Malawi
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Malawi. "The Africa Group". 8,387 miles from Auburn, AL to Lilongwe, Malawi. Malawi. Located in Southeastern Africa Roughly the size of Pennsylvania Total population of 15,263,000 people. Malawian Government. On July 6, 1964, Malawi gained its independence by separating from Great Britain.

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Malawi

Malawi

"The Africa Group"


Malawi

8,387 miles from Auburn, AL to Lilongwe, Malawi


Malawi1

Malawi

  • Located in Southeastern Africa

  • Roughly the size of Pennsylvania

  • Total population of 15,263,000 people


Malawian government

Malawian Government

  • 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).


Malawi

First President Dr. Hastings K. Banda


Malawi

Current President Joyce Banda


Malawian economy

Malawian Economy

  • Agriculture makes up about 64% of the national income and 87% of total employment

  • Top exports include:

    • 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.


Malawi

Market


Malawi

Hand-carved souvenirs


Malawian education

Malawian Education

  • 91% of children attend primary school.

  • The literacy level in Malawi is 74% of citizens.


Malawian health

Malawian Health

  • Life expectancy

    • 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.


Malawi

Rainbow Home-Based Care Clinic


Malawi

Area 25


Malawi

Home Visit with KCN


Malawi

Malimbe Village-Mobile Clinic


Mtendere village

Mtendere Village


Mtendere village1

Mtendere Village

  • Founded by the Blanchard family in 2005 through the 100x Development Foundation

  • Population

    • 136 children, ages 2 to 22 years old

    • 16 Housemothers

    • 4 Aunties


Malawi

Mtendere Village


Malawi

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

Basic Life at Mtendere Village

  • School

    • Teachers work at the village in order to provide supplemental homework help for all of the children

    • All of the children walk to primary school, which is located about half of a mile away from the orphanage

    • At the end of primary school the students take an exit exam and their choice of secondary schools is based on their scores.


Malawi

Morning Walk to School


Malawi

Keeping it in the Family

  • 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 village2

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

Teaching Interventions


Malaria

Malaria

Nicole Bentley, Elizabeth Bunch, Amanda Ladner, and Madison Martin


Purpose

Purpose

  • 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

WHO and other governmental agencies' prevention efforts

  • 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 insecticide-treated 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

Barriers to Receiving Health Care

  • 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).


Malawi

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

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

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

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

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 diagnosis1

Primary Community Diagnosis

  • 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.

    • They additionally have a lack of access to health care, which is one of the major issues in Malaria prevention and treatment


Malawi

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 ineffective.


Secondary community diagnosis

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 diagnosis1

Secondary Community Diagnosis

  • 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)

    • 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 medication and resources


Malawi

Malaria Rapid Test


Tertiary community diagnosis

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 diagnosis1

Tertiary Community Diagnosis

  • Education, education, education!!

  • Emphasizing the consequences of not seeking prompt medical attention if Malaria is suspected and not following the prescribed treatment regimen

    • Mild Malaria -> SEVERE MALARIA & DEATH

  • Education on additional consequences of not correctly following treatment regimens

    • Including the possibility of creating drug-resistant strains of Malaria, which have already begun to occur in many countries.


Malawi

Complications of Untreated Malaria


Intervention

Intervention

  • 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.


Intervention1

Intervention

  • 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

Summary

  • 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

HIV/AIDS

Kayce Anthony, Brooke Bodine, Kyndall Newberry, and Ruthie Schaefer


Purpose1

Purpose

  • 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

A little about HIV/AIDS

  • 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


Hiv aids1

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

Social Stigma Toward HIV

  • 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


Social stigma toward hiv1

Social Stigma Toward HIV

  • offensive to the "sexual experience"

  • signifies cheating or homesexuality

  • women do not ask for fear of being beaten


Community diagnosis

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 diagnosis1

Community Diagnosis

  • 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

Community Intervention

  • 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 intervention1

Community Intervention

  • 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.


Malawi

After educating the house mothers on HIV/AIDS transmission


Hitting home

Hitting Home...

  • 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

Winnie's Footprint

  • 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


Summary1

Summary

  • 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

References

Central Intelligence Agency, The World Factbook. (2012). Africa: Malawi.

Retrieved from https://www.cia.gov/library/publications/the-world-factbook/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.


References1

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


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