PALSA PLUS crosses the SA border

May 2008

Hello - you’re wel’cm! Your first time in Malawi? –
Oh! You’re very wel’cm!’
This was the warm greeting that Lara Fairall and Gill Faris received during their 4 day visit to Malawi in April 2008.

The KTU PALSA PLUS introduction to Dignitas International (DI) in Malawi came from Merrick Zwarenstein (our partner in Canada, whom you have seen on our DVD, Changing Practice: The PALSA PLUS Story). As the DI website states, they are ‘a pioneering medical humanitarian organization working with communities to dramatically increase access to life-saving treatment and prevention in areas overwhelmed by HIV/AIDS’. We really saw this in action with their decentralization of ARV care to the districts and community based programmes.

In February 2008 Sandy Thompson, the DI Community Based Programme manager, and their doctor, Marion Kambanji, visited the KTU. Thanks to our Western Cape PALSA PLUS trainer, Gadijath Appolis, they experienced a PALSA PLUS training and could see a South African healthcare facility in action. After discussions with Ruth Cornick and Lara Fairall, the seeds of our partnership were watered, so ours was a follow-up visit as we wanted to see how their healthcare system works, and talk to those working on the ground in order to develop the PALM (Practical Approach to Lung health Malawi) guideline and training.

We made use of every minute of our days in Zomba. We were taken to Matawale clinic, Zomba Central Hospital, and two rural facilities, namely, Domasi Health Centre and Likangala. We also paid a visit to the District Health Office. Their health services are run by very few doctors but mostly, Clinical Officers, Medical Assistants, Nurses and Health Surveillance Assistants. Nurses in Malawi seem to be focused on maternal and child health. We learnt much from our visits and discussions; the Malawians are ahead of us in terms of decentralization of HIV care, but sadly, technology to assist in diagnosis is almost non-existent. We were saddened by the level of poverty and ill health and lack of resources. The KTU is humbled and honoured to be working alongside DI to develop PALM PLUS. 2008 is guideline preparation and hopefully the training will start in 2009!

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