Malawi 2004 - 2007 |
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Healing in Malawi
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If you are sick in Malawi, you have two choices - to visit the local health centre and hope they have some sort of pill in stock or to trust in the power of the ancestral spirits. If you are an HIV + male you may also choose to sleep with a virgin, a well-known cure. We had the opportunity to visit the first two, but declined the third option . 1. Traditional Healing The village was one of those road-side clusters of crumbling mud houses with grass roofs that you pass with no reason to stop or engage curiosity. A few mud-caked children gathered to wave shyly or stare in sullen insolence. A few women were slouching around attending to their endless trail of household tasks. We were greeted by an older man with bare feet wearing a ripped jacket that had once been brown, a shapeless hat and patched frayed-bottom trousers. He was unshaven. This was the village head, the first-level traditional chief, appointed by the Traditional Authority Chief (TA) who covers several villages. At the top of the structure is the Paramount Chief to whom all owe their allegiance. This structure is still very important . Even the President is expected to show deference to his local chief when he visits his home District. Village heads and T.A.s also act as local magistrates, judging local disputes and criminal acts according to traditional law. This co-exists with state law and there is currently a donor-funded project to clarify the appropriate assessment and referral of cases to the court system. In village life form is everything. It is here that the blundering ' asungu ' is likely to step on an etiquette bomb in the middle of a cultural minefield. Women often kneel at men's feet as a greeting - in some areas they prostrate themselves. There is a great deal of submissive behaviour. Men and women clap their cupped hands together softly as they hunch their shoulders and bend their legs in appreciation. Women courtesy. The honorary Kenyan ' asungus ' and myself ended up walking like Groucho Marx as we greeted our way across the compound towards the healing hut. The mud building was a surprise. Not so much because it was dark and dingy but because it was crowded with around seventy or eighty people. Men were seated on the earth floor to the right and women sat to the left. On the wall was a single poster promoting a political party at the last election. We sat on the mud floor at the rear of the hut where the session was in full-swing . The healer was a tall angular man dressed in a long white shapeless robe covered in a Christian cross motif. This was complemented by a matching pill box hat. His long arms ceaselessly pointed gesticulated and traced his meaning in the ether, whilst his body and legs moved like ferrets in a bag inside the long voluminous robe. In his right hand he held a bible, which was often opened to emphasise a point. But it was his voice that really captured the attention. I felt as though I was watching an old blues artist. His course husky voice rose and fell in volume and pitch in an endless tirade. One moment in the highest register, the next closing to a near whisper; always delivered at breathless speed. However, this was not the whole story. His every call was answered by a plump woman seated on the ground in front of him. This high-volume, high-speed, high- energy, call and response created an atmosphere that reminded me of the best of hucksters at the local street market. Lots of energy, and never time to collect your thoughts. I was puzzled by the need for this double act and I turned to my Chewa companion to ask what he was talking about. " his words can't be understood" she explained "she is the only one who knows what he is saying." Indeed, he was speaking in tongues and she was his conduit to the waiting world. The first case we witnessed was a woman who looked to be in her mid twenties . She had travelled the 20 kilometers from Lilongwe for healing. Her problem was that she could not be with child. She was on her own and this would not produce the desired result, so she was asked to choose a surrogate husband from amongst the sheepish men. The unfortunate man shuffled to the front and coyly held her hand. The healer set off on another roller-coaster tirade, gesticulating and vigorously tapping the Bible as the story unfolded. The unfortunate woman had been cursed by somebody. Her fallopian tubes had been tied in a knot. The curse would have to be removed by magic and traditional medicine. She left happy. It became obvious that this healing session was performing a variety of purposes. It was soap story, entertainment, counselling, community bonding, and spiritual hope in a world that could offer little in the way of rational solutions. The women took a lively part in proceedings, often breaking into song, laughing uproariously and generally offering comment and advice. The men kept quiet. A man with a physical complaint followed and yet again a woman who could not get pregnant. She too had to select a stand-in spouse as it emerged that the fault was not hers. Her husband lacked vigour. It was he that should pull himself together, take his medicine and act like a man. If not she would probably have to look elsewhere. Fertility is important in a world that offers no protection to the ageing parent nor much technological help with the work of staying alive. I could have spent the whole day in this beguiling atmosphere but we had a programme that could not be denied and as we rose to leave the healer was still in full throaty flow after several hours of performance. At the rear of the hut there was a pharmacy. It contained a variety of gnarled roots, and unrecognisable unguent substances. I asked the chemist whether he could cure all ills and what he thought about hospital medicine. He was very balanced. No he could not cure all illness and he often sent people to the hospital when he thought he could not help. We bowed and scraped our way back to the Land-Rover. 2. The Area 18 Health Centre The centre was a collection of low single story buildings on a hill in Lilongwe. The area had a lot of Malawi Housing Association buildings that offer simple but relatively cheap rented accommodation. There was a pregnancy unit with 9 beds and general medicine building. There was little evidence of much equipment and the pharmacy looked very bare. Yet another building had rows of benches and a large black board filled with writing. This was where Mums came to learn about child care . There is now a system of child care passports. These work on the basis that people value what they pay for. A very small charge is made for the booklet which keeps a record of treatment and helps people to get to the care they need. What immediately struck me was the contrast in atmosphere with the traditional setting. This place was filled with glum people sat on benches in corridors, talking little and seeming to have little to say. It was obviously important to people but there seemed to be little of the high expectation and hope of the village scene. People seemed as though they were ground down by high demand and low resources. The acute shortage of doctors and nurses has led to the use of many para-medical staff. Hospitals are run not by doctors, but by auxilliary doctors who are staff trained for two years. Many of the nurses are ill-trained and drained of motivation. Nursing training is often seen as a route to other Government employment. However, when I spoke to the V.S.O hospital maintenance engineer he was much more upbeat about the state of hospitals. There has been a major programme of building. He said that the doctor in charge of the District was very motivated and tried to maintain high standards . The exception was the Area 25 Health Centre which was easy pickings for rascals. Everything was stolen that could not be secured. One very sick woman had the indignity of having the mattress stolen from under her. Whole toilet bocks were dismantled and glass slats from louvered windows lasted no time at all. Desperate measures were taken. The staff decided not to treat anyone from Area 25 until they got together to sort out the problem - 'they know who's doing this, they have to take responsibility'. ***************************
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