Download Malawi - Nicole Elizabeth Kosmala

Malawi
"The Africa Group"
8,387 miles from Auburn, AL to Lilongwe, Malawi
Malawi
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Located in
Southeastern
Africa
Roughly the size
of Pennsylvania
Total population
of 15,263,000
people
Malawian Government
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On July 6, 1964, Malawi gained its
independence by separating from Great
Britain.
Operating as a multiparty democracy, the
first elected president was Dr. Hastings K.
Banda in 1964.
The country is currently run by President
Joyce Banda (Central Intelligence Agency,
2012).
First President Dr. Hastings K. Banda
Current President Joyce Banda
Malawian Economy
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Agriculture makes up about 64% of the
national income and 87% of total employment
Top exports include:
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Tea
Tobacco
Sugar
Smallholder farmers produce a variety of
crops: maize, beans, rice, casava, and
peanuts (U.S. Department of State, 2012).
53% of the population is below the poverty
line.
Market
Hand-carved souvenirs
Malawian Education
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91% of children attend primary school.
The literacy level in Malawi is 74% of citizens.
Malawian Health
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Life expectancy
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44 years of age for males
51 years of age for females (Central Intelligence
Agency, 2012)
Rural clinics serve as primary health care
facilities that address all health care needs.
Rainbow Home-Based Care Clinic
Area 25
Home Visit with KCN
Malimbe Village-Mobile Clinic
Mtendere Village
Mtendere Village
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Founded by the Blanchard family in
2005 through the 100x Development
Foundation
• Population
o 136 children, ages 2 to 22 years old
o 16 Housemothers
o 4 Aunties
Mtendere Village
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Basic Life at Mtendere Village
Made up of 16 houses where 4-8 children live with a
housemother and operate as small families
Children get three meals a day
Basic Life at Mtendere Village
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School
o Teachers work at the village in order to provide
supplemental homework help for all of the children
o All of the children walk to primary school, which is
located about half of a mile away from the
orphanage
o At the end of primary school the students take an
exit exam and their choice of secondary schools is
based on their scores.
Morning Walk to School
Keeping it in the Family
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Although it is funded by 100x, Mtendere
village is managed in Malawi by Malawians.
This helps the children embrace their
culture and avoid being culturally
Americanized.
Mtendere Village
The children of the village have
either deceased parents or
parents who simplly could not
have provided for them.
All children get to spend the
summer months with their
families if they are able to
care for them.
Teaching Interventions
Malaria
Nicole Bentley, Elizabeth
Bunch, Amanda Ladner, and
Madison Martin
Purpose
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The United Nations' Millennium Development
Goals are actively combating HIV/AIDS, Malaria,
and other diseases.
The World Health Organization identifies the
prevalence of Malaria in 99 countries throughout
the world. Within these countries, it was
estimated that 3.3 billion people were at risk for
contracting Malaria (2011a).
In Malawi alone, 39% of clinic and hospital
admissions are a direct result of Malaria (World
Health Organization, 2011b).
WHO and other governmental
agencies' prevention efforts
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According to emerging studies in 2007,
approximately 60% of the country has been
given insecticide-treated mosquito nets free of
charge (Roca-Feltrer, et al., 2012).
25% of the children under 5 continue to sleep
without the protection of their insecticidetreated mosquito nets (World Health
Organization, 2011b).
The number of cases of Malaria increase
between the months of November and April
because these months are considered Malawi's
rainy season (roca-Feltrer, A., et al., 2012).
Barriers to Receiving Health Care
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85% of the population lives in rural
communities (Lindgren, T., et al., 2011).
Only 43% of children under the age of five
with a fever received anti-malarial
treatment (Chibwana, A., et al., 2009).
17% received treatment within the first 24
hours of the onset of fever (Chibwana, A.,
et al., 2009).
The World Health Organization reported 8,206
deaths in 2010 in Malawi; 7,600 of these
deaths were children under the age of five
(2011b).
Target Community
•The target community that we focused on was Mtendere Village.
•Mtendere village consisted of sixteen small houses, each with three
to four bedrooms. The houses were brick with concrete floors, and
the boys and girls were split up by age and sex.
•Each house was headed by a housemother.
•Also, on the campus there was a basketball court, a recreational
building, and a swing-set area for the children to hangout and
socialize with each other.
Population
The population that we focused on within our
target community were children under five
years of age. After traveling to the local
health clinics (Area 25) we realized that most
of the patients that had symptoms of malaria
(fever, malaise) were children under five.
Health Condition
•Malaria is caused by a parasite that is passed from one human to
another by the bite of infected Anopheles mosquitoes. After
infection, the parasites travel through the bloodstream to the liver,
where they mature. The parasites then enter the bloodstream and
infect red blood cells.
•The major signs and symptoms of malaria include fever, chills,
malaise, headache, and in severe causes coma and death.
•In Malawi alone, nearly 39% of hospital and clinic visits are a direct
result of malaria.
•While we were in Malawi, we learned about the common
medications used to treat malaria.
•We administered children that presented with malarial symptoms
paracetamol for 3 days for fever and LA for 3 days to treat the
parasite.
Primary Community Diagnosis
Risk for ineffective wellness maintenance
among the population of Mtendere Village
and Malawi related to lack of education
regarding and proper use of malaria
prevention methods, such as using mosquito
nets correctly and draining standing water.
Primary Community Diagnosis
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In Mtendere Village, despite educating the
children on Malaria, correct usage of
mosquito nets is rare.
The children also still go near areas of
standing water, which are breeding grounds
for mosquitoes.
In Malawi, many people (especially in the
rural areas) have not received proper
education on malaria prevention.
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They additionally have a lack of access to health
care, which is one of the major issues in Malaria
Misuse of mosquito nets was extremely common, with many people using
them for their gardens or makeshift fences. Also, many nets that were
actually used correctly had holes in them which rendered them
Secondary Community Diagnosis
Risk for adverse complications of Malaria
among Mtendere village and the
communities of Malawi related to lack of
access to Malaria testing and lack of Malaria
testing equipment.
Secondary Community Diagnosis
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Mtendere village is closely located to a private
hospital where the children can receive medical
attention promptly, so this is more of an issue with
the rural communities.
Many people either live too far from clinics and
other health care facilities, or the rural clinics
that they do have access to do not have Malaria
spot testing equipment, so they are diagnosed
based on symptoms (which often times are
extremely vague)
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Or they are not diagnosed at all, which can lead to
severe/complicated malaria and eventually death
Diagnosing without having a definitive test can
potentially lead to over-dispensing of Malaria
Malaria Rapid Test
Tertiary Community Diagnosis
Readiness for enhanced knowledge among the
communities of Mtendere and Malawi
related to complications of a lack of
compliance to Malaria treatment regimen
and consequences of untreated Malaria.
Tertiary Community Diagnosis
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Education, education, education!!
Emphasizing the consequences of not
seeking prompt medical attention if Malaria
is suspected and not following the
prescribed treatment regimen
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Mild Malaria -> SEVERE MALARIA & DEATH
Education on additional consequences of
not correctly following treatment regimens
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Including the possibility of creating drug-resistant
strains of Malaria, which have already begun to
occur in many countries.
Complications of Untreated Malaria
Intervention
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As discussed in our community diagnosis,
our goal was to provide education about
malaria and discuss the proper uses of
mosquito nets and educate everyone on the
signs and symptoms of malaria so they
receive treatment as soon as possible.
Intervention
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In addition to educating Mtendere village on
Malaria prevention, we were able to work
in the clinics diagnosis malaria and testing
for it as well.
While fever and malaise are the most
common signs and symptoms, it takes a
quick blood test to determine if Malaria is
the cause.
We were able to diagnose and treat several
children who tested positive for Malaria
Summary
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Despite numerous programs, initiatives, and
plans, Malaria remains one of the leading
causes of death in Malawi.
Lack of resources and health care,
education, and proper use of preventative
measures are the main causative factors to
this fact.
It is our hope that with this additional and
reemphasized information, incidence of
Malaria and Malaria-related fatalities will
decrease.
HIV/AIDS
Kayce Anthony, Brooke
Bodine, Kyndall Newberry,
and Ruthie Schaefer
Purpose
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The United Nations'
Millennium Development
Goals are actively
combating HIV/AIDS,
Malaria, and other diseases.
Currently in Malawi,
940,000 people are living
with HIV/AIDS
HIV/AIDS has become the
leading cause of death in
Malawi
A little about HIV/AIDS
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It is transmitted through bodily fluids and
can take 10-15 years to show up as a
sickness
One of the main ways it is spread in Malawi
is through needle-stick transmissions
Nurses have a low supply of sterile needles
and need to give 500 injections in one day
and end up using the same needle all day
long, spreading all kinds of diseases to
innocent people
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HIV/AIDS
It can also be spread from mother to baby
during childbirth and breast feeding
According to 100x, 52% of pregnant women
in Malawi are HIV positive and 120,000
children are currently living with HIV
Social Stigma Toward HIV
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It is more difficult to educate the public as
well as the individuals infected because of
the social stigma associated with HIV
Some people believe that it will upset the
ancestors to discuss sexual practices with
outsiders
In addition, homosexuality is frowned upon
in Malawi and a person can get a maximum
of 14 years of hard labor for punishment of
being outwardly homosexual
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Social Stigma Toward HIV
offensive to the
"sexual experience"
signifies cheating or
homesexuality
women do not ask
for fear of being
beaten
Community Diagnosis
Risk of HIV/AIDS among Mtendere Village
related to genetic predisposition, lack of
access to preventive resources, and a social
stigma about sexual practices.
Community Diagnosis
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Mtendere Village is affected by HIV/AIDS
more in an indirect way in terms of the
children.
Many of the children are living at Mtendere
because of parents and siblings that have
died from HIV/AIDs.
However, there is one child that lives at
Mtendere Village that is living with the
virus.
Community Intervention
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We worry that during their teen years the
children of Mtendere Village will go off to
secondary school and not have knowledge
of safe sexual practices and how to protect
themselves from contracting the viruses
We believe the teenage group of Mtendere
would have benefitted from a safe sex
seminar during our time in Malawi
Community Intervention
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In addition, we felt it was important to
speak to the children and their
housemothers about the importance of
making sure their nurses were using sterile
needles, out of a new package, each time
they received a vaccination.
After educating the house mothers on HIV/AIDS
transmission
Hitting Home...
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This is Winnie. She was
the newest addition to
Mtendere Village and was
born with HIV. During our
stay at Mtendere, Winnie
was at the hospital
fighting complications
from HIV, such as
Tuberculosis and Malaria.
Winnie finally ended her
short battle with HIV the
day after we returned to
America...
Winnie's Footprint
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During Winnie's short life, she brought a lot of people together praying
for her and supporting 100x in moving forward with medical
advancements in Malawi
100x has started a foundation in honor of Winnie's life to help pregnant
mothers and children to get proper nutrition and education on how to
prevent the transmission of HIV
Summary
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HIV/AIDS is a huge problem in Malawi
Education is ESSENTIAL in teaching the newest
generation how to avoid transmission and protect
themselves
Stigma about sexual practices is a huge barrier in
teaching proper protection, and must be eradicated
from the thought process of the Malawian people so
they can see how important it is to protect yourself no
matter what
Nurses need to be educated on the importance of
using sterile needles for each individual patient.
Patients must be educated as well to make sure their
nurse is taking their needle out of sterile packaging
during each visit
References
Central Intelligence Agency, The World Factbook. (2012). Africa: Malawi.
Retrieved from https://www.cia.gov/library/publications/the-worldfactbook/geps/mi.html
Chibwana, A., Mathanga, D., Chinkhumba, J., & Campbell, C. (2009).
Socio-cultural predictors of health-seeking behavior for febrile
under-five children in Mwanza-Neno district, Malawi. Malaria Journal,
8(219).
Lindgren, T., Deutsch, K., Schell, E., Bvumbwe, A., Hart, K., Laviwa, J.,
&Rankin, S. (2011). Using mobile clinics to deliver HIV testing and other
basic health services in rural Malawi. Rural and Remote Health, 11(2),
1682.
Roca-Feltrer, A., Kwizombe, C., Sanioaquin, M., Sesay, S., Faragher, B.,
Harrison, J., Geukers, K., Kabuluzi, S., Mathanga, D., Molyneux, E.,
Chagomera, M., Taylor, T., Molyneux, M., & Heyderman, R. (2012). Lack of
decline in childhood malaria, Malawi, 2001-2010. Emerging Infectious
Diseases, 18(2), 272-278.
References
U.S. Department of State. (2012). Background note: Malawi. Retrieved from
http://www.state.gove/r/pa/ei/bgn/7231.htm
World Health Organization. (2011a). Global health observatory (GHO).
Retrieved from http://www.who.int/gho/malaria/en/index.html
World Health Organization. (2011b). Global health observatory data
repository. Retrieved from http://apps.who.int/ghodata/?vid=440
Zikomo!