Not a Bicycle, But a Canoe

Not a Bicycle, But a Canoe

Paddling from Zambo to Mvunguti village. Photo credit: MSH.

Three decades ago, life in the lakeside village of Zambo was calm. The small village of 10 households was rich in resources. All they needed was satisfied through fishing, as there was little that would grow given the sandy beaches. Nestled in the Mangochi district of Malawi, Zambo village is 40 kilometers from the nearest health facility, Monkey Bay Community Hospital.

A decade and a half down the line, the 10 households turned into 78 households. Monkey Bay, the closest hospital, was still 40 kilometers away and rough terrain hampered access to it. Pregnant mothers had to deliver at home as it was expensive to get to the hospital.

Access to health services -- let alone reproductive health services -- was extremely poor. Families had to weigh the costs of access against the benefits. Stock outs and delayed service provision as a result of thinly spread service providers further affected access to health services.

For family planning, the situation was worse. Mothers were in poor health as a result of frequent births. Children were in poor health as a result of closely spaced births that did not allow enough breastfeeding time.

Mercy Kalua (right) and a client. Malawi. Photo credit: MSH.

Today the situation is different, especially for family planning services. Nearly four years ago, the Community Based Family Planning and HIV and AIDS Services (CFPHS) project, funded by USAID, trained a community-based distribution agent from the village, Mercy Kalua. According to her, women and children are a lot healthier today than they were before she was trained to provide family planning services in her community.

“At first it was difficult for people to accept family planning methods but as time went by, and after learning of the advantages of family planning, a lot of people started practicing it,” Mercy said.

She provides information on contraceptives and arranges referral for methods she does not offer. As a community-based distribution agent, Mercy offers pills and condoms. She links clients to Health Surveillance Assistants for injectable contraceptives and the health facility for other methods.

Mvunguti Village, Malawi. Photo credit: MSH.

Apart from her village (Zambo), Mercy serves another much larger village, Mvunguti, by the lake. Out of the 62 clients she has in the Mvunguti village, 18 have accessed permanent family planning methods. Nearly half of all eligible clients in Zambo village have accessed permanent family planning methods, Mercy said.

To reach Mvunguti, Mercy has to travel 10 kilometers by canoe. Canoeing is the most convenient form of transport as one cannot ride a bicycle due to the sandy beaches on the shore.

When offered a bicycle by the project, Mercy said thanks, but no thanks: it’s a canoe I want.

Annie Chirwa is a Nurse/Midwife Technician at Monkey Bay Community Hospital in Mangochi district. Madalitso Kapyola and Vandros Chowe worked with the Community-based family planning and HIV&AIDS services (CFPHS) project, led by MSH, in Malawi.