In action - Kwitanda – Here I Come! 🏍️🚖

Reflections from My First Week on Exchange 😊

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I arrived in Malawi on the 1st of June, landing in the capital city, Lilongwe. After a long journey, I spent my first night at a lovely place called Forty Four Hotel. It was surprisingly comfortable, and at just 45 euros (including breakfast), it was a great welcome to the warmth and hospitality of Malawi.

The next morning, I began my journey to Balaka District, located in the Eastern Region of Malawi - about a 4-hour drive from Lilongwe. From my accommodation in Balaka, I travel to Kwitanda, which is approximately 25 km away. I usually take a matola (a public taxi, typically a pickup truck or a small car), and from the depot, I hop on a motorbike taxi for the final stretch - about 5 km into the rural villages, past where the tarmac ends.

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Getting to Know Kwitanda

This week, I had the opportunity to begin my fieldwork in Kwitanda, a rural area in Balaka District. I was based at the Kwitanda Health Centre, observing their work and the overall health outreach efforts in the region.

Kwitanda covers a wide area with very limited access to public services - especially transportation. The health centre’s catchment area spans around 30 km, and there is no formal public transport system. Most people rely on bicycles, motorbike taxis, or matolas that operate on their own flexible schedules.

There is also a second health facility in the region run by the Christian Health Association of Malawi (CHAM), about 15 km from Kwitanda Centre. However, most locals prefer the government-run Kwitanda Health Centre because public healthcare is free in Malawi, whereas CHAM requires payment for services.

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Community Health and the JBJ Foundation

One thing that really stood out to me is the collaborative and community-driven approach to health in Kwitanda. The area has benefited from long-term support by the JBJ Foundation, which works in partnership with Malawi’s government and local stakeholders. Their interventions are evidence-based and have actively involved the local community - from planning to implementation.

The result? Real, impactful change.

Locals have been trained as health assistants and outreach workers, contributing to improved health access and education across villages.

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The “Village Clinic” Model - Healthcare That Travels

One inspiring practice is the “Village Clinic” model, where each village has designated health workers who bring services directly into the community. These workers know their assigned villages well and tailor their services to meet the specific needs of their people - especially when it comes to preventive care.

This model has brought real improvements in well-being and shown the power of locally rooted healthcare solutions.

More about the Kwitanda Community Health Project:
Kwitanda Community Health Project | JBJ Foundation

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Strong Community Spirit 💛

Not long ago, Kwitanda didn’t have a maternity ward. Pregnant women faced long, often impossible journeys to the nearest hospital. In response, the community rallied together, negotiating with authorities for a local solution. The deal was: a maternity unit would be built if the community contributed.

They did just that - donating bricks and building materials, ultimately covering 40% of the costs, while the government funded the remaining 60%. A beautiful example of community action and ownership!

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Everyday Life at the Health Centre

The Kwitanda Health Centre is staffed by 42 professionals, led by a dedicated Medical Assistant, Chikumbutso Malinga, who has worked here for over ten years. His deep ties with the community and local teams have made a significant impact on how health services are delivered.

Each day starts at 7:30 AM with a team briefing and ends at 4:30 PM - though schedules are flexible to meet urgent needs. For example, one day I arrived to find the director had already started his shift at 4:00 AM!

Every month, the team holds comprehensive meetings to review activity reports and share updates with their international and national partners, including:
-JBJ Foundation
-AMREF
-Save The Children
-UNICEF
-DAPP Malawi
-Family Health Services (FHS).

Despite resource limitations, the centre maintains a 24/7 emergency service and sees 80–100 patients per day, with about 2 deliveries daily.

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Local Challenges and Hope for the Future

While the health centre is doing impressive work, Kwitanda still faces many challenges:
-Poverty and long distances to services
-Poor road infrastructure and electricity access
-Weak internet connectivity
-Lack of organized public transport.

Major health threats include:
-Child malnutrition
-HIV/AIDS
-Malaria
-Early marriages and teen pregnancies.

There is a pressing need for youth-specific health programs, which are currently lacking. The centre is actively seeking partnerships to bring these services back, noting a rise in teen pregnancies since previous youth outreach initiatives ended.

Despite all this, Kwitanda is rich in community strength, willingness to change, and committed professionals striving for a better future!

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Gratitude 🙏

A huge thank you to Chikumbutso Malinga and the entire team at Kwitanda Health Centre. Your warm welcome, openness, and dedication are deeply inspiring.

I’m excited to continue this journey and learn even more in the weeks to come.

Zikomo kwambiri, Kwitanda!

With gratitude,
Tanja

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Quick Facts

Kwitanda Area
-Population ~19,300
-2 Health Centres (1 government-run, 1 private CHAM)
-About 50% under 18 years old
-About 3,200 children under 5
-High illiteracy rates
-Nearest hospital: Balaka District Hospital (~25 km)

Key health concerns: Malnutrition, HIV/AIDS, early marriages and pregnancies.

Kwitanda Health Centre Staff
-Medical Assistants: 2 (1 intern)
-Nurses: 4
-Community Midwifery Assistants: 2
-Health Surveillance Assistants: 15
-Hospital Attendants: 6
-Data Clerks: 3
-HIV Program Assistants: 6
-Pharmacy Assistant: 1
-Nutrition Assistant: 1
-Security Guards: 2

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ADDITIONAL MATERIAL

JBJ – About us
About Us | JBJ Foundation
 
JBJ - Malawi priorities
Malawi Priorities Project | JBJ Foundation
 
AMREF
Healthcare in Malawi – Amref Health Africa UK
 
Save The Children
Malawi | Save the Children International
 
UNICEF
Contact Us | UNICEF Malawi
 
DAPP
About - DAPP Malawi

Family Health Services
Family Health Services(FHS)
 
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Ministry of Health
Ministry of Health Malawi - Official Government Health website
 
Public Health Institute of Malawi
National Public Health Research Division – Public Health Institute of Malawi

Malawi health system
Malawi health system
 
Promoting investments in primary healthcare system in Malawi
UNICEF_MLW_Health_Budget_Brief_2024-25.pdf.pdf
 
CHAM – operates in Balaka, in Kwitanda catchment area
Christian Health Association of Malawi – To Serve and To Heal
 
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Kamuzu University of Health Sciences – About KUHeS
KUHeS - About KUHeS
 
Kamuzu University of Health Sciences – Nursing
KUHeS - Nursing
 
Malawi College of Health Sciences
MCHS - A Leading Health Institution in Malawi

Christian Health Association of Malawi
Christian Health Association of Malawi – To Serve and To Heal
 
Nkhoma College of Nursing and Midwifery 
Nkhoma Nursing
 
Let’s craft a better tomorrow. Together.
Karelia University of Applied Sciences - Karelia University of Applied Sciences

Karelia University of Applied Sciences
Degree Programme in Nursing | Study Guide, Karelia