asked students to reflect on their relationships with others and themselves.

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Below is a picture of ideas generated by the students of things they value.  Due to the intermittent internet, we have been forced to think on our feet and have done several impromptu role plays when access to online videos has failed!

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Next week, being our last week, we plan to see as many of the remaining services we have not yet accessed. We will also be delivering a final workshop at the House of Hospitality on psychological formulation and factors influencing mental wellbeing.

On a completely random note, I have just received news that my Service Related Project has been published in this months Clinical Psychology Forum so we will be celebrating with a glass of vino!

For now, tionanenge

Kelly & Hayley

Challenges, successes and sustaining ‘umoza’

Challenges, successes and sustaining ‘umoza’

On Monday we met a gentleman who shared his experiences of current governmental processes that make it difficult for him to start his own business. Within this, he shared feelings of deep shame at being forced to ask for money from a religious organisation in order to buy food. This got us thinking about the links to many of the experiences clients share with us in the UK, due to current austerity measures. We know about the impact of shame and stigma on psychological wellbeing. Thousands of miles from home we encounter the same struggles and challenges.

We delivered a workshop at the House of Hospitality yesterday on formulating and managing challenging behaviours, following consultation with the staff team.  We were very grateful for how well this was received and the thoughtful discussion at the end of the session. Staff asked about the use of medication and seclusion in the UK and provoked some really helpful reflections by asking how different the two processes really are. They wondered if they potentially serve the same function in isolating, excluding and ‘shutting’ individuals away.

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We have also been asked to present to clients and staff in the Institute of Vocational Training on ways to enhance self esteem. In doing this, we’ve wondered about the transferability of Western psychological strategies to our current context and again reflected on how reliant some of these practices appear to be on privilege.

We have just delivered our second presentation of the week to teachers at the Child Development Centre. As mentioned in our previous posts, teachers shared their struggles in understanding and managing challenging behaviour in children with a Learning Disability.  Today, we introduced strategies and skills for consideration.  We are hopeful, from the feedback, that staff found this useful when they provided comments including, “there is always a function behind a behaviour.”

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Since delivering these workshops, we have reflected on how to sustain links between services here and in the UK, and possible ways to promote continuing professional development. We wonder if this may be achieved through the use of video recorded presentations or e-learning programmes that could be shared regularly.  Food for thought once we return home!

You’ll be glad to know that the banana bread was a success and resulted in one staff member asking for the recipe. High five Kathy!

Tomorrow, we will be spending time getting to know the newly developed older adult services, as well as spending more time with the Street Children project and learning to play the drums (hopefully!)

We will be sure to update you soon,

Kelly & Hayley

The power of privilege

The power of privilege

Wow…it’s been a busy week! We have spent the last week liaising with teaching staff at the Child Development Centre to gain more insights into how they work with children (and their families) in supporting their learning and skill acquisition.  We have now been given a number of topics to present at the Child Development Centre (CDC) and the House of Hospitality and we are looking forward to presenting these later this week. We are currently in the process of baking banana bread to take with us for our first training session but without a measuring scale and a reliable oven this is proving to be a tricky task. This trip so far has taught us to be grateful of many things; washing machines, warm showers and cooking equipment are just some items we will be sure to be grateful for when we return the UK. Although said in jest, the whole experience has really opened our eyes to the level of privilege many of us have in the UK and the challenges that many people in Malawi, indeed Africa routinely face.

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As well as working into the CDC and House of Hospitality we have spent some time with the Umoza children and what an utterly incredible experience this was. Watching the children singing, playing drums and dancing to traditional Malawian music made the soul smile more than a little. We were obviously aware of the meaning of the word ‘umoza’ but it wasn’t until we came to Malawi did we fully understand it or feel it. It is an absolute privilege to be here and meet so many wonderful people. One thing that did strike us though, was when a number of western teachers entered the site and started to video and take pictures of the children, this made us think a lot about consent and their reasons for doing this. It was obviously an incredible experience and one which people wanted to capture but we wondered how teachers and professionals would react if visitors entered a western school and begun taking pictures without an introduction.  We understand that there are cultural differences here but the question regarding motives has really got us thinking about the importance of consent.

On Friday, we were kindly invited to the Brothers House for an evening meal. We were invited to participate in their evening prayers before being treated to a feast of amazing food, drinks and even Brother Raphael shared his Toblerone with us and even posed for a picture (see below- he provided consent!). Throughout the evening, we got to hear about their roles in different services and heard their passion for supporting individuals in distress.  Caroline, Amy and Ian will be pleased to know that we got to sample bread and butter pudding for our dessert, based on a recipe they shared with the Brothers a few weeks ago! It was very enjoyable.

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After a busy week, we decided to visit Lake Malawi again, with our flat mates who are working for World Vision. We spent time at the wonderful Mayoka Village in Nkhata Bay.  The site promotes ecological sustainability and one way of doing this was through their use of compost toilets(!) and the site was very unobtrusive on the hillside.  Staff were very friendly and we got to see more of the lake by taking a boat ride and utilising the free canoe to explore the bay area.  Thankfully, we did not capsize, although it was a bit hit and miss at times. Intrusive thoughts of crocodiles and ending up stranded in Mozambique were enough to make us turn around at a fast pace.

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As mentioned earlier, this coming week we will be delivering our workshops across the service, based on our observations, discussions and collaboration with staff teams so far. We will keep you posted on how these go…but for now we are off to check on this banana bread!

Kelly & Hayley

 

We might have took Lilongwe, we knew we’d get there someday…

We might have took Lilongwe, we knew we’d get there someday…


We’re currently sat at King’s Cross Station awaiting the final stages of our journey home and finally have internet access to update you on our time in Lilongwe. 

Since leaving Kelly and Hayley in Mzuzu we travelled to Lilongwe (with a quick detour to Zambia for 2 nights!) and have been spending time getting to know the brand new inpatient mental health services recently opened there. 

Wall painting in the hospital reception area

We were warmly welcomed by both staff and patients at the hospital and were privileged to talk to them about their experiences. 

On Monday morning we were invited to attend a meeting about the development of a risk assessment policy. Mwawi, the programme manager, facilitated the meeting and reminisced about our involvement in the beginning of this work.  It was interesting to see the ongoing development of this process following a workshop facilitated by Caroline and Olivia 2 years ago. 
We were moved to hear stories from some of the patients about their experiences of mental health difficulties and how others have understood and responded to these. These stories were difficult to hear and emphasised the importance of talking about and reducing the stigma around mental health in the community. 

Communal courtyard of the acute ward

We were struck by the space, layout and general feel of the ward and noticed some similarities to inpatients units in England. One key difference was the shared bedroom and bathroom facilities which on one hand created a community within the unit, but on the other offered little space for privacy.  
Bedroom shared by 6 patients

Whilst spending time at the hospital we had the opportunity to meet with various staff members, including counsellors, nurses, and clinical officers (who have a role similar to British psychiatrists). Something which lots of staff highlighted was the struggle to access resources and share ideas to inform their practice; this has led to us think about developing a forum for international professional peer support. 

During our final days in Malawi we were all aware of how at home we felt and how difficult it felt to leave the Warm Heart of Africa. With a few plots to stay foiled (see picture below of Amy nearly missing the plane!) we embarked on our long journey home. We kept our spirits up by thinking about the developments we have planned and our intention to return to this wonderful place. 


We’re pleased (if not slightly jealous) that Hayley and Kelly will be continuing the work of Umoza Trust for the next few weeks and will hand the blogging baton over for now…

Tionanenge – see you soon! (Please excuse the spelling any Chitumbuka speakers) 

Funky chicken, beaches & bewitchment

Funky chicken, beaches & bewitchment

On Friday, Hayley and I spent a whole day at the House of Hospitality, engaging with service users with a broad range of mental health difficulties. We were made to feel very welcomed by staff and clients, and aimed to better understand how the service works and the pathways to discharge.  As mentioned in our previous post, there was a strong sense of community, and many of the clients have visits from family several times per week.

Hayley and I were taught to play a range of card games and got to see, first hand, the power of music in the Malawian culture when we attended their disco in the afternoon. The funky chicken will now features as part of their dance moves thanks to Hayley’s introduction of it!!

We will be spending more time with staff and the service counsellor to gain a better idea of the challenging behaviours they identified and possible ways to support them in managing these.

Over the weekend we spent time in the very idyllic Kande Beach. We were struck by everyone’s friendliness and curiosity about who we are and what we are doing in Malawi.  Our trip was very eventful as the car we were travelling in got stuck in the sand!  Children and adults from the local villages rushed to our aid and kindly helped dig us out and lift the car. Wow!

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Yesterday, we spent time at the Child Development Centre and had the opportunity to travel with the children on the school bus, home to their local villages. It was such a lovely chance to see the children light up when met by their family members at the different bus stops.  Although this was a very positive part of the day, it was very difficult for us both when confronted by the level of sedation in very young children.  This experience of how children with additional learning needs are cared for was somewhat different and something that we aim to explore further with staff at the Centre.

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Today, we spent time at the inpatient service again and had the opportunity to contribute to ward review discussions and develop a broader understanding of how mental health is conceptualised in Malawi. It was our first experience of including beliefs about bewitchment, punishment in some way by a higher being and voices symobolising messages from ancestors in formulating psychological distress.  We are looking forward to learning more about this in our future visits to the service.

We’ll keep you updated with our further ramblings soon!

Kelly & Hayley