Kasungu district have registered 417 cases of child marriage from January to August this year, a situation which has put at stake the future of young girls in the district.

According to social welfare officer in Kasungu, Harrison Thindwa, the area of Traditional Authority (T/A) Njombwa tops the list with 95 child marriage cases with Sub Traditional Authorities Mawawa and Mangwazu coming in second and third, having registered 73 and 63 child marriages respectively.

Thindwa said that apart from poverty, the lack of coordination between the government and organizations that are involved in the matter of child care is contributing to this practice.

Meanwhile, chairperson for civil society organizations in Kasungu Braxton Banda said that the lack of funding in the government’s child care departments is another factor that is holding back the work to end child marriage.

According to United Nations Population Fund (UNFPA), Child marriage in Malawi is a significant problem with 42.1% of women 20–24 married by age 18.

First Ladies of Southern African Development Community (SADC) region have expressed concern over the negative effects of COVID-19 pandemic on women and girls in the region.

Malawi’s First Lady, Monica Chakwera corroborated the sentiments with the first ladies Tuesday at Kamuzu Palace in Lilongwe where she chaired SADC First Ladies virtual meeting on the impact of COVID-19 in the region.

She said the pandemic has threatened the fundamental ways of life through preventative national responses including lockdowns, curfews and working in shifts.

Chakwera noted that the region continues to have limited number of vaccines that have been administered and this has exposed many communities to the crisis.

“That means our women and girls continue to be extremely vulnerable to the impacts of COVID-19 on various spheres of life including on other dimensions like key health services and access to social amenities,” she said.

The First Lady added that disasters and emergencies affect women and men in different ways and are exposed to increased risks as the obstacles they face in their everyday life.

“This pandemic is having a devastating impact on all of us, but more so for our women and girls. We are in real danger of seeing a reversal of the progress made in challenging and breaking down these barriers.” she noted.

Chakwera said there was need to ensure that the needs of women and girls are central to that recovery pathway and investment in girls’ education should be a priority.

The First Lady said the pandemic affected the education sector more when schools were forced to close due to increased number of COVID-19 cases.

“As women, we need to ensure that our needs are reflected on, valued and regarded central to our recoveries as we move forward. We need increased resilience in our communities to face crises such as this pandemic, and our starting point should be women and girls,” she added.

Chakwera observed that the pandemic has seen increased domestic pressures, violence and a rise in harmful practices to women and girls.

“We have witnessed an increase in harmful practices including gender-based violence (GBV) and underage pregnancies. For instance, 53 percent of women surveyed in United Nation Population Fund (UNFPA) and UN Women 2020 survey reported that there was a negative change in GBV since the onset of the pandemic, and the situation had deteriorated,” she explained .

The First Lady pointed out that due to the pandemic the pressure on health services has led to sexual and reproductive health and rights not receiving the attention that it needs.

She said increased resilience in communities to face crises such as this pandemic, should let the starting point be women and girls.
First Lady of Botswana, Neo Jane Masisi said the pandemic has made more women and girls suffer through GVB.

She disclosed that Botswana has made an effort to amend laws to ensure that perpetrators of GVB should be given stiffer punishments.

First Ladies of Mozambique and Democratic Republic of Congo (DRC) expressed similar sentiments saying women have been left vulnerable as a result of the pandemic which calls for restrictions in movements of people.

Mana

It has been revealed that the availability of Youth Community Based Distribution Agents (CBDAs) could help the youth to have access to Family Planning Services.

Speaking in Kasungu on Tuesday, during a training of 50 CBDAs including youth CBDAs, National Family Planning trainer in the Ministry of Health, Nelson Mkandawire said young people are willing to access family planning services but there are some hindrances.

“The youth who are willing are unable to be reached with FP services. Another issue is that the youth are more comfortable with their fellow youth and can easily be helped,” he said.

Family Planning Association of Malawi (FPAM) with support from UNFPA and Ministry of Health is training the CBDAs from different catchment areas across 18 health facilities in Kasungu.

FPAM is conducting the training under the UN Joint Programme for Girls Education (JPGE III) project with the aim of ensuring continued Sexual Reproductive Health and Rights (SRHR).

First Lady, Monica Chakwera has urged different stakeholders to support government by constructing changing rooms for girls to use in all schools in the country to enhance menstrual hygiene.

Minister of Gender Community Development and Social Welfare, Patricia Kaliati made the call on behalf of the First Lady on Friday in Mangochi during the launch of ‘Advancing Menstrual Health Equity in Schools and Communities Across Malawi’ project.

The Event was held at Thema Community Day Secondary School in the area of Senior Chief Nankumba in Mangochi where 650 reusable sanitary pads were distributed as part of launch and also in commemoration of the International Menstrual Hygiene Day which falls on May 28.

Kaliati said it was the desire of the First Lady that all schools in the country have changing rooms and that all girls have access to proper sanitary hygiene, hence the call for support in construction of changing rooms.

“We don’t want to see any girl dropping out of school or even not taking part in every day classes because she’s menstruating,” the Minister said.

She added that, “We have provided sanitary pads to 650 girls and we are going to distribute more than 5,000 sanitary pads to girls in seven districts to ensure uninterrupted education to girls in the country.”

The Minister applauded all partners implementing the Advancing Menstrual Health Equity in Schools and Communities Across Malawi project namely, Days for Girls Malawi who are working in partnership with Shaping Our Future Foundation.

The Project is being implemented on pilot phase targeting adolescent girls and women in seven districts namely, Rumphi, Mzimba, Kasungu, Lilongwe, Dedza, Mangochi and Neno.

Chief Executive Officer for Days for Girls Malawi, Celeste Mergens, commended the First Lady for bringing together a number of partners in promoting menstrual hygiene.

“Girls often have their menstruation in school and this makes them feel uncomfortable especially when they do not have the menstrual care products they need, hence our intervention to ensure that they have something they can count on monthly,” she said.

The CEO hailed the First Lady for her commitment in the cause describing it as an honour for Days for Girls Malawi to work with Madam.

“The kind of commitment in the First Lady is something that I’ve never seen in any other country: it is remarkable and exemplary,” Mergens said.

The Advancing Menstrual Health Equity in Schools and Communities Across Malawi project is being implemented with a funding of US$78, 000 from Plan Malawi and UNFPA.

About 1175 young girls in Nkhata Bay have completed a six-month mentorship training in gender-based violence (GBV), harmful practices (HP), sexual reproductive health (SRH) and village saving loans (VSL) courtesy of Girls Empowerment Network (GENET).

GENET District Coordinator, Julie Msosa said the girls are trained in what we call safe spaces where young girls come together to share their experiences and learn what gender-based violence is and their responsibility in speaking out and reporting GBV.

“This is done under the guidance of their fellow young woman whom we call mentor and the current cohort was recruited last year (2020) and as they have graduated from safe spaces, new girls will be enrolled ,” said Msosa.

She added that one major stride GENET made was to facilitate formation of clubs for the girls where they were given grants and basic training in financial management and the mentees who graduated over the weekend were from eight traditional authorities of Mankhambira, M’bwana, Zilakoma, Fukamalaza, Fukamapiri, Timbiri, Mnyaluwanga, Zilakoma and Kabunduli.

Seventeen-year-old Maggie Chirwa of Traditional Authority Mankhambira in the district is one of the mentees who graduated from safe space last Saturday. She said the grant has been a big push as it enabled her to go back to school.

The programme is funded by UNFPA through Spotlight Initiative which aims at eliminating violence against women and girls.

UNFPA on Tuesday released the 3rd edition of an animated series dubbed “Nthambi”.

Nthambi series details the life of a Malawian girl-child, a 17-year-old single mother from a rural setup.Commenting on the series, UNFPA Malawi Resident Representative Won Young Hong,, Malawi says: “Nthambi’s character is a product of extensive research and the story line will be informed by UNFPA’s vast experience in the area of sexual and reproductive health and rights. Her voice represents the aspiration of many girls who don’t have the platform to either enjoy or demand their sexual reproductive rights.”

Nthambi’s story starts when she hears, at a community meeting in her village, of the International Conference of Population and Development (ICPD) that will take place in Nairobi, Kenya in 12-14th November this year.

Although she does not know what she will find in the meeting of Nairobi, she decides to go there because she overheard girls like her will come and discuss the challenges they are going through.

Driven by a will to change her circumstances, she takes a bus to the city in the hope of reaching Nairobi. Along the way, the adventure unfolds as she meets different characters who will expose her to the harsh realities of being a girl as well as a woman in Malawi while forming a unique friendship with people she meets on her way to support each other.

“The chance meetings with different characters will shape her understanding on areas such as sexual reproductive health, HIV/AIDS and education,” adds Young. “Our hope is that through the journey of Nthambi, her friends and our audience will also learn a wide range of issues, challenges, and barriers related to sexual and reproductive health and rights adolescent girls and women are facing every day in Malawi.”

According to Young, UNFPA has made the animated series more engaging by also inviting feedback from its audience to shape the script. This way, the animated series will capture some of the aspirations of the youth and how they want us to shape policy so that they can thrive within their own environment.

Despite some positive shifts, the Malawian adolescent girls and women still face a plethora of problems that range from social to structural, which often excludes them from standing for opportunity.

The series has been running on UNFPA Facebook page, Twitter and YouTube channel from Wednesday the 18th of September up to November when the ICPD conference will end in Kenya.

Every week, UNFPA will release a three-part series which will form an episode based on a specific themes.

National Youth Network has said youth in the country have agreed to lobby for the legalization of safe abortion.

This was said by the chairperson elect for the network Chikondi Njaya during the general meeting the network held in Mponela, Dowa.

Njaya said youth have agreed to first present the idea at the International Conference on Population and Development slated for November in Kenya.

“The problem is that we are losing a lot of young girls due to unsafe abortion so it’s better just to have a law that allows people to abort pregnancy safely,” said Nyaya.

The meeting was organised by the Ministry of Youth, Sports and Culture with funding from the United Nations Population Fund (UNFPA)

UNFPA Country Representative Young Hong said youth gatherings are important because they bring out a lot of issues that affect them and solutions are made.

“You need to bring out all your issues at forums like these and bring them to the authorities through your executive. You also need to have a very strong communication strategy so that you don’t leave anyone behind,” said Hong.

Director of Youth in the Ministry, Judith Susa assured the youth that the Ministry will always be there to support youth activities and continue formulating policies that favour the youth.

“We are one of the few African countries with brilliant youth friendly policies and our plans are clear that we want to promote youth representation at different levels,” said Susa.

The meeting was attended by youth representatives from districts and elected the new National Executive Committee, (NEC)

Malawi’s First Lady Gertrude Mutharika on Monday called upon all women in the country to embrace the tendency of going for cervical cancer screening.

Madam Mutharika said all the Districts Hospitals in Malawi have got the screening facilities making it possible for more women to be going for the screening.

She said this at Kamuzu Palace in Lilongwe, when she received assistance from the UNFPA of cryotherapy machines which are used to screen women for cervical cancer.

Said Mutharika, “On 11th August this year in Ntcheu, I launched the Stop Cervical Cancer campaign, and I am glad to note that many women now go for cervical cancer screening.

“This assistance has come in time as it will help to complement the already existing machines in our various district hospitals for I know some of the machines are old and might be malfunctioning.”

According to Madam Mutharika, out of 20, 000 women who go for cervical cancer screening, 2,300 women are found with the problem and 1, 600 women die because of it, making it a gargantuan challenge for Government to look into it.

“As a way of curbing the problem, government made available screening facilities in all the district hospitals, but with this kind assistance from our partner UNFPA, it will go a long way to deal with the problem further,” she said.

On her part UNFPA Deputy Representative Dr. Rogaia Abdelrahim concurred with Mutharika on the need for more women to be going for screening in the fight against cervical cancer.

UNFPA as a partner to government in the health sector, they have given the cryotherapy machine to help fight against the problem of cervical cancer in Malawi.

“Any woman, who attained the age of 18, should go for the screening and do likewise after five years. In the same way, HIV positive mothers, need to go for the said screening after every two years,” she urged.

She said Malawi ranks the top most when it comes to issues of cervical cancer in Africa because of many reasons including early pregnancies, maternal complications, having multiple sexual partners, among other things.

The cryotherapy machine given which are worthy MK10 million have since been distributed to Dedza, Mchinji, Ntcheu, Nkhatabay, Mangochi and Chiradzulu, district hospitals.

United Nation Population Fund (UNFPA) Tuesday donated 76 motorcycles to Ministry of Gender, Children, Disability and Social Welfare to reach more women in rural areas.

The motorcycles have been donated to ease mobility of workers towards Gender Equality and Women Empowerment Programme (GEWEP).

Speaking after receiving the donation, Minister responsible Patricia Kaliati said the programme will help to reach more beneficiaries on issues of gender.

“Issues of gender based violence are high because women are not educated and economically empowered and lack a lot of resources to support their families, so men took advantage of that to abuse them.

“Our girls are also going into marriages early; impregnated and defiled, but now under the programme which we have on the girl child from UNFPA with support from European Union we have achieved a lot,” Explained Kaliati.

She said the motorcycles would be taken to one stop centres, victim support units and to mother groups to mobilizing girls to go back to school and the motorcycles would help to reach remote areas.

Kaliati added that time has come for women to sort themselves and get out of been silent to end problems for the country to achieve development goals by 2030.

However Principal Secretary (PS) in the Ministry Dr Mary Shawa asked UNFPA officials to register the motorcycles with Private Vehicle Hire Organization (PVHO) to have number plates and to train the user.

She said the motorcycles would be much taken care of if the users are well trained to avoid accidents and unnecessary breakdowns.

UNFPA Deputy Country Representative Dr Rogala Abdel Rahim said government through the ministry of gender is very committed on issues related to women and girl child.

She added that they have collaboration together and the handover of motorcycles would help to facilitate the officers in the field to which women and girl child are affected.

GEWEP is implemented in 13 districts by UNFPA with support from EU.

The US and Malawi governments Tuesday expressed worry over the rate the country’s population is growing, describing it as “way too much” for a country like Malawi.

Director for USAID Health Office in Malawi, Peter Halpert, and Principal Secretary for Health, MacPhail Magwira, sounded the concern in their separate addresses during the launch of the Family Planning Costed Implementation Plan (CIP) 2016 – 2020 in Lilongwe.

Halpert said the country’s population growth might be the most significant threat to Malawi’s long-term development and prosperity if it remains unchecked.

“Forty million people,” said Halpert, pausing for effect. “That is the estimated number of people that will be living in Malawi by the year 2040 if women continue to have five or more children in their families – that is more than double the current population.

“Why this rapid population growth is a serious issue is because it puts a tremendous strain on already stretched sectors, including health, agriculture, education, and economic development.”

The USAID Malawi Health Office Director said the country was already experiencing food shortages every year, periodic stock outs of vital drugs and medical supplies, increasing scarcity of land, and that the problems would be even greater when Malawi’s population reached 40 million.

He added that USAID would continue to support the Malawi government to increase access to reliable information and quality services, recognizing that a couple’s decision to have a child is part of their reproductive rights.

“The United States Government does this because issues of population growth in one country have great impact on the rest of the world,” said Halpert.

In his keynote address before officially launching the Family Planning CIP 2016 – 2020, Principal Secretary for Health, MacPhail Magwira, said government was equally concerned with the population growth hence, the establishment of the CIP 2016 – 2020.

“Forty million people by 2040 will indeed be a mammoth task considering that we are already struggling with a population of 16 million plus,” said Magwira, adding, “This is why government is intensifying family planning and reproductive health services to save lives, lower levels of unplanned pregnancies and increase survival rates of under-fives.”

He said although Malawi was a model in issues of family planning and reproductive health in the sub-Saharan Africa, the country’s contraceptive prevalence rate was not perfect.

“The country’s Contraception Prevalence Rate remains at 33 percent and with the implementation of this Family Planning CIP 2016 -2020, we hope to work with our partners to increase it to 60 percent by the year 2020,” explained Magwira.

UNFPA, who are partnering with government and USAID in implementing the Family Planning CIP 2016 – 2020, have since pledged to give all the necessary support Malawi government would need in the implementation of the 5-year CIP.

The 5-year plan document was launched under the theme ‘Increased modern CPR for married and unmarried sexually active women aged 15 to 24 years from 33% to 60% by 2020’.

The CIP aims at serving as a roadmap for government, civil society, traditional authorizes, and development partners among them USAID and UNFPA for the next five years.

The planned activities under the launched plan include addressing barriers to family planning, long distances or inadequate access to services, and negative community attitudes related to family planning.

Full implementation of the CIP will avert 6 thousand maternal deaths, 47 thousand child deaths, and save MK25.5bn, according to USAID.

Development partners have since urged the ministry of health to be the chief advocate in implementing the plan, and that other government institutions should implement complementary policies that put women at the centre of Malawi’s development.

Malawi’s celebrated and award-winning Hip Hop artist Gwamba has been invited to perform in South Africa next week.
He leaves the country on August 9 for the UNFPA Safeguard Young People (SYP) album launch slated for August 12 in Johannesburg.

Gwamba, the UNFPA Malawi SYP ambassador will perform at the event alongside Botswana’s Zeus, Lesotho’s Stlofa, Swaziland’s KrTC, Zambian Kaliwo, Zimbabwean Brian and The Dogg from Namibia, who are also SYP ambassadors in their countries.

The eight musicians recorded the album in April and the project comprises two group tracks and solos from each of them. They have also done a song together called “We Will”, which came out in December.
The “Ndiyima Pachulu” rapper expressed his excitement about his first ever performance in the South African city.

“I’m very excited. I can’t wait to be back in Johannesburg and perform with the guys,” said Gwamba in an interview.
He will be reuniting with his fellow musicians after their previous performance at the Bushfire Festival in Swaziland in May

Gwamba’s trip to South Africa comes just after the release of the song “Siuli Wekha”, a UNFPA Malawi theme song that features him, Third Eye, Young Kay, Piksy, Faith Mussa and Nesnes promoting the rights of a girl child.
“This is my Malawian family that I’ll be working with in the SYP projects locally,” revealed the rapper.

Gwamba was appointed UNFPA Malawi ambassador in November 2014 after releasing a series of hit singles from 2013, the year he won the Best Hip-Hop/Rap award. His ambassadorship has taken him to several countries across the SADC region.

The UNFPA is supporting the implementation of the regional SYP development programme which aims to empower adolescents and the youth, with a special focus on adolescent girls; protecting them from STIs such as HIV, unwanted pregnancies, unsafe abortions, early marriages, harmful cultural practices, gender-based violence and to promote equitable gender norms.

A women’s Mother’s Day fun run has been set and will take tomorrow in Mangochi Boma.

The Fun Run, a Nation Publications Limited’s (NPL) corporate social responsibility initiative is aimed at raising funds for the purchase of medical equipment for maternity wings of public hospitals in the country.

This year’s event will raise funds for Mangochi District Hospital and its satellite health centres.

FaceofMalawi speaking to project coordinator Herbert Chagunda in an interview said most of the critical items for the district hospital and surrounding health facilities have already been procured.

“We are, however, asking for other well-wishers to come in because we are yet to purchase some medical equipment,” he said.

Some of the items that have already been procured include oxygen concentrators, delivery sets, suturing sets, baby weighing scales and adult weighing scales.

“We are very grateful to well-wishers and organisations that have supported this year’s Mother’s Day Fun Run,” said Chagunda.

During the Fun Run—NPL  employees, representatives from partner organisations and other well-wishers led by NPL chief executive officer Mbumba Banda, Parliamentary Health Committee chairperson Juliana Lunguzi, UNFPA and Unicef country representatives—will brave a two-kilometre distance from Ayiche Wosope (which is close to a mini-forest as we approach Mangochi to the district commissioner’s (DC) office.

The Fun Run will also be spiced up with traditional dances, drama and an open air concert by Mibawa Band.

Since its inception in 2005, the project has raised over K80 million for nine public hospitals across the country.

UNFPA Malawi is incorporating the CONDOMIZE! campaign in deep-rooted and prominent cultural practices in the country in its quest to increase condom use among the youth and ultimately, reduce unplanned pregnancies and HIV infection.

The Gule Wamkulu, a generally secret cult and ritual dance practiced among the Chewa people of Malawi, Zambia, and Mozambique, has now adopted CONDOMIZE! At a campaign in Malawi’s central district of Mchinji, its followers used song and dance to highlight the importance of correct and consistent condom use.

“It is a great step that members of the Nyau, who are the custodians of the Gule Wamkulu, are helping us to spread the CONDOMIZE! messages,” said Milika Mdala, UNFPA reproductive health and commodity security officer. “We have made great strides because Nyau followers are responsible for the initiation of young men into adulthood and we know that young people will also learn about CONDOMIZE! from the cultural set-up.”

Condom use among young people is very low in Malawi, according to Lupenga national surveys, including the Malawi Demographic Health Survey 2010. This is a major contributing factor to high HIV infection and fertility rates among the youth.

Gule Wamkulu is a prominent cultural practice which is respected countrywide and dates as far back as the 17th Century. The cult dancers wear masks and costumes made of rags, straws and wood to depict different kind of characters, including the dead, different races of people, wild animals and machinery. As they dance, the characters portray different forms of behaviour and sing songs on morality and social values. In CONDOMIZE! the songs encourage condom use, and speak against early pregnancies and about the importance of HIV prevention.

Principal youth officer in Malawi’s Ministry of Youth, Deus Lupenga, agrees with Mdala on the significance of involving Gule Wamkulu in the campaign. “It carries a lot of weight to have the custodians of culture as part of the campaign. A lot of people in Malawi subscribe to ideas and issues related to their day-to-day life and many, especially young people in rural areas, believe in Gule Wamkulu. We are making good progress and taking CONDOMIZE! to new heights.”

The Ministry is working with UNFPA on cultural studies to discover more entry points for CONDOMIZE!

“We want to reach out to as many young people as possible,” said Mr. Lupenga. “Urban culture is also being taken into consideration by involving hip hop and modern performers, as we target young people with CONDOMIZE!”

UNFPA Malawi and the Government of Malawi are this year scaling up the campaign to 10 of Malawi’s 24 districts, after successfully condomizing college and university students around the country in 2013, Ms. Mdala said. The districts being targeted have high HIV prevalence rates.

“With this campaign, we are working on destigmatizing the condom and promoting its proper and consistent use to prevent pregnancy, STI infections, HIV and AIDS,” she said.

CONDOMIZE! is expected to increase demand for locally branded condoms from different sources and outlets. It is also expected to strengthen the capacity of stakeholders, including the education institutions and the media, in creating demand for condoms among young people, and to strengthen networking and collaboration among stakeholders in condom programming.

The CONDOMIZE! team sets up an education zone with an open display of condoms of different shapes, flavours, textures, sizes and colours to allow the audience to choose from a wide range of condoms to suit their taste. Condoms are distributed in the crowd. People are also taught condom art pin making so that they become familiar with condoms. Messages are disseminated through comedies, music and dance.

The campaign has so far engaged diverse groups of people, including journalists, youth leaders, youth workers, health workers, government officials and key partners in adolescent health.

Source: http://africa.unfpa.org/public/site/africa/op/preview/news/pid/18451#sthash.MG1mSgWM.dpuf

The tropical September heat took one of its savage waves on Malawi’s southern lakeshore area of Makanjila in Mangochi district forcing 49 year old Lifa Wile to sag under the shade of a palm tree, 20 metres away from his destination, Mkwanda Health Post. His feet, biting after a two kilometre long travel on foot as it also succumbed to the burning side effects of Stavudine, an ingredient of the first line anti retroviral therapy treatment regimen prescribed to tame the human immunodeficiency virus that was detected in his body some two years ago, could not take him any further.

Defeated, Lifa says he had sent his wife, Gertrude, to collect the life prolonging drug from the health post, which operates once a week, on Wednesdays, by a volunteer clinical officer Patrick Msosa who works for Madina Social Services. Lifa says Msosa had single-handedly negotiated with the owner of the house to open a health post since the nearest public health facility, Makanjila Health Centre, is situated 36 kilometres away.

He says the other facility, Lulanga Health Centre, which is six kilometres away, is privately owned and as such charged fees for the villagers in this remote rural setting to access health care. “Most of the residents here have since time immemorial depended on fishing in Lake Malawi as a source of income but due to the dwindling catches in recent years caused by human over population and climate change the trade is no longer as lucrative as it used to be,” he says with a drooping face adding that as a result villagers can hardly afford medical services at Lulanga Health Centre let alone travel to Makanjila, where a one way journey costs about MK1, 000, an equivalent of US$3 on a hired push bike. Unfortunately encountering a push bike is also a rare treat in this part of the world. But lady luck smile at Lifa and many more who experience his predicament over the ART effects as last week President Joyce Banda directed that all hospitals in Malawi stop administering ART drugs laced with Stavudine because of the toxic effect they have on patients. She urged doctors to adhere to the World Health Organisation (WHO) recommended regimen. Lifa laments that for more complex medical conditions a person has to travel to Mangochi District Hospital, 142 kilometres away or hire a boat through the lake at about MK2, 000 or US$6 to Senga Bay in neighbouring Salima district. In a nearby village, Mary Mdala, is struggling to wrestle off the stigma and discrimination associated with her health condition where her vagina constantly without restraint leaks urine. The condition called obstetric fistula, is an injury to the pelvic organs that occurs when a woman experiences a long a obstructed labour. According to UNFPA, a UN reproductive health agency, during the second stage of labor, the baby’s head presses the soft tissue of the vagina against the bones of the pelvis resulting in an abnormal opening between the vagina and bladder or between the vagina and rectum.

This opening, the fistula, causes constant leaking of urine or feces out of the vagina. “Despite the fact that the condition is preventable and treatable, it still affects many women in developing countries every year, yet has been eradicated in developed countries, says the UN agency. The World Health Organisation (WHO) estimates that there are between 2 million and 3.5 million women suffering with obstetric fistula in the developing world. The Malawi College of Medicine says Malawi has not collected sufficient national obstetric fistula prevalence data but indicate that the country’s 2004 Demographic and Health Survey (DHS), for the first time sought information on the conditions prevalence. “An analysis of the 2004 DHS data found a lifetime prevalence of 4.7 per cent and a crude incidence rate of 15.6 per 1000 live births,” says a study by the college adding that data from the same 2004 Malawi DHS estimated a 20 per cent prevalence rate for complications after delivery and that obstetric fistula cases account for 2 per cent of all deliveries. “A high prevalence of cases were reported in the Southern region (1.9 per cent ) and among the rural sites in Malawi, Mangochi district ranking highest at 2.7 per cent ,” it says explaining that another study reported that there were 29 patients (7.6 per cent) with a combined urogenital and recto-vaginal fistula. “Obstructed labor was the cause of about 379 fistulas and the remaining 29 were not of obstetric origin,” says the college attributing the problem to the many barriers that the women face before they are able to be seen at health facilities. “It is highly likely that most fistula cases remain undetected in the community and that the burden is far greater than has been estimated. Information on the prevalence of fistula in Malawi is important as it would indicate the actual extent to which the obstetric services are failing to meet the needs of pregnant women in the country”. Mary does not know how old she is but looks to be about nineteen or twenty.

She has never been to school because her area is not serviced with the luxury of education. The only form of education she has gone through is the Islamic Madras, where she was taught the principal tenets of the Islamic faith through the study of the Holy Q’uran and the Hadith, the life of Prophet Muhammed. Islam is the prominent religion in Makanjila brought by the Arab slave traders in the 16th century. Mary was once married but the husband left her before she gave birth to her first baby who caused her fistula condition. Like Mary, many women across the country continue to suffer from child bearing because of the long distances they have to travel to access medical care. Henry Chimbale, the Ministry of Health official spokesperson says government understands the issue about distances patients have to undertake to reach health facilities and as such has devised a plan to train post secondary school educated young Malawians in community midwifery for a period of 18 months. “The approach will address the issue of distance as well as reduce maternal mortality to 675 from 984 per 100, 000 live births,” he says adding that it will increase the access to the prevention of mother to child transmission (PMCT) of HIV, an intervention not found among traditional birth attendants who conduct home based child deliveries services in the absence of health facilities. However, with the lack of formal education in most women in Mary’s home area and other parts of the country, marriage and child bearing is considered the best gate way to a better life and what more with lack of facilities to motivate young health workers to work in rural settings such Mary’s area as community based health facilitators.

A 2008 national census established that the country’s average total fertility rate stood at six children, one of the highest in the world. The National Statistical Office (NSO) says that among the major contributing factors to the high fertility rates are adolescent fertility rates. The census showed that Malawi’s population is largely youth, with a median age of 17 years implying that more young people are entering the reproductive age group. Adolescent (aged 15 – 19) constitute 9.7 per cent of the total population of Malawi and the census showed that for every 1, 000 women aged 15 – 19 there were 193 births, says the NSO explaining that high adolescent fertility rates imply higher school drop out rates among girls, higher cases of complications during pregnancy, higher mortality rates and higher levels of infant and childhood illness and mortality. The Statistical Office concluded that in respect of the total population aged 12 years and over, for every 1, 000 persons, 575 are married with more girls entering marriage than boys. Malawi is one of the poorest countries in the world ranked 171 out of 187 countries on the United Nations Human Development Index with approximately 85 per cent of the population living in the rural areas and subsiding on rain fed agriculture. According to the Malawi Poverty and Vulnerability Assessment of 2007, about 56 per cent of the rural population lived in poverty as compared to about 25 per cent who resided in urban areas.