This is my answer to Why do you do what you do? – to serve in the spirit of thanksgiving.

I am thankful to the people of Malawi, the mothers and children at SOS village and Blessing Trust, the staff and patients at St. Gabriel’s, the students and faculty at the University of Malawi College of Medicine, therapy team at Chimteka, and friends in Namitondo. Special thanks to Alexander Ngalande, Comfort, and Suave Gombwa at the Family Centered Care Unit. They gave me a place to learn, teach, share, exchange and be a part of the lives of many special patients who are on a difficult journey supported by palliative care.

There are many challenges in Malawi – especially for the vulnerable populations of children, people with disabilities, people living with HIV/AIDS. At times, it is difficult to see beyond the overwhelming needs. The people have shown me how – to share a smile, to reach out to one another, and to build a strong community.

“Life will always provide matters for concern. Each day, however, brings with it reasons for joy… Be gentle with this life…and do whatever is done in a spirit of Thanksgiving.”

(from Always We Begin Again)

I’ll be returning home tomorrow, but look forward to returning to Malawi next summer to work at St. Gabriel’s, teach at the University of Malawi College of Medicine/School of Physiotherapy, work at the hospital in Blantyre with a focus on their pediatric palliative care program, and mentor physiotherapy students at St. Gabriel’s.


With a child on her back

August 8, 2011

I spend a lot of time walking through the open hallways at St. Gabriel’s – traveling from ward to ward, searching for a nurse or a doctor, coordinating care, relaying messages about patients.

Along the way, people greet each other and often stop to chat. “Chat” is a common word here, one not heard much at home.

These are pictures of one of the young girls I greet at least three or four times a day in the hallway. She is carrying her little brother, and helping her mother by bringing food from the kitchen to her other brother – who is being cared for in the pediatric ward. Her brother has been on the ward for seven weeks. She is always smiling, and greets me politely.

The child on her back is almost as heavy as she is…yet is no burden for her.

How old are you?

August 7, 2011

It’s a question that most of us can answer, and our exact age carries special significant in our culture. When I am reviewing the file of an elderly patient here in Malawi, I often see the age written as a range, 70-75, or 70+, for example.

I have found it interesting to try to inquire about the patient’s age. Usually, the person helping the patient at the hospital – the guardian – is one of the patient’s sons or daughters. I learned an interesting strategy from the nurse in the palliative care unit. First, you find a son or daughter who knows their age, or their birth year. Then you ask what order they are in the family. Then you ask how many years there are between siblings. If you can count back to the birth year of the first born, you are close to the mother’s age of about 17 or 18. From there, you get her birth year and age. This works well for finding the age of fathers too.

This week, we had this conversation with the daughter of an elderly patient who had a stroke. The daughter was the fourth born. However, we learned that all of the children were twins, each set only one year apart, and her mother had had eight sets of twins! Her age was estimated to be close to 95.

So, “How old are you?” is a simple question at home. Here, it brings out a life story and amazing insight into the patient’s family history.

Saturday in Chimteka

August 6, 2011

Today I traveled with Titi and Alice, occupational therapists; Morgan, a speech therapist, and Evelyne, a physical therapist to a rural area west of Namitete – near Chimteka. Evelyne has started a project there that includes therapies for children and education for schoolteachers about children with disabilities. Today, Titi was giving a workshop about visual perception, visual impairment and strategies for the classroom. While he was giving the training, Alice and Morgan were providing therapy in a village about a half and hour a way. Evelyne was also providing therapy, and educating a group from a local HIV support group about how to encourage exercise in people living with HIV/AIDS. Meanwhile, I was training a pilot group of volunteers from the Parents Of Children with Disabilities Association of Malawi that will be contacts for Evelyne in the remote villages. These contacts will be connected by the MedicMobile cell phone communication system. John Harrison (the project manager at Chimteka Children’s Support Center) and Christi Brooks (a Peace Corp volunteer) and I were training these contacts in how to use a cell phone. It took us the majority of the day to make sure they were confident in turning the phone on and off, connecting the charger properly, as well as finding and reading text messages. The contacts will receive a message from Evelyne each week about which children in the villages in their area should come to the therapy program on Saturday. The contacts will be responsible for notifying the families of the children. This will hopefully help the families know when the therapy team is coming for their children. Sound like a busy day?

Alice and Titi, occupational therapists


Morgan, speech therapist

Teachers learning about Special Needs Education

Titi working with the teachers


The Malawian head teachers that were facilitating the workshop


Information is posted on flip chart paper on the wall


This primary school was accessible

Titi's dinner that traveled under the back seat on the way home