Tuesday, 9 August 2011


I want to tell you the story of Chikumado (meaning ‘Someone who is not happy’)
Chikumado’s mother lives in one of the many extremely poor villages about 20kms. outside of Lilongwe, the capital of Malawi. As far as I can find out she has had ‘psychiatric problems’ for some time. Her husband Cidy claims to have married her because ‘I had been without a woman for such a long time so I thought I would take care of her.’ I believe that he too is highly unstable. It is not clear as to whether her first child, a girl now two years old, is fathered by her husband or was the result of a violent incident.
I only met Cidy and his wife today.
I had arrived on labour ward at the usual time just before 7.30am. Checking for any problems that needed to be solved from the night I then attended the morning ‘hand over’ meeting. I then returned to labour ward where I take the daily responsibility of leading the morning round with the clinical staff, students and midwives. This is wonderful opportunity for teaching in the practical situation as we discuss each and every case in detail learning and planning care.
My mobile phone rang twice but it was not a good time to take the call so I let it ring. The third time it rang I answered the call. Beatrice is a nurse/midwife colleague who I have known almost since I first arrived in Malawi over three years ago. She is running a small charity organization set up 4 years ago by an Marican midwife (Joanne) with the aim of supporting the families of our orphans from Bwaila. That is to say when a mother dies in our care they will support and encourage her close family to care and raise the child in the village rather than take it into care(orphanage) We have worked together closely for all these years and I will call Beatrice whenever there is such a situation. She is caring and reliable and doing a much needed task which should be covered by the Social Services but as in many things here in Malawi is sadly lacking.
‘I am at the central hospital ‘she explained. ‘One of the babies we have been caring for has died and we have no way of return the baby’s little body to its village’
How could I resist? How could I deny this plea for help?
I agreed to help
Fortunately labour ward was not too busy and we were well staffed so I set off in my car to the hospital to find her.
What a sorry sight met me as I arrived. The small accompanying procession of women approached my car, the small corpse wrapped in a colourful cloth, the distraught father carrying his dead child and my friend and colleague Beatrice. They all climbed into my car and we set off on our sad journey home.
Whilst we drove Beatrice told me the whole story.
Beatrice had first become involved with the family when Chikcumado was five months old and weighing just 2.8kgs. He had been brought to the hospital by his father severely undernourished and extremely sick. After a short stay on the paediatric ward he was discharged home is the care of his father. The baby’s mother was not fit to care for him as was evident. Beatice continued to make regular visits to the village providing milk powder and nourishment and slowly Chikcumado began to gain weight. The situation was still precarious and when at 11 months he was still malnourished and failing to thrive he succumbed to pneumonia and severe anemia. His father once more brought him to the hospital. Treatment was given and after three weeks, during which time his father never left his side, Chikcumado began to make progress. He now weighed 7kgs. At the beginning of this week one of the ward assistants brought hot water to the father so that he could bathe his child. Unfortunately she failed to tell him that the water was straight from the stove thus allowing him to dip his son into boiling water sustaining severe burns to most of both his legs. This was too much for the small undernourished child to deal with. He died three days later.
We arrived at the village and were met by the village headman and members of his family. It seems they were unaware of what had occurred and certainly had not supported Cidy over the past weeks. The baby and the anguished father were taken into the family mud hut and a procession of women started to arrive to pay their respects as is custom. We enquired as to the whereabouts of the Chikumados mother but no one seemed to know where she was. They had not seen her for days. She was eventually located in a dilapidated hut next to where we were standing. How it was that no one knew or cared I fail to understand but it became clear that she had not been receiving any help from the village or her family. Yes…. now I began to understand clearly how it was that this whole situation had occurred. There are many superstitions surrounding people with psychiatric disorders which often results in them being outcasts in the village.
Entering into the hut I found Chikcumado’s mother sitting on the floor of what can only be described as a space fit only for animals. Her other small child lay sleeping in her lap filthy dirty and covered in faeces. A pan of beans was burning in a pan over a small fire made of sticks. I touched her face; I smiled and talked softly to her. I could do nothing. I left the hut and sadly walked away. We said our farewells to the father and the family respecting traditions and drove back to Lilongwe.
Beatrice will visit again and try to give care and support for the other little child, just 2 years old but with little hope for the future, with little hope for survival.
Lucas will return on Friday after seven weeks in Spain with his Papa. Lucas is privileged. Lucas is happy and healthy.
I thank God for Lucas.