Malawi thoughts

ideas about a summer in Malawi

Seasons for food

In rural communities weather shapes a lot the day to day lives. Seasons have great impact on the activities that you do: right before the first rains begin you need to clean the field, plant seeds, and apply fertilizers, during the rainy season you need to continue with weeding so your crops can grow better, then harvest season comes and it is time to remove all your hard labour from the land and do some primary processing so you can store it or sell it. During the dry season you can plant vegetables, but a lot of time is also spent in activities to improve your house like making bricks and then using them to build or improve your house or kitchen.

During my time here we were in the dry season, or winter season.  Rains usually go up to May or June, but this year by early-May they had stopped. We had some few drizzles and 3 days of heavy rain up until now. Winter in the tropics is simply not comparable to winter in Canada, but it was cold! July is the coldest month and I needed a sweater every night, and even during the day sometimes. When I first arrived I would eat dinner outside with my family under the stars. By mid-July it was just too cold for that!

When the winds stopped a bit, they were off to catch some fish

With winter winds start by the lake. Since my district was by the lake (my village is separated from the lake by a mountain, which can be crossed in about 4 hours of walk) fish is one of the most common relish (side dish) to eat with nsima (look at the post on how to make nsima). With the winds it gets too dangerous for the fishermen to go in the lake because their canoes can flip. When fishermen fail to go in the lake, the communities have no more supply of fish, and their options for relish become extremely limited. Because of the fact it is winter, relish is already harder to find because there are less things growing, and then for weeks one of the most reliable (and cheapest) options is removed: fish.

 

 

 

 

Nsima with beans, potatoes, and bean leaves. No fish here...

For two weeks while fish could not be found in the market, we would buy processed dehydrated soya pieces. Other options were eggs and beans but these are even more expensive so you would not see them as often. In my household soya pieces are a seasonal food, we eat it in the winter while the winds are strong by the lake. But in reality they are anything but seasonal, they are processed to have a long validity period so they can be found in the shops all year round. However, season factors greatly influence when families will buy them, making them somewhat into a seasonal food!

Fruits are also harder to find during winter. Bananas and papayas are available all year round, and those were my only options during my stay. Guavas had just finished ripening when I arrived, and now mango trees are covered in flowers, so by November those will be ready.

In Canada, where for most people your food comes from many kilometres away, you can pretty much find whatever you want all year round in the supermarkets (but with some price fluctuations). It is a simple concept but that many times we forget: foods are seasonal. At different times of year you eat different things depending on what is growing – and also what is not growing.

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Checking toilets, checking my learning

Some time ago  I went to have a meeting with a village chief to talk about sanitation. When I arrived there, other men from his family were also at the meeting. One of them was specially vocal and was urging ME to tell THEM what they should be doing to improve sanitation in their village, because I would be able to tell them new things that would greatly improve their life styles.

But what do I know?

I never had to use the bush to defecate, I had never used a latrine until I got to Malawi! They were the ones who taught me how to take care of latrines, how adding ashes to the pit minimizes smell.

I never worked with health issues until getting here.

They were the ones teaching me all along, so my approach was to ask them questions to extract the answers that they already had. But the first step is to understand what we are doing now. If we know how things are now then we can work to improve them.

So Chief, how is your village doing in terms of sanitation?

Ah it is very good! All houses have toilets, with drop hole covers, and hand washing facilities.

Really, all houses have all these?

Oh sure sure!

I have been here for a few months, I have lived with 3 different families, and talked to a few households. I learned quite a bit about hygienic behaviour in these villages. But by no means did I sit in front of latrines waiting for someone to come use it and check if they remembered to cover it after, and if they washed their hands once they had left. I had never visited this specific village, but only a few neighbouring ones.

My assessment is that the latrines are being used but the drop hole covers and hand washing facilities not as much.

I told that to the chief, but now it was my word against his.

How can I know better than him?

Again, I have been here for a few months, I have lived with 3 different families, and talked to a few households.

This is the chief we are talking about, HE is from this village!

So we decided to go visit some households to really get a definite answer on the sanitation status of this village. As we were walking towards the first house there were too many thoughts going through my head. What if my assessment was wrong? How will I explain that what I was talking about was a misunderstanding? What will I do now if in fact they are all using toilets, covers and washing hands? How sure am I about what I have seen and done so far here?

We were getting close to the latrine now, I took a deep breath.

That household did not have a hand washing facility. The next one was perfect. The third household did not have a cover in their toilet. And after that the next toilet was well kept, covered, and had water outside.

As we continued to visit the rest of the village, that was the trend: about half of the households were not using hand washing facilities or drop hole covers.

Chief demonstrating and explaining importance of washing hands

I have many days like this, in which I doubt myself, the things I have seen, the conclusions I have draw.

Did I really understand that situation correctly? How far can I extrapolate that one time event?

My placement is getting to an end very soon.

I had never worked as a development worker before. This is my first time in Africa.

I have learned a lot. I tried to always keep an open mind and keep checking my assumptions and conclusions.

I tried to be humble, we are talking here about less than 4 months of experience.

Do I understand development now? I cannot claim that I grasp all the intricacies of why certain regions in the world have such a hard time to improve their livelihoods.

Was I able to change the world? Certainly not! Was I able to change Malawi? I do not think so either. What about my village? Maybe I made some impact, but only time will tell its breath and duration.

Despite all the great stories, the AHA moments, the situations that put a big smile in your face, this is not straight forward. There are few moments that are not ambiguous or uncertain.

when school is off….

How are people in Malawi?

Their lives are so different, we live in such different situations!

How are they different from us?

 

This is a post about how similar we are.

And a post about how teenagers like to take stupid pictures.

 

Classes finished in Malawi in the end of June and they only begin again in September. So now the students who went away to study are back home, and those who had stayed in their village do not have to leave the house so early to make to class.

In my house my 2 brothers and 2 sisters are with us, and once we had a cousin who came to spend part of her holidays with us.

I spent countless days during my vacations with friends passing time by trying to come up with the silliest things to do and then record it by taking a picture. Here is the proof:

(meninas, desculpa que voces tem que fazer parte disso, mas essas fotos merecem!).

Strike a pose

A lot of coordination went into this one...

Things are indeed much different in Malawi.

I talked a bit about weddings and funerals.

You need to walk far to get water.

Some places are very isolated, so transportation and communication are hard.

Families grow most of the food they eat, especially maize and cassava.

But things are also surprisingly similar. One afternoon when we were all at home without much to do, so I lent my camera to my siblings and these are the things they came up with:

Strike a pose- Malawian version

So who came up with the most ridiculous things to do?

The roads to development

I just finished reading “The End of Poverty” by Jeffrey D. Sachs. One of his arguments why some countries are rich and other are poor has to do with geography. Geography determines a lot of a country’s economy. Natural resources are the most common featured looked at. If a country has mines or oil, for example, that will greatly influence how they develop. But Sachs also argues that a country’s location and topography also influence a lot a country’s economical development, and the right combination can greatly difficult it. The case of Bolivia illustrates this argument: “this is a landlocked country up in the Andean mountains facing incredibly high transportation costs. The only products that Bolivia has ever been able to transport are commodities with a very high value per unit weight because only those commodities can successfully overcome the high transportation costs”.

I find that Malawi has a very similar situation. It is also a landlocked country, in other words it has no access to the sea. It is true that the mountains in Malawi do not even come close to the magnitude of the Andeans, but in the area where I am the hills and mountains create similar transportation issues.

On the way to the nearest commercial centre

The village where I stay is in a hilly region and there are only dirt roads. Right now is the dry season, so I do not run into this problem, but when the rains are heavy these roads become pure mud. Even when the roads are dry they are have many holes and signs of erosion from the rains. This makes transportation very difficult because not all cars can get through. To add to the problem there is a fuel shortage in Malawi. To make a trip from a commercial centre to this village it must be really worth using the scarce fuel in these difficult roads. Therefore, transportation is scarce. 2 to 3 cars leave early in the morning, and only come back at the end of the day, so all travellers are concentrated at these peak hours. These cars are the ones that transport women to the market on Wednesday to sell bananas and tomatoes, that take the village representatives to the district capital for meetings, that take the tobacco growers to town to check if they received their payments, and that take all the products produced and consumed in the village: maize, bananas, sugar packs, bottles of Coke and Fanta etc.

The car came to pick up more plantains to take to South Africa

Life in these villages is greatly affected by transportation. Everything here is more expensive to account for transportation costs. Because transportation is unreliable it can delay business for many days. For example, many women buy plantains from farmers to sell them to exporters who come here once a month. Because the plantains will travel far they must still be green to endure the entire trip. But if the buyer runs into problems to get here and his arrival is delayed a few days, not only will the women spend all this time waiting around instead of being able to do other productive activities, but their plantains also begin to ripe.

Now looking more at national level, we come back to the fact that Malawi is landlocked. Without access to the sea and unable to have big ports to trade easily with all other ports in the world, Malawi has to rely on roads connecting the ports of its neighbouring countries (mainly Tanzania and Mozambique) to its cities, or use rivers. All this traveling certainly adds to the price of all things that enter or leave the country. The end result is that products produced in Malawi become less competitive as their price rises and products imported to Malawi are expensive, all to compensate for the added transportation.

But how do you fight these problems? You cannot really change the fact that Malawi is a landlocked country without any major turmoil or wars. The roads connecting villages to cities need to be improved, but if they are scarcely used due to low population densities (not so many people and things will travel per kilometre of road), it becomes a very difficult investment to make while there are so many other sectors which also need funds.

I think for a while a common comment will still be  “iiih, transportation is a big problem here…”

How do you change behaviors anyway?

I want to update you on what is happening with me related to work.

 

Right now I am focusing on the intervention stage of my placement where my end goal is to influence households in the community to re-adopt and maintain the habit of covering toilets and washing hands after using the toilet. The essence of my work right now is behaviour change.

For a while now the community has been told to do this things. In the beginning they did, but then they relaxed and many forgot about it all together. They are still told now and again to wash hands and cover toilets, but nothing is really changing. The question in my head is, “what do we need to do so they really adopt this behaviour?”

 

In the words of one of my co-workers at the health centre: “Ihhhh, this is a hard question, Vivian”

 

To help me answer it, I decided to first understand how I adopt behaviours. Then, I might find some insights that I can translate to this problem I am trying to solve. I already talked about how flossing relates to this in a previous post. Here are some other habits that I analysed:

 

Exercising twice a week

 

I am not a big fan of the gym. Running staring at myself in the mirror as my face gets red is not so thrilling for me, but I do enjoy very much swimming. By forcing myself with a schedule (going after EWB meetings) and making a commitment (taking classes) I forced myself to go to the pool twice a week. It really worked, for most of the semester there I was in the pool every Monday and Wednesday night.

 

Once the classes were over I did not have the same feeling that I had committed to swimming, it only depended on me, so I slowly stopped as exams approached and other things piled over. But when I do go back to the pool and leave with the “jello-like” feeling I remember why I like to swim so much.

 

Studying

 

I study hard for exams because I will be hopefully rewarded with satisfactory grades. But, I only do it a few days before the deadline . I only do it in advance if I know that in the future it will help me (I  will have more time for other things, or not feel as stressed).

 

Eventually I get so sick of studying that I do anything that I can to avoid it (including cleaning my entire apartment). Taking a long break allows me to be motivated to do it again.

 

So these are some of the facts of how I adopt a behaviour and how I stop it.  And these were some of the insights I got:

 

What are the things that facilitate me to adopt a new behaviour?

I see a direct benefit of doing it

I am forced to do it

I am constantly reminded about it verbally

I see something that reminds me to do it

Other people are doing it

Create a schedule that forces me to do it

I paid to be able to do it

I have time to do it

It is a novelty

I have nothing else to do

Understanding why I should do it

 

 

What makes me stop the behaviour?

I forget for a few days, and then I stop all together

I am not motivated to do it

I get distracted or carried away  as I am about to do it

Initial motivation is absent

It feels too hard to catch up

I have done it too much, I’m sick of it

 

What motivates me to adopt behaviour?

My own drive to do it

I see immediate benefits

People tell me in the future there are benefits

I think there will be benefits in the future

Peer pressure

The image I want other people to have of me

External recognition

I will be rewarded for it – sometimes financially, or with other things like appraisal

It boosts my self-image

It feels good to do it

 

 

After all this reflection, it became even more obvious that  just telling someone to adopt a new behaviour (cover toilet and wash hands)and checking-up on them will not make that person do it. There are a lot more things that need to be happening as well. So now I am working to introduce some of those other things in our current approach.

 

All this was done using my own experiences, but Im hardly representative of the entire population. This is your turn: Describe a habit (other ones that I analysed were writing in a journal, flossing, eating snacks) and then try to extract what were the things that made you adopt it, made you stop, and that motivated you. Now post your answers as a comment!

Relating to people – Tales of mixed reactions

Lets do some matchings between emotions and events I experienced in Malawi.

The events are:  1. Wedding  2. Funeral

The emotions: A. Excitement B. Disconnect

So what is the correct pairing?

1B and 2A, in other words, I felt very disconnected while attending a wedding, and extremely excited at a funeral!

Here in Malawi funerals are a time for the entire community to gather to support the bereaved family. It is very shameful for a person to be prohibited from attending a funeral. The funeral activities actually begin before the actual burial, as members of the community visit the family to comfort them and help with chores for the ceremony. At the first funeral I attended when I arrived at the family’s house I saw the women sitting on the ground around the house catching up with each other and taking a break from household work. The ones sitting closest to the house where the ceremony was happening were singing. The men were sitting by another house under the trees chatting as well. In the back a large group of women were gathered making quite a bit of noise. The atmosphere was quite different in this area as they pounded maize, separated the grains, cooked, and went to fetch water. All these gathered people were able to talk to each other, catch up on community happenings, and just chat away for a long time. In this setting I felt very excited as I was part of the community chatting with the women, helping to fetch water etc. It is easy to forget that this is no ordinary community gathering, and the reason all these people were there at that moment is because someone died.

It turned out we did take a picture together!

Weddings are a lot more privet. This time you need to be invited personally to attend the celebration. The wedding I attended was a traditional Christian wedding, in many aspects similar to weddings in Canada. The groom’s sisters and the bride went to a hair salon the day before to get their hair curled, the night before there was a rehearsal, and the bride wore a white dress. Amidst all these familiar situations I could not ignore the feeling that this day was not really about the bride and the groom. After the actual wedding there was a party where the guests gave their gifts to the couple. There they were sitting watching their friends and family dancing towards them with gifts in their hands or heads. They might have been just hungry or tired, but they did not look like they were sharing in the happiness.  This was no arranged marriage, the groom asked the girl quite a few times if she would marry him and it was up to her, not her family, to decide.  After the wedding the groom complained that we did not have a chance to take a picture together. I replied that he should have asked someone to take that picture, but he told me that he had no control over that. At that point I felt extremely disconnected, it was hard for me to comprehend all the things I was observing.

I am not sure why the wedding had that effect on me.

But being an outsider at the wedding felt like a much bigger deal than it did at the funeral. Does that mean it is easier to connect with other people in moments of sorrow than in moments of happiness?

Maybe.

If that is the case, what are the implications of these reactions when talking to people about what is happening in places very far from us such as Malawi?

Shit, this is my job – Part 5 Intervention

What now?

As I mentioned on my first post about work, I will use all my new understanding to test out some hypothesis to try to improve the success of CLTS. This is the stage I am at: my intervention.

**Disclaimers: 1. This will make a lot more sense if you read first the other posts in this series

2. These are the plans I have right now, they are completely subject to change

 

In EWB we often use something called an impact chain to help us decide the things we will do keeping the final goal in mind. So you start from the end and then work backwards.

 

This is the impact chain I created for my intervention:

As you can see now I will be working in this “system of accountability”. What I mean by that is I want to find a way that village headman can work with the health extension workers (HSAs) and natural leaders (NL) so that even a long time after triggering occurred they are still visiting households in their village to make sure people are still using their latrines, drop hole covers and hand washing facilities. The village headmen also need to be reminded about these visits, that can be done by the group village headman and traditional leader.

This system would be part of the training that traditional leaders receive in CLTS.

There is one question I also want to try to answer: “when should this system be introduced to traditional leaders?” My plan to answer this question is to have two groups receive the training at two different stages of CLTS: one will receive before the triggering, the other will receive after the triggering. I hope that we will be able to see some differences of how CLTS progressed between these two groups which can be attributed to the timing of the training.

Shit, this is my job – Part 4 The flossing problem

Community Led Total Sanitation (CLTS) is all about behaviour change: people deciding by themselves that it is not acceptable to use the bush to shit and so they construct and use latrines, drop hole covers and hand washing facilities. Latrines are commonly being adopted in communities where CLTS has been introduced. Covers and hand washing facilities are built but are not being used very often, and if they break they might not even be fixed.

Why are latrines being more successful than drop hole covers and hand washing facilities?

To help answer this question I like to think about some characteristics of behaviour change (these are some I put together, there are many books that talk about the factors to create behaviour change)

  • Adopting new habits can be a slow process.
  •  In general behaviour change is done in steps.
  • Changes of behaviour that bring direct benefits and satisfaction are easier to occur and maintain.

The second thing I like to think about to answer the same question is the flossing problem (try to answer the following questions – what about posting them as comments?):

What are the benefits of brushing your teeth? What are the benefits of flossing?

You probably brush your teeth multiple times day. Why?

Now, how often do you floss? Why is that?

These are some of my conclusions for the flossing problem:

People will usually brush their teeth as they see direct benefits and enjoy the “clean” feeling. Flossing requires time investment and in comparison it does not bring as many immediate rewards. Therefore a much smaller percentage of the population flosses regularly even though they know they should floss. When you go to see your dentist, she (in my case) does not need to remind you to brush your teeth, but she will for sure remind you about flossing. And it works, right after visiting my dentists I’m flossing very often, but as time goes by…

Flossing is a more difficult habit to pick up (maybe because of the problem of investment versus rewards), and you need to be reminded about it often.

A traditional latrine and drop hole cover

With sanitation we face the same problem. People will readily adopt latrines as they are more comfortable and dramatically decrease occurrence of diarrhea and cholera. Washing hands after using the latrine is a much harder behaviour to install even if the people know why they should do it. When talking to different families in the communities I visit, they tell me about the importance of using hand washing facilities and drop hole covers, but when visiting their latrines I find many times that the drop hole cover is not being used and that the hand washing facility does not even work.

Shit, this is my job – Part 3

“Cool,you talk to people! what have they told you?”

These are some things I wrote on my “learning report” that I want to share with you (it’s more about what I have learned than what people have told me directly):

Traditional leaders are organized in a hierarchy structure. First there is the Traditional Authority (TA), then the Group Village Headman (GVH), and then the Village Headman (VH).  The TA should be the first person to be approached when arriving at a village or introducing a new program, then GVHs and finally VHs. VHs are the ones responsible for solving problems at the village level. If they fail to do so the GVH gets involved, and then, if again necessary, the TA gets involved.

Usually traditional leaders are retired elderly men (but in some places they can be women) from the noble family of the village. They have other jobs besides being a VH such as: farmer, shop owner, tailor etc. They also have hobbies (chatting with friends, hunting), which means a small amount of their time is actually devoted to VH roles.

Sometimes VHs cannot fully perform their duties, so they have representatives to help them. These representatives are as legitimate as the village headman himself and they are called VH as well (It took me a while to understand this). VHs may also be absent from their village: young VHs might want to work in town thus leaving a representative at the village to perform VH duties, VHs might chose to retire in a nearby town where they will be more comfortable etc.

Often their roles are summarized as to gather, mobilize, encourage and motivate the community.

In my area, before CLTS was introduced there was a training for traditional leaders so they could know what was going to happen in their villages. After the training they explained to their communities the things they had learned, and told them to prepare for the triggering (the event which introduces CLTS in the community). Sometimes these preparations actually worked against the triggering as they tried to hide places people use to shit.

After triggering occurred a group of leaders from the community was formed to make sure all the households were building latrines. The traditional leaders worked with this committee as well as the health extension worker to keep motivating the community in their efforts to stop open defecation.

As time went by the committee, the traditional leader and the health extension worker followed-up less often with the village. What happened then is that some households stopped using their latrines, drop hole covers and hand washing facilities. In fact this is one of the biggest problems I found: in the long term the new behaviours were not always lasting.

Another reason for that problem is that many villages considered CLTS as a project, not a program. Once they had constructed everything they figured their mission was accomplished. If CLTS was seen as a program at the village level, maybe follow ups would have continued.

Shit, this is my job – Part 2

So now you understand a little bit more what I am doing here, but how do I do that?

My day to day consists of creating conversations with as many different people as possible. Some conversations are more structured than others: they range from a chat while I am walking to a certain place all the way to a formal interview. Sometimes I have specific answers I would like to obtain, other times I am trying to understand a situation with the help of the person I am talking to.

There are very interesting aspects (and of course difficulties) that come from talking to people to obtain information.

You probably have noticed that you speak in a different way when you are chatting with your friends, or having a family dinner with your grandparents, or having a meeting with your boss. You change how you say certain things, and you chose carefully WHAT you will tell them. There are a lot of things involved in these conversations, and an important one is the image you want them to have of you.

Here is the same thing. I am a white foreigner (or how they say in Malawi, Muzungu) coming to talk to them about shit. First of all the topic is taboo. When you meet a new person rarely the topic of conversation will get anywhere near shit, but for me, this is exactly where I want the conversation to go (and often it will happen right next to their toilet). Fine, despite the awkwardness, now we are talking about shit. There are many things they can decide to say about shit, sanitation habits, health etc. Just like we do with our friends, family, and bosses, they choose carefully what they will tell this Muzungu, because it will greatly affect the image the Muzungu will have of them. And who wants to be remembered by this white foreigner as the person who decides to go to the bush instead of using the latrine and forgets to wash their hands?

There is another aspect that comes about when relying on conversations when working in Malawi: Language. The official language of Malawi is Chichewa, English is wide spoken in towns and work places, and there are many many regional languages, in my area there is Chitonga and Chitumbuka.

These are some people with whom I talk often:

  • Health surveillance assistants (HSAs) – they work as health extension workers promoting health in the communities through vaccinations, talks etc.
  • Traditional leaders – Village headman, group village headman, traditional authority
  • Natural leaders – leaders in the community involved with promoting sanitation
  • Families in the communities

HSAs speak English very well, so it is very easy for me to communicate with them. Some community members, traditional and natural leaders speak English, but for the most part I need a translator to help me. Having a conversation in two different languages adds a lot of uncertainty:

How was my question really translated?  Did the nuances of my question get through as well? Are there some hidden meanings I am missing?