An Impossible Summary

How do I summarize my experience in Malawi? It certainly isn’t an easy task. Alright, let me try…
I learned so much about Malawi, Canada, nursing and myself on this trip, and honestly that doesn’t cover it all! I learned that Malawi is a beautiful country, with spectacular sunsets and sunrises. It’s mountains go on for miles and every turn on a road leads to a different landscape. The water so clear and blue. It’s people, incredibly friendly people, full of hope and joy, who will give you the shirt off their back – if indeed they have one. They are so supportive of one another. They often suffer quietly, so as to not make a disturbance. I saw the difference between what it means to survive, rather than to live.
I knew going into this trip that though things are very different around the world and people suffer, not everyone wants to be like us North Americans. Actually being in Malawi and seeing it first hand though really drove this point home. We need to get out of our minds that we are better, that people look up to us and want to be us. They don’t. We try to portray an image of perfection when, the justice system allows for innocent black men and women to be killed, when native americans are shoved onto tiny plots of land, are kidnapped and murdered and nobody bats an eye, when thousands of homeless people die on cold winters nights because there is nowhere else to go, I could go on. And yet through all this, we have the audacity to believe that everyone in the world wants to be like us. That there even is an us and them.
Whenever tempted to pity, which happened often, I was reminded of a conversation a friend and I had about pity. Who are we to pity others as though our country is perfect. Canada is so far from perfect. Pity does nothing. Literally nothing. It allows one stand idle, thinking that just feeling badly about a situation will actually do something. All this happens while others actually suffer around them but they feel better because they were sad about someone’s misfortune. Pity is for the pitier.
Being in Malawi was hard. It was tiring. It was frustrating. We saw preventable suffering, things that we could fix and cure if only we had the resources. People dying because of miscommunication, overbooked ORs, unfair distribution of resources, remote living quarters, the list goes on. People died, young and in vain. Being there was hard, but it was an amazing experience, hopefully a life-changing one. Through all of the pain and suffering there was hope and joy. We saw how little things that we take for granted, things like a needle, or some tape, scissors, or gauze can save a life. We saw resourcefulness and true, genuine gratitude.

Zikomo Malawi, you’ve opened my eyes.
Tionana Malawi, we shall meet again some day.

-Julia Sturino

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MNE 2019

Travelling can open eyes. It can open minds and it can open hearts.

            If you let it.

Seeing a country and a people different from your own can teach you so much about the meaning of life and what is really important.

            If you let it.

Any words that I attempt to employ in order to share the depth of our experience in Malawi will fall short of their task. But they are all I have to use to describe it.

            So I will try and let them speak.

My time in Malawi has taught me so much. It taught me of the value of life. It taught me of its fragility and how we – even as health care professionals – can not give or take it. It taught me to treasure the days, the hours and the moments given to me. I learned to seize opportunities, to run away from idleness and towards my calling to give what was given to me and to serve with whatever is in me.

My time in Malawi has humbled me incredibly. The vastness and majesty of the world we live in can make you feel so small. The more you see of it, the more you realize how little a part of it you are. This lesson – to take yourself a little less seriously – is both humbling and freeing. The poverty which we have witnessed has humbled me as well. We see people with almost nothing – still smiling and laughing in the face of adversity. It has reminded me that everything I have – things to fill needs and all the superfluous – is grace.

My time in Malawi has encouraged me enormously. We have met so many outstanding, hardworking and selfless individuals all throughout our time there. Nurses and doctors work tirelessly to relieve suffering and bring health. In Malawi I was struck by the immense potential of nursing care. It can do so much good. A nurse can take away tears and give smiles. He can give dignity, humanity and hope in times of despair. She can be a shoulder to cry on in times of trial. And we can rejoice with patients and families in times of joy and recovery. I have seen this happen by the hands of so many colleagues, and I have been privileged to use my own hands to do the same.

I knew the Malawi Nursing Exchange would impact me greatly. I knew I would learn a lot. It was an incredible experience, during which I only scratched the surface of everything I want to learn and do, but I am coming away from it having learned and grown incredibly. Thank you Malawi!


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Malawi 2019

In 7 weeks in Malawi
I have seen a part of the world I never thought I’d ever see
I have lived in a village in which I experienced a hospitality that was unique, different and familiar at the same time
I have been exposed to new standards as a nurse
I have seen the direct impacts of being out of resources and learned to truly appreciate the tremendous luck to be full of resources at home
I had the opportunity to see the outcomes of what an overloaded health care system causes
I’ve experienced my first patient death. That same patient was younger than me
I learned to be more forgiving of myself and that trying to play God would only make me go into a whirlpool of frustration, confusion and guilt.
I saw a patient die in front of me as I’m performing CPR on her in front of her family
But most importantly
I have experienced the graciousness lf the people of Malawi. I have felt the love that pours out of the people’s heart; hearts that barely have anything for themselves but are willing to sacrifice it if it brings joy to someone else. I have worked with devoted health care team members who went above and beyond to ensure that patients had a chance of stepping out of the hospital. I have seen Malawian co-workers express the same frustration that I did.
I have learned about myself more than I ever could in 7 weeks than I ever did so far at home as a future nurse. I have learned about how devastating unrealistic and untruthful expectations can be to one’s self. I realized that saying: I gave my 100% is not an excuse for failure but rather the most honest statement you could say when you are faced with disappointment or failure after attempting every options you have in your tool box.
In 7 weeks I have gone through many ups and downs. Incredible highs and devastating lows. But if you were to ask me: would you go again?
Yes, in a heartbeat
Cedric Sam

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The Warm Heart of Africa

As I was leaving my room, from the residence, on Friday to head towards the airport, I could not believe that I was on my way back to Canada. The first three weeks that I spent in the village seemed long initially. Even though I felt home sick from time to time, I still enjoyed every single moment; the joy and warmth of the ladies who were cooking food for us, the kids who were playing around and dancing with us, the beauty of the landscape, the view of the milky way on a dark night, and so much more! As we moved to the residence in Lilongwe (Malawi’s capital), the weeks just flew by one after the other. I feel grateful for all the knowledge that was shared with me and my group by the healthcare team members throughout my stay in Malawi. Before going to Malawi, I knew about the lack of resources that this country could possibly have; however, being in the position of trying to care for someone where the resources are scarce, provided me with more insight and appreciation for what we have back in Canada.

As I’m reflecting on my journey while in Malawi, I can see how this experience has greatly influenced my nursing practice. I will forever cherish these seven weeks that I spent on this beautiful land, the warm heart of Africa

Malawi, tionana

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Until next time…

It is now the end of our journey in Malawi, I can honestly say that I am now even more grateful than when we started the trip. I got to experience so much and learn even more. We were strangers in this land and yet we were welcomed with open arms and warm smiles. Yes we went to the hospital and dealt with conditions, that where we come from, are less than ideal. However that was just one aspect of their beautiful country. They have so much to offer to the world, they just need the opportunity to show it. Malawians show their sincerity in almost all of their actions in their daily life. They became a role model for me to achieve. By going into each endeavour with my honest intentions.  I truly believe that I can achieve anything I set my eyes on. Hence I am grateful and I am happy I got to be part of this unique experience that made me grow and broaden my horizon. I will always remember the country that truly became my warm heart of Africa.

Tionana Malawi!!

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Tionana Malawi by Jessica Loewen

As we start packing and wrapping up final goodbyes, I am both sad to leave and relieved to go home. I never thought I would gain such an appreciation for the things we take for granted. I mean things like functioning toilets, hot water to shower with, washing machines and the like. Residing in Malawi for the last 7 weeks has taught me more than just nursing skills. It has taught me humility, compassion, patience and a deeper gratitude. These lessons came with a price, as I started to understand my own privilege, they left me with guilt. I can’t help but feel my work here isn’t finished, there’s so much yet to learn about the culture and nursing practices. Everyday brought new challenges, new experiences and new friends. I am truly grateful to have had this experience, and I recognize now more than ever the gift I was given. One thing I hope to carry in my heart is the strength Malawians possess, particularly the women. Each one I have met has inspired me to keep working hard and to be strong. Thank you Malawi, you have taught me much.

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The Gift of friendship

Now that I am writing, we are on the plane on our way back home. This amazing journey, with all its ups and downs, has come to an end.

This experience has been really unique on so many levels. The adventures that we have had, the people that we have met, and the challenges that we have faced, all have helped me grow so much. I gained so many valuable skills and personal experiences, but there is one thing that is more valuable to me than all of these and that is the gift of friendship.
We are eight people in this group; some are older and some younger; some are quiet and some are loud. All of us have very different personalities and characters and each of us hold different values close to our heart. But we all have one thing in common, we are all genuine in the friendship that we offer; this is what I realized during this trip.
I came to this trip terrified. I felt fearful because living with eight people who have a culture very different from mine was terrifying for me. I was very much afraid of being misunderstood, as we have a language barrier between us although I am fluent in English. I also thought who will I talk to if I need help? If I need some encouragement? Additionally, I have some strange habits that might cause misunderstanding. I eat with my hands sometimes; I tease my friends all the time; I am very stubborn and opinionated; my jokes might not come across as jokes, and so many more. Due to these habits, acceptance and understanding in friendship is really important for me. I enjoy being who I am and if I feel I need to explain myself all the time, it makes it hard for me.
The first test of this friendship happened during the second week of our stay when I hurt my back very badly. I bent once and I couldn’t stand straight anymore. It was very scary and uncomfortable; however, it turned into a very sweet experience as I felt truly supported. Once I said I cannot move, everybody stayed with me and tried to calm me down. For the rest of the trip, I didn’t have a good back, but my friends had my back.
Everything else that came after just proved to me this friendship is getting stronger. When I was angry, they listened to me; when I was wrong they reminded me; when I needed help they offered it to me; when I apologized they forgave me. When I was afraid to jump into the water from a rock, they encouraged me. They helped me be steady when I was standing there, looking at the water, shaking. I never thought I would do it once, with their cheers I did it twice.
This is what friendship is all about. For me, friendship is about disagreement but listening to what the other side has to say. It is about listening to each others’ joys and sorrows, is to laugh and shed tears together. Friendship is when she taps you on the shoulder when you are silently crying. Friendship is when she forgives you even though you have done her wrong. Friendship is when he comes and takes your heavy bag without you even asking. Friendship is when he tries his best that you get all the notes, tries every cable that he has to make your internet work. Friendship is when she comes out of her own net to tuck yours in, when you cannot move because of your back pain. Friendship is when she knows what makes you laugh, and laughs with you. Friendship is repeating the funny part of a song together whenever you feel like it. Friendship is when the ladies from the village took turn carrying your bucket of water so that you don’t have to push your back. Friendship is when they teach you a new word every day and cheer whenever you repeat it. Friendship is when they remember your name even though you don’t remember theirs. Friendship is being among the people who know you are full of faults and flaws, but they give you their best.
This post was supposed to be a reflection on the whole trip, but my trip couldn’t have been so rich if it wasn’t for the people that I met and I travelled with. Warm heart of Africa taught us the meaning of the true acceptance. When they offered us the little that they had just to show their appreciation, we saw their heart of gold. They took us in and accepted us so warmly that when we were leaving, I felt like leaving my long known family. I am forever grateful to be on this trip for the gift of friendship that I received from my people and the people of Malawi.
Moujan. May 4th 2019

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Time to say goodbye

We are heading home in 3 days. I have no idea if I will ever see Malawi again. It is has been a strange trip for me. I come from a small family in which I am the only child. My world at home is a world of peace and quiet. Malawi, on the other hand, is a tiny sliver of landlocked land that contains 19 million people, with more being born day in and day out. When taking pictures of scenery, it is often difficult to do so without a person entering the frame, or noticing someone’s house in the background after you have taken the photo. It is the starkest contrast to my own understanding of the world that I have yet to come across. Malawians live their entire lives in the social realm: they enjoy roomfuls of people; sound and loudness, they dislike being alone or in silence. Lucy, the founder of Ndi Moyo Palliative Care Centre, showed us the Centre’s meditation room and told us that the room is often only used by foreign visitors and religious leaders. Malawians prefer to use the mediation room to charge their phones because they dislike the quiet nature of the room. Malawians congregate outdoors in large groups, play political messages at high volumes from huge speakers on the back of trucks, and will chat you up at the first opportunity. It is hard to be an introvert in Malawi.

Nevertheless, I have felt at home here. I have adapted and grown to enjoy it. Did this happen because I knew it was only for seven weeks? Perhaps, but I know nonetheless I will miss it. I find myself staring out the window on our car rides trying to soak the last of it all in, watching Malawians and their culture played out on the roadside, as it so frequently does, trying to carry it home in my memory. I hope it will not soon be forgotten, replaced by the familiar world of Montreal and Canada and the excitement of family and friends, of work and school, of the future and the adventures it holds. I will hold the warm heart of Africa in my own heart and let the memory of it shape me and guide me forward

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Palliative Care

On Monday, April 29th we visited Ndi Moyo, a Palliative Care centre in Salima District. I had the opportunity to visit Salima District Hospital to see palliative patients who have been admitted there due to complications of their diagnoses. Rex, a palliative care nurse from Ndi Moyo, was performing rounds on palliative patients under his care when the ward nurse pointed out to him a woman with breast cancer, who is not part of his program but who should be seen as soon as possible. She is sitting on the concrete floor of the hospital with only a blanket underneath her, and is leaning against her husband for support. It is clear that without his help she would be too weak to sit up. She is naked from the waist up, and is only covered below the waist by a chitenge (a traditional cloth wrapped around the waist). With her breasts exposed, it is clear that a tumour is growing in the right breast, which is swollen and misshapen. As we review her history with her family, we learn that her initial diagnosis when she first sought medical care was stage 3 breast cancer. With this diagnosis there was no surgery that could be performed because the cancer had already spread. She had been receiving chemotherapy until she became too anemic to continue, so her family had brought her to Salima District Hospital 10 days ago in the hopes that she would receive a transfusion.  

As Rex examines her, he finds her quite weak with pale conjunctiva, a telltale sign of anemia. Her family also mentions that she has a pressure sore (a wound which can be caused by pressure on one area of the skin from staying in the same position for too long). Rex proceeds to lay her down on the floor to assess the sore. As he uncovers her buttocks, the foul smell of the wound makes me take a step back and Rex confirms what I already suspect based on the smell. “Her coccyx is gone”, he says, by which he means that the skin protecting the coccyx bone is no longer there. It has been worn away by sitting on the concrete floor for 10 days. I ask why she was not put in a bed on admission and the ward nurse tells me that the ward was full when she was admitted, so the only place left for her was the floor. But now as I look around the ward I see a free bed, so I insist that she be transferred there. Why did she not get transferred to a bed with a mattress when one became available? It is a hard truth in Malawi that sometimes there are no answers to questions such as these, and this is immensely frustrating. Now in addition to being burdened with cancer and anemia, this woman will have to hope that this wound, caused be no fault of her own, will be able to heal without infection

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Operation Smile

On our first day at Kamuzu Central Hospital in Lilongwe, we passed by posters advertising Operation Smile. I have heard about Operation Smile at home in Montreal. I know they provide services to repair cleft lips and cleft palates. The organization assembles teams of doctors, nurses and surgeons who travel around the world to provide surgical tools and expertise to medical hosts in countries such as Malawi, enabling hundreds of patients to receive surgeries that they might not otherwise have received. As we pass through the doors and stand in the entrance of the operating theatres, we are met by a nurse from Australia who is part of the team and she happily takes a few minutes of her time to outline the selection process of patients and the logistics of a medical mission of this sort. Operation Smile was based in Lilongwe from April 4th to 13th, and during that time they expected to complete over 350 surgeries.

Operation Smile is just one of many groups whose aim is to provide quality medical care in third world countries. So many medical professionals from the first world give up their vacations and personal time to come and contribute to this worthwhile cause. As we approach graduation and begin our careers, I am wondering what my impact will be on someone else’s life. I hope to be a part of something good, now it is just a matter of finding my place

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