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The joy of voluntary nursing in Malawi

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After 24 years spent nursing in Dundee, Pam Wilson decided it was time for a change. Then she spoke to a former volunteer who inspired her to apply to VSO. She’s now working as a clinical nurse instructor in MalawiCollege of Health Science in Zomba. A career break granted by her local NHS trust means her pension contributions are being paid and she’s guaranteed a post back in Dundee at the same grade to the job she left.

After 24 years spent nursing in Dundee, Pam Wilson decided it was time for a change. Then she spoke to a former volunteer who inspired her to apply to VSO. She’s now working as a clinical nurse instructor in MalawiCollege of Health Science in Zomba. A career break granted by her local NHS trust means her pension contributions are being paid and she’s guaranteed a post back in Dundee at the same grade to the job she left.

Can you tell me about where you're working and what you’re doing?

I’m a clinical nurse instructor – one of three VSO volunteers working at the Malawi College of Health Science in Zomba in Southern Malawi. I teach both at the college and on the wards of Zomba Central Hospital.

I also travel all around the southern half of Malawi supervising students in their clinical placements at various rural hospitals and health clinics. Back in Dundee I taught just one student at a time. Now I'm teaching classes of 65 second-year students and a new intake of 62 first-year students!

When I arrived in Malawi I’d never taught in a classroom before, and I’d never used Powerpoint for given a lecture. I’m now quite comfortable doing both.I’m really enjoying teaching the students in both the classroom and in their clinical placements where I can see them improving the care given to their patients.

Are you involved with projects outside of your day-to-day job?

Yes – several. One involves helping to establish twinning links between Scottish GP practices and Malawian health centres. This is a three-year project backed by the Scotland Malawi Partnership. Our goal is to set up internet networks to build two-way educational, medical, nursing and patient group links.

We hope to twin up to 20 clinics in the southern half of Malawi. I’m busy working with a Malawian colleague, Paul Nkhoma, to find suitable government-run clinics on the Malawian side of the project.

What kind of challenges are you facing?

At the moment power cuts are a big issue. Only seven per cent of the population has electricity but as the demand increases, the generators can’t cope. Every other night there is no electricity from 5pm–9pm and often as you get up in the morning it goes off again, just when you need a cup of coffee!

Speaking the language is a bit of a challenge but I’ve mastered the greetings and can understand some of what is being said. In the classroom we teach in English and when I’m on the wards the students act as interpreters when necessary. Lack of resources at the college makes teaching difficult sometimes. I’ve tried to address some of the shortages by using my DFID grant and donations from home to buy books and equipment.

Tell me about where you live and what you do outside of work.

I have a lovely house in a small village called Matawale, just outside Zomba. Mr Mbewe is my night guard and he’s fantastic. He also does my washing, cleans the house, maintains the garden and makes curtains. I do my shopping in the market in Zomba. It’s wonderful - you can find almost everything you need there. It’s also good fun bartering with the stall-holders.

My social life is better than at home. I have a great network of other volunteers, UK ex-pats and Malawian friends. We mainly socialise at weekends with parties and trips to various tourist spots in Malawi – walking up ZombaMountain or visiting beautiful Lake Malawi.

What kind of new skills do you think you'll bring home with you?

Classroom teaching, using Powerpoint and other classroom aids. Teaching large numbers of students with confidence. Endless patience, having coped with everything starting late and plans often changing at the last minute without being informed about the changes.

Would you recommend volunteering to other people?

Yes. It’s a wonderful, fulfilling and very rewarding experience. The preparation training that VSO gives you pre-departure is excellent, the care and support given to me while in Malawi by the programme office has made it all very easy to settle into living and working here. I’ve been here since April 2005 and I’ve enjoyed it so much that I’m extending my placement by nine more months. It would be nice if another Scottish volunteer would replace me when I leave in December this year. It will be very difficult to leave.

VESTER CHISALE is a trainee nurse at the Malawi College of Health Sciences in Zomba. Now in her third year, Vester has been taught by VSO volunteer Pam Wilson since she arrived at the college. The number of Malawian nurses being trained has doubled because of volunteers like Pam. But in a country where one nurse attends to 100 patients, there’s still a critical need for more. Vester urges more UK nurses to volunteer so that the next generation of Malawian nurses are equipped with the vital skills to save more lives.

At 15, Vester Chisale fell ill and was taken to hospital. Her experiences there shaped her future. ‘The nurse in hospital cared for me very lovingly and tenderly,’ remembers Vester. ‘It was she who inspired me to join the nursing profession.’ Now 22, Vester is in her third year of a diploma in Nursing and Midwifery at the Malawi College of Health Sciences.

‘We do make mistakes sometimes but she waits for you, she doesn't shout, she just calls you aside and says ‘try this, try that’


Throughout her diploma Vester has received invaluable support from VSO volunteer Pam Wilson. Pam has had a very positive impact on Vester and her fellow students. ‘We have really enjoyed our lessons with Pam,’ says Vester. ‘We do make mistakes sometimes but she waits for you, she does not shout, she just calls you aside and says ‘try this, try that’. During her stay here we have learnt a lot, not only from the medical side but also from her way of living. It has been a very good experience to interact with Pam.’

Vester and Pam have worked in a number of clinical settings and are currently based in the midwifery department of a health centre close to the college. It’s Vester’s favourite placement so far. ‘In the nursing department we meet people who are sick from diseases, or have been involved in an accident. It is hard to see three or four patients dying each day,’ says Vester. ‘But here in the midwifery department, we see lives coming, that’s the birth of a baby. You really need to take care as any mistake you can make can cost all the lives – the life of the baby as well as the life of the mother, so it all depends on you.’

Despite a shortage of books in the small library, insufficient computers and overhead projectors in the college and a lack of basic equipment like drip stands in the health centres, Vester and the other trainees are dedicated to their work. ‘They are very committed to their training and learning,’ says Pam. ‘They work very hard, even when conditions are tough.’

The students’ dedication stems from a desire to help their fellow Malawians. ‘Many nurses are leaving Malawi, going overseas looking for greener pastures,’ says Vester. ‘But they must remember that nursing is a calling. Fellow Malawians are suffering a lot. With few nurses, it means that patients even die in the queue waiting to be attended. Malawi needs more nurses, so I’m encouraging my fellow Malawians who are just finishing school to join the nursing profession.’

In the meantime, Vester wants more UK nurses like Pam to work in Malawi. ‘We have the information, but we lack the skills due to lack of equipment. The British nurses have experience of the equipment so they can teach us to use it. We need them to come and help us Malawian nurses.’

It’s possible that if those Malawian school leavers do pursue a career in nursing, one day they could be taught by Vester herself. Her positive experiences working with Pam have inspired her to take her education further. ‘I’m still hoping to continue with my education,’ says Vester. ‘After finishing my diploma I will work for a year, then I will do a degree course and then I can even pursue a master’s. After that, I will continue working in the hospital environment.’

For more information, see:

www.vso.org.uk/healthjobs

http://www.vso.org.uk/volunteering/nhs_partnership.asp

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