Tuesday, 24 April 2018

Goodbye Malawi, and thank you

I haven't visited Malawi since August 2017. Usually, I'm out there every few weeks and sometimes more frequently than that. However, in recent months the events described in my last post (Thank you Scotland's NHS) have taken over and it has been up to a good friend and colleague of mine to engage in the activities I might otherwise have been doing.

Not just my visits to Malawi have stopped: my writing has too. I only have energy for so much, and getting through the treatments has often been challenging enough. So the posts on this blog, and on my Edinburgh one have petered out.

So what now?

I am now pretty certain that I will not be returning to Malawi in the foreseeable future, or perhaps ever again. While I had until recently promised myself that I would be back for a last fling in September this year, indeed had discussed it with specialist medical staff and the organisation for which I work, I now know in my heart of hearts that this is not going to happen. Compromised immune systems don't respond well to air conditioning in planes, let alone the interesting range of bacteria and viruses on the ground once one gets to one's destination.  It helps no one to travel to a country with a far less developed health service than our own and not only risk one's own health but potentially take time, attention and resources away from other people, and disrupt their work. So much, so disappointing.

That does not mean, however, that I have completely severed my connection with Malawi. Work continues, but carried out in Edinburgh rather than in the field. Naturally, such working methods are not sustainable. The longer I stay away, the less relevant and useful my work will be to the people with whom and for whom I work. So, some intensive desk work over spring and summer will morph gently into a wind down and conclusion.

So, it's goodbye to Malawi.

I am not going to attempt to reflect on the effectiveness or otherwise of my work. That is for others to do. Indeed, one of my more recent posts, Taking stock, described what exactly it is that I have been doing.

No, this post is not about what I have done for Malawi. It is about what Malawi has done for me.

One of the more exasperating aspects of working in a developing country is the difficulty in being allowed to do so. The usual mantra is that you are not allowed to work in Africa unless one has already had experience of working in Africa. Catch 22. I was fortunate to be taken on in my earlier posting in Uganda because I had had experience at the hard end of travelling around and staying in Cameroon, though only as a visitor to a project in which my son was engaged. At the end of two and a bit years living and working in Uganda, I was irritated to be told by a senior staff member in the organisation to which I was attached that I had 'now' become useful and could be deployed elsewhere.

There is an element of truth in such dismissive comments, however. Those of us who have achieved senior positions in our own countries, may feel that we 'know it all', that we are the 'experts'. How different it is, however, applying our knowledge and deploying our skills in a completely different setting.

Foreign 'experts' can be a liability in developing countries. We expect change to happen too quickly, or we see what needs to be done and, particularly in education, find it difficult to accept that our work is unlikely to improve the experiences of children in the shorter term. We get frustrated. We have unrealistic expectations based on our own countries with their efficient transport systems, well-established working arrangements, generous funding of public services and completely different childrearing practices. Scottish public servants - teachers, medical staff - may consider themselves to be underpaid and overworked, but at least they receive their salaries regularly and on time and are not struggling to feed and educate their own children.

When we foreign consultants come along with our expectations of what constitutes effective professional practice, based on international educational research and our own personal and professional experience, our advice may be totally unrealistic and ignore deeply entrenched cultural views on, for example, how teaching should be carried out or children disciplined. Fortunately, the long standing and respected work of organisations such as UNICEF provides a frame of reference and a basis on which the rest of us can build.

In my own case, I have benefited enormously from the generosity with which my Malawian professional colleagues have shared their own experiences and understanding. During long journeys up and down the country, I learned of their own educational journeys, not all of which had been straightforward, of life in rural villages and the obstacles which so many children face, of the hugely significant impact of religious belief, both Christian and traditional, on community life. More mundanely, I learned about the Malawian education system and the impressive achievements of those who survive it against all odds. Thank you Fritz, Michael, Steve and Harrison, professional staff working for Link Community Development, who took responsibility for my education as we bounced down rough dirt tracks in search of primary schools out in the bush. Thank you also to the inspectors and advisers in the Education Ministry's Directorate of Inspection and Advisory Services, and to the principals and staff in Malawi's teacher training colleges. Never once did any of you express surprise at my naivety and ignorance. Your support and input during all aspects of my work has been invaluable.

When I worked in Scotland, I often felt that I did so under pressure. However, I had no idea how fortunate my Scottish colleagues and I were in terms of the time available for the activities we were expected to undertake, the relative ease with which we could travel from one side of the country to another or the availability of technology to enable us to work efficiently.

In both Uganda and Malawi, school inspections have to be undertaken in roughly half a day, very different from the week available for similar activities in a Scottish school. Developing countries do not have the money to employ enough officers to undertake longer inspections or to pay for the travel and subsistence necessary. My Malawian colleagues have to be able to grasp the key features of practice in a particular school within two or three hours. Papers cannot be taken away to be studied at leisure, for one will not be returning to that school for a long time, and anyway, the following day one will be in another school. If inspections or supervision by advisers cannot be carried out within such a short timescale, then there is no point to them. Without external evaluation, the quality of education in individual schools and across districts continues unmonitored and children's experiences suffer. To be effective and relevant, consultants' work must be carried out in partnership with local professionals who can provide the contextual surround which makes their work practicable. Learning has to be two way. My own learning has been immeasurable.

Without this learning, my Scottish assumptions about how Malawian schools are administered would have been quite unrealistic. My understanding of the extent of preparation and support which Malawian teachers receive, or do not receive, would be severely lacking. It is only too easy in such circumstances for the pronouncements and reports of external consultants to be quite out of synch with the reality of the situation on the ground. We fly in, deliver our reports, and fly out again. My inspectorate and advisory colleagues, in contrast, have to be sensitive to  the nature of the demands made on minimally educated classroom teachers and school leaders, while at the same time making clear recommendations for improvements in practice, for the benefit of children.

This does not mean that international consultants have nothing to offer developing countries. They can help inspectorates extend the scope of evaluation so that it focuses more closely on issues which matter, in particular, the experiences and achievements of young people, rather than just on data collection and transmission. They can also help local officers develop the range and types of evidence on which evaluations are based so that they are well founded. However, such development and the training necessary cannot be carried out without awareness of the local context. That context is provided by the local colleagues with whom one works. I could not have done my work without them.

Thank you also to the ordinary people of Malawi, to the hotel staff, the street pedlars and the shop assistants whom I got to know quite well, and who greeted me on my way back and forth to work. I pity those foreign consultants who only ever stay in luxury hotels away from the buzz and bustle of the local markets and street traders, and who only ever travel by private car. I have heard of 'experts' who are so frightened of stepping outside the hotel compound that they never actually meet a real Malawian, and this in one of the safest and friendliest countries in the world. While admitting that my own experience has still been quite limited, I feel that I have seen a fair bit of the country and its people.

There are individuals I shall always remember: the educated young men carrying out their wood carving by the side of the road, struggling to make ends meet and support their younger brothers and sisters through school in a country where having a permanent full-time job is a rarity; disabled and albino beggars working their way down the queues of traffic; and young mothers and prematurely aged grandmothers with underfed children strapped to their backs, trying to collect sufficient small coins and stained low-denomination notes to buy a handful of maize for the evening's porridge. Many of the people one passes are the casualties of the education system: educated but jobless, child brides thrown out of the marital home, the disabled denied the educational support which would have enabled them to become independent. They are the permanent reminders as to why we do the work we do. Only education can help. And that education has to be better than it currently is, which is where consultants like me come in.

Well, as I have already written, I am unlikely to return to Malawi. However, during several of my recent visits to Edinburgh's Cancer Centre, medical staff have reminded me that the Western General Hospital has well established links with Malawi. One of the consultants and several of the Breast Care nurses are helping to train and support their Malawian colleagues at the newly established cancer centre in central Malawi.

And although I myself am unlikely to make the journey again, I have just arranged for my mother's 70-year-old Singer sewing machine, still going strong after all these years, to be refurbished and transported to Malawi, where it will be used for vocational training by a wonderful organisation called Tools for Self Reliance.

So, I may not be going back to Malawi but other people from a range of different backgrounds and with different kinds of expertise, will make that journey. And no doubt, they, like me will arrive thinking that they are there to teach other people skills with which they are unfamiliar. And they like me, will eventually realise quite how much they have learned themselves.

Goodbye Malawi, and thank you.

Sunday, 31 December 2017

Thank you, Scotland's NHS

Half a dozen years ago, while living in Uganda, I went down with a serious disease - not life-threatening, but extremely unpleasant. And, in fact, nothing to do with being in Uganda. Indeed, I received excellent healthcare at my GPs' surgery and, later, the International Hospital in Kampala, little different from the care I would have had in Britain. The only reason I returned to Britain for a while, was for investigations, not available in Uganda, into the causes and control of residual pain. In the end, I came back to Uganda and my husband and I finished off our contracts, Stuart having carried out both our jobs while I was away.

Despite my satisfactory healthcare in Uganda, there was one key difference, however, between the two countries: in Uganda we (actually the insurance company used by our sponsoring agency) had to pay for this care, and not at overcrowded public clinics but at good private institutions. Not that we don't pay for public healthcare in Britain, of course, but it is free at the point of use and the comfortably off pay more through their taxes than the relatively poorer. You can argue that resources in the UK are still not enough, of course, but that is not the main point of this post.

The point of this post is that if I had been an ordinary Ugandan woman living in a village, working perhaps in subsistence agriculture and bringing up a large family, not only would I not have received such good quality care, but, worse, my health could have been irreparably damaged. Specifically, I could have lost the sight in one eye. Not only did I need to take expensive drugs for the underlying medical condition, but the doctor had to train me to look after my eye to avoid infection. I had to make regular purchases of dressings, eye patches, strips to make the eyelid close on the paralysed side of my face and eye drops. And a Ugandan woman would have had to travel some distance to the clinic, if lucky in the back of a pickup, if not on foot. All this is in a hot climate, with flies and copious amounts of red dust.

Graca Machel recently wrote that access to health is a human right. She quoted the following statement from the Constitution of the World Health Organisation: "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being". In Africa, millions, however, are faced with the choice between medical care and providing food for their families. Mme Machel is campaigning for universal access to affordable and accessible healthcare, of good quality.

In Kenya, 83% of people lack financial protection from health care costs, a similar proportion as in South Africa. Malawi does not charge fees in public health facilities (though they are very overstretched). As a result Machel writes, Malawi has a child mortality rate of 64 deaths per 1,000 compared with 109 in Nigeria. In Scotland, infant deaths have fallen to an all-time low of 3.7 per 1,000. Health is about money. Life is about money.

The recent publication of Tracking Universal Health Coverage: 2017 Global Monitoring Report states that 800 million people spend at least 10% of their household budgets on health expenses for a sick family member. 100 million of these people will be forced into extreme poverty as a result, forcing them to survive on just $1.90 or less a day. Nevertheless, over the last few years, overall health has improved through access to antiretroviral treatments for HIV/AIDS, immunisation, family planning, and treated bed nets to protect against malaria. It does not take much, however, for economic or political problems in individual countries to threaten the scope and effectiveness of such programmes, as the WHO has just reported about immunisation in Kenya, which has dropped from 85% coverage to 68%.

Across the world, there are significant differences in health service coverage between the wealthiest and the poorest, even within individual countries. The World Bank reported that only 17% of mothers and children in the poorest fifth of households in low and lower middle income countries received at least six of seven basic health interventions compared to 74% of the wealthiest fifth. Without adequate healthcare, children will not reach their potential nor countries achieve their aspirations. Health affects education, family life, employment, food security and trade.

Such discrepancies in the health of different communities within the same country do not just occur in the developing world, of course, though the causes and relative impact of such discrepancies may be more notable. In Scotland, as in sub-Saharan Africa,  access to healthcare may be influenced by a number of factors.

Geography may be one factor. For example in Scotland, it is more difficult to access health services in rural areas and on the islands compared with the Central Belt. The current appeal for a cancer charity notes that it costs some patients £150 per month in travelling expenses alone to attend the necessary clinics.

Social factors are also significant. The Herald recently reported on the impact on Scots of benefit cuts, which have resulted in widening health gaps between richest and poorest, with the most deprived significantly more likely to die from alcohol abuse, coronary heart disease and cancer. In Scotland, it is not so much provision of health care that differs across the country as uptake of screening services such as those for bowel and breast cancer.

Social and economic factors influence health-related behaviour. More affluent people may check on symptoms sooner than the more deprived. And you can see why. They have better access to transport and more money to pay for it. They may find it easier to miss work to attend an appointment. It is difficult to attend clinics when on zero hours contracts or doing two or more jobs to make ends meet. The pay the more prosperous may lose as a result may not have as much significance for their budgets or for their continuing employment as it does for the poorer, particularly if repeat visits are necessary. Wealthier people are more likely to be able to afford childcare and may find it more straightforward to organise. Above all, as we know, some households are under severe stress. They may be headed by parents whose personal lives and family organisation may be affected by mental health problems which make it difficult for them to take on yet another challenge. 

The Herald reports that more than 21,000 people in Scotland died before the age of 75 in 2016, but the rate was 3.7 times higher among the poorest Scots compared to the most affluent - up from 2.7 in 1997. The differences are particularly noticeable in communities and families under stress. Deaths from overdoses, suicides and assaults are over six times higher among the poor as among the prosperous. The article lists some shocking data, many associated with the impact of smoking, obesity and alcohol consumption. These factors not only have a significant impact on health differences within Scotland, but also, as most of us are aware, in Scotland compared with the rest of the UK.

After adjustment for differences in deprivation, premature mortality (<65 years) in Scotland is 20% higher than in England & Wales (10% higher for deaths at all ages); similarly, the excess for Glasgow compared with Liverpool, Manchester and Belfast has been shown to be approximately 30% for premature mortality, and around 15% for deaths at all ages. 

The City of Glasgow and nearby council areas have some of the highest levels of premature death in the country. With a population of 1.2 million, life expectancy at birth in greater Glasgow is 71.6 years for men, nearly seven years below the national average of 78.2 years. It is 78 years for women, over four years below the national average of 82.3. In 2008, according to the World Health Organization, life expectancy for men in the Calton area of Glasgow was 54 years, attributed to alcohol and drug abuse, and a violent gang culture, exactly the same life expectancy as in Uganda at the time.

These areas in the west of Scotland are also those where deindustrialisation has had the greatest impact, where poverty is at its highest and recent and ongoing benefit cuts are having the greatest effects. Not that there is no poverty elsewhere in Scotland, of course, for example in the rural areas of the Highlands and Islands and in other cities like Dundee and Edinburgh. Even prosperous Aberdeen has areas of acute deprivation. But not as high or as intractable, perhaps, as in the west.

Indeed, inequalities in health are becoming increasingly evident across the UK. A study just published by the Nuffield Trust has shown the 'devastating impact' of deprivation on child health. The UK's poorest teenagers were 70% more likely than their peers to appear in Accident and Emergency services. School aged-children from the poorest areas are two and a half times as likely to be admitted to hospital in an emergency for asthma as those in the richest areas. Anecdotal evidence from doctors points to the return of rickets and other diseases more often associated with nineteenth century slums and poverty stricken villages in the developing world. The increasing numbers of children brought up in temporary accommodation - 3,000 such children in London alone, an increase of 52% over the last five years - are reflected in increasingly negative health statistics. The Joseph Rowntree Foundation has found that almost 400,000 more children in the UK lived in poverty last year than in 2012-2013.  And it is not going to get better. The Institute for Fiscal Studies has predicted that the number of children living in poverty is likely to rise to 5.2 million over the next five years. Increased poverty means increased ill health.

In 2016, the Office for National Statistics reported huge disparities in health and longevity between different areas of the UK. Women in prosperous Richmond-on-Thames live 15 years longer than those in deprived Tower Hamlets. Scotland has the worst longevity rates, but also some areas where people may live the longest in good health during retirement, for example on the Orkney Islands where rates are similar to Richmond. Orcadians on average live 12.5 years longer than people in Glasgow.

Nevertheless, while our health services in Scotland and the UK as a whole are demonstrably overstretched, though not as much as those in sub-Saharan Africa, few of us in Scotland doubt that our local and national governments on the whole aim to ensure that all Scots have the access they need. The pressures come from increasing demands on the system. How this compares with the situation in the USA before the Affordable Care Act, and what is happening now, as Trump attempts remove the little support there is!

It is true that in Scotland, the prosperous and very rich may use private health care provision; however, most people use the National Health Service, confident that it will serve them well. In sub-Saharan Africa, on the other hand, governments pay millions of dollars providing expensive private healthcare in foreign hospitals for their politicians and civil servants, and, including their families, dollars provided by ordinary taxpayers. The daughters of Uganda's President Museveni gave birth abroad to save themselves and their babies from the risks their fellow Ugandans face in the country's maternity units.

Now, I would be the first to accept that Scotland experiences a different sort of poverty from that in the developing world. Indeed, people in Uganda and Malawi might have a wry smile when reading some of the Scottish data. Dying before the age of 75, as reported in The Herald? In Uganda, Stuart and I used to play the game 'spot the old person' when driving along the road, there were so few of them compared with the increasing proportion of older people in our own country - around 40%. At the time we lived in Uganda, only between 2 and 4% of the population was aged 60 or above, the result of decades of conflict and the impact of HIV/AIDS, malaria and other diseases. On the whole, Ugandans do not die of obesity, though the children of the more prosperous are now being fattened up on burgers, pizzas and 'sodas'. While junk food and fizzy drinks are frowned on among the middle classes in the UK these days, in sub-Saharan Africa they are signs of prosperity and even relatively poor families may occasionally buy them as a treat for their children. When the organisations I work with hold community meetings, it is de rigeur to provide 'sodas', and people feel cheated if they don't get them. So, as extreme poverty falls in the developing world, the health problems of the west may begin to creep in. While the west may have the facilities, though not necessarily the will, to deal with such lifestyle problems, the developing world almost certainly does not. In Malawi, most ex-pats fly home or to South Africa for treatment.

Nevertheless, as the Gates Foundation Report has recently pointed out, health statistics in the developing world are generally improving. There is hope. Effective action can be taken. In all countries improvement 'just' takes the will of local and national government and the willingness of taxpayers to influence this will through voting for political parties prepared to take radical action. And, we might add, through avoiding the twin temptations of corruption and tax evasion. 

Now, what has brought these health issues to my mind just now? It is Christmas, after all, not necessarily the most appropriate season for solemn comparisons of national health systems.

All of us who have made frequent visits to the developing world are well aware of the fortunate lives we lead here in the west, lives which even the professional colleagues we work with might find it difficult to imagine. Six years ago, in Uganda, I was able to keep the sight in my left eye because I was European. I was able to learn how to live with chronic pain because I had available to me the medical resources of one of the richest countries in the world. I was able to receive ongoing medication by means of free prescriptions which meant it was less likely that the condition would recur. And I didn't have to undergo my treatment while producing the only food my family was likely to eat, through subsistence farming on exhausted or poorly-irrigated land. I didn't have to use my children's or grandchildren's school fees to pay for my healthcare, nor was I tempted to forgo treatment in order to keep them in school. Our National Health Service saved me from these painful choices.

This year, in between my usual trips to Malawi, a routine mammogram in Edinburgh homed in on a tiny lump in my breast. Without this routine screening, available to all women my age in Scotland, neither I nor clinical staff would have been able to find the troublesome cells by touch for they were buried too deep. By the time this lump had become obvious, it would probably already have shed malignant cells leading to secondary tumours elsewhere in my body. As it was, I climbed on board a conveyor belt of diagnosis and treatment employing the most up-to-date procedures and medication. Oncology services at the Western General Hospital in Edinburgh are among the most advanced in the UK. The hospital's staff must surely be among the most humane and caring.

So, here I am now, at the end of December, surgery successful and chemotherapy underway. It will be quite a long haul. By the time the chemo is over, there will be radiotherapy and medical procedures to deal with the impact of these therapies on my bones. Active treatment should be over by the end of May but Scotland's NHS will monitor my progress and continue to deal with any after effects for some years. And as long as our country remains reasonably stable in economic terms, I have no reason to doubt that the NHS will continue to provide this oversight and care. Only a looming Brexit and consequent withdrawal from Euratom, the source of the medical radioisotopes necessary for such treatment, are making me uneasy.

Even within Scotland, I am very fortunate. I don't have to travel for two hours from the Borders to receive my treatment, nor do I have to rely on ferries and tiny planes to transport me from the Western or Northern Isles. My husband and I can well afford the necessary transport arrangements and the little luxuries that make the treatment liveable with.  I am also mindful that mine is one of the more straightforward cancers to treat; other people, even in Scotland, are nowhere near so lucky.

If transport is difficult to organise, I can, if necessary, call on an ambulance. I don't have to balance on the back of a push bike or pickup like a Malawian. All my treatment so far has been in outpatient clinics, but if I ever needed to be treated on an inpatient ward, I know that the NHS would provide me with food and bedding, which they will even launder for me. I won't have to sleep on a mattress on the floor, nor will I need to keep a grandchild off school in order to cook my meals and provide my nursing care. I know that the hospital has a supply of safe water and electricity and is unlikely to be affected by power cuts. I will have the use of regularly cleaned flush toilets, rather than a pit latrine in the hospital compound.

But then, if I were Malawian, the treatment I am in the middle of just wouldn't be provided in the first place.

The impact of budget cuts on national health services in all the constituent countries of the UK has been significant. Inequalities in the state of people's health in different geographical areas, and in access if not provision, are unacceptable. It is morally wrong that the poor die 12 years earlier than the comfortably off.

However, I also cannot forget how fortunate I am that this prosperous European country of Scotland can provide me with some of the best treatment in the world. Because I live in Scotland, I am going to live.....

Malawi registers success in child healthcare services - Muluzi, 5 December 2017, Nyasa Times
Concern as Baby Immunisation Coverage Stalls, 28 December 2017, The Nation
Africa's Health Challenge is a Human Rights Issue, by Graca Machel, AllAfrica, 18 December 2017
Half the World lacks access to Essential Health Services, World Bank  and the World Health Organisation, 14 December 2017
Health inequalities widening in Scotland with the poorest nine times more likely to die from alcohol harm, Helen McArdle, The Herald, 20 December 2017
Excess mortality in Scotland and Glasgow, The Scottish Public Health Observatory, 2017
Mystery of Glasgow's Health Problems, Ali Muriel, The Guardian, 6 November 2012.
Glasgow has the lowest life expectancy in the UK, BBC News, 19 October 2011
Excess mortality in the Glasgow conurbation: exploring the Glasgow effect, James Reid, PhD thesis, University of Glasgow Faculty of Medicine, September 2008
Behind the Glasgow effect, Michael Reid, Bulletin of the World Health Organisation, October 2011
Health of Scotland's Population: Mortality rates, Scottish Government
National Register of Scotland, Age-standardised death rates
The Affirm Study, University of Edinburgh
Scotland's Stillbirth rate reaches a record low, The Scotsman, 25 March 2014
Huge health gap revealed between UK's rich and poor, The Observer, 24 December 2017
Figures reveal huge inequalities in health and longevity across the UK, The Guardian, 11 October 2016
Does it matter if the UK leaves Euratom?, 12 July 2017, BBC News

Tuesday, 28 November 2017

Goodbye to Banda, Mugabe and Africa's Big Men

A couple of days ago, I woke up to this tweet from the much-loved Reverend Richard Coles:

'It is the 20th anniversary of the death of Dr Banda, the only MP from Willesden to have become president of a nation (Malawi). He murdered four of his ministers by having tent pegs driven into their temples and was an Elder of the Church of Scotland.'

Unsurprisingly, the tweet, with all its non-sequiturs -  was followed by a string of facetious responses about tents, pegs, the Old Testament, brain surgery and the church. Twice I crafted pedantic replies attempting to bring some balance to the story, which I immediately deleted, not wishing to take things over-seriously.

I wanted to refer to Banda's struggle to achieve an education in the country which we British had made one of our 'protectorates', his rejection by colonial society and, worse, by missionary hospitals despite his hard-earned medical training and experience and his genuine attachment to both Scotland and England, where he had lived and worked. I wanted to point out how such rebuffs and racism contributed to his becoming the nationalist leader he was, for good as well as for ill - for good there was, among all the lurid evidence of violence, tyranny and rapacity. To this day, Malawians express considerable respect for (Hastings) Kamuzu Banda. We British need to understand this and try to appreciate why that was. If you wish to find out more, read my earlier post Remembering Hastings Kamuzu Banda. Nice man though Richard Coles is, his tweet smacked of White Man's condescension.

It is just coincidence that this minor incident concerning Malawi's first President took place the same week that President Mugabe, Zimbabwe's first President, also became its first ex-President. What do we know, then, about Robert Mugabe? What do we know about Zimbabwe, or rather Southern Rhodesia, as it used to be ? What do we know about the impact of British colonialism on Rhodesia and on Mugabe himself?

The impact of colonialism on Rhodesia

The clue is in that name, Rhodesia. The country, like its northern counterpart, now Zambia, was demarcated by the imperialist Cecil Rhodes and his British South Africa Company (BSAC) in the 1890s. Its foundation was both commercial and ideological. Rhodes dominated the diamond market from his base in South Africa and was attracted by the prospect of mineral mining elsewhere in southern Africa. He also believed that the British were 'the first race in the world'. It was Rhodes who said 'the more of the world we inhabit, the better it is'. As Prime Minister of the Cape Colony, he described Africans as 'living in a state of barbarism'. He was one of the architects of the Native Lands Act 1913 which limited them to 10% of the land. Rhodes claimed that 'the native is to be treated as a child and denied the franchise. We must adopt a system of despotism, such as works in India, in our relations with the barbarism of South Africa'.

Through trickery, Rhodes managed to persuade Lobengula, king of the Ndebele of Matabeleland (in what is now Zimbabwe) to let him open mines on his land. When the British colonial office found out, they did nothing. In 1889 Rhodes obtained a charter from the British Government for his British South Africa Company to rule, police, and make new treaties and concessions from the Limpopo River to the great lakes of Central Africa. He attempted to get the concessions in Katanga (in Congo) and Bechuanaland (Botswana), failing in the latter when local kings appealed direct to the British government. His BSAC fought the Ndebele and Shona to gain control of what became Rhodesia. His dream was for the British to govern Africa 'from the Cape to Cairo'.

Rhodes died one of the wealthiest men in the world. His will included a bequest for the development of a Secret Society which would work towards the extension of British rule throughout the world, including emigration from and colonisation by Britain. Clearly, that bequest never became reality, but Rhodes' beliefs and actions and those of other colonisers like him, had already done enough damage, and damage continued over decades.

In Rhodesia, the Land Apportionment Act of 1931, which remained in force for decade after decade  decreed that 58 million acres be reserved for whites and 25 million (later reduced to 1 million) for blacks.  By the time Zimbabwe belatedly achieved its independence in 1981, its 700,000 indigenous farmers occupied 53% of the country's land - the poorest land, unsuitable for large-scale  agriculture. In 1990, only 8% of black farmers owned productive land suitable for commercial farming. The rest of the productive land, 15.5 million hectares, 39% of the total area, was owned by 6,000 commercial white farmers.

Most of these settlers, like Alexandra Fuller's family, had arrived relatively recently, after the end of World War II and in full knowledge of what white rule entailed. White people of modest means and little education could move to Rhodesia and 'live like kings', as colonialists had done in India for centuries. While it may be true that white farmers successfully developed the productivity of their fertile land, their increasing wealth was not shared with the people whose country it was. They made no efforts to develop in the black majority the agricultural and technical skills required to make best use of the land, nor would they sell their land except to other whites, usually those arriving from Britain after the war.

During the early 1960s, most of Britain's colonies achieved independence. In Rhodesia a few brave politicians and activists suffered for their opposition to the overtly racist regime of Ian Smith. However, most white settlers overwhelmingly supported him (one of 'ours', an ex-fighter pilot) and his white minority party. His Unilateral Declaration of Independence in 1965 would have excluded the black majority from power until well into the 21st century, an intolerable proposal.

Robert Mugabe, imprisoned for 10 years by the regime for a 'subversive speech' and even refused permission to go to the funeral of his three-year-old son, in due course led the black guerilla struggle against white rule. While in theory Britain had imposed sanctions against the illegal white-led regime, it did not enforce them with any conviction. After all most of Britain's Conservative Party supported the settlers: 'our kith and kin', as they called them. Surprisingly, it was the pragmatist Margaret Thatcher who eventually took practical action to deal with the impasse, in the interests of the free market.

In due course, talks were held, compromises were made and preindependence elections eventually took place. Mugabe, whose party Zanu-PF won, said afterwards, "I never trusted the British. Never at all. I do not think they meant well towards us...I do not think they wanted a liberation movement, and especially one which I led, to be the victor."

Nevertheless, despite his reservations, Mugabe made a powerful speech of reconciliation.

"The wrongs of the past must now stand forgiven and forgotten. If we ever look to the past, let us to do so for the lesson the past has taught us, namely that oppression and racism are inequalities that must never find scope in our political and social system. It could never be a correct justification that because the whites oppressed us yesterday when they had power, the blacks must oppress them today because they have power."

Unfortunately, and largely because of the intransigence of the settlers, Zimbabwe never went throught the truth and reconciliation process which South Africans in time experienced. Despite Mugabe's refusal to take revenge, most settlers did not take up the offer of reconciliation. They continued to support Smith and white supremacy through further elections. Smith never apologised for his illegal action, although thousands of people had died during the 10-year civil war it triggered. While some settlers may have become marginally more respectful to their African neighbours than before, most however, retained the racist attitudes which had brought them to the country in the first place and which had become entrenched over the years.

However, the settlers had a bolt hole, Britain, which many of them now used. They live among us to this day, probably voting for UKIP and Brexit. The indigenous population, on the contrary, had nowhere else to go. They also owned very little productive land, for the land issue was never properly resolved. Although it is said that Britain provided £2 billion to transfer some land to the indigenous people, it is unclear how much actually did change hands. Britain was cautious about land transfer because of the precedent it might set. The result was that it was Mugabe who carried out these transfers years later to provide recompense for the veterans who fought for independence. They forcibly took over white farms but without the skills and experience which subsistence farming required, let alone commercial enterprises.

In 2002, Francis Sengwe said to the newspaper This Day: "There are a few white people who individually own plots of farmland as big as the size of Imo and Abia states combined. Where is the justice and equity in that? Our parents suffered in the hands of these people. My parents worked in a tobacco farm owned by a white man and we had nothing; in our own country. President Mugabe is only trying to correct some of these imbalances and the British would not allow him to have any peace."

We all know the rest of the bitter story, for example, the violence meted out by Zanu-PF to the people of Matabeleland. Zimbabwe, like all but two of the 54 African countries invented by Europeans at the end of the 19th century, is ethnically divided, with 17 national languages. Many of the current tensions in African countries directly relate to those colonial decisions: think of Nigeria (tension between Hausa, Yoruba and Igbo), Kenya (tension between Kikuyu, Luo and Kalenjin) and Cameroon (tension between Anglophone west and Francophone east), to name but three. This is not to excuse the violence nor the deaths of 20,000 Ndebele. We do, however, have to understand Britain's contribution to so much that has gone wrong in Zimbabwe. And not just Zimbabwe.

The impact of colonialism on Kenya

Kenya very nearly became White Man's Country, like southern Rhodesia and South Africa. The British colonial government had displaced the Kikuyu from the most fertile land, replacing them with dissolute younger sons of the British aristocracy, who made Happy Valley their playground. The Kikuyu, expelled from their ancestral lands, moved into the lands of the Luo and other smaller tribes. The tensions were still present in this year's elections, which still had their basis in tribal loyalties. Kenya has 42 tribes, with three mutually incomprehensible language groups. Tribes which lived on the border with Uganda are split between the two countries. Debate as to exactly where the border should be continued right up to Idi Amin's day. Families and clans remain divided.

Kenya's white farmers made a fortune during World War II but nevertheless forced down the wages of their black workers. After the war, more settlers came. The slogan was 'Officers to Kenya, men to Rhodesia'. The Kikuyu launched the Mau Mau rebellion, a bitterly fought conflict. The British deployed 12 battalions as well as fighters from other tribal groups. They carpet-bombed the rebels' forest hiding places then shot them down when they emerged. The British set up concentration camps where appalling atrocities took place, including death by beatings, torture and castration. It has taken until now for reparation for these atrocities to be made by our government. The casualty rate by the end of the rebellion included 12,000 Mau Mau supporters, 1,800 African civilians and 3,000 African soldiers and police. How many white settlers were killed? Thirty two.

Unjust expropriation and allocation of land, exploitation of tribal divisions and both overt and implicit racism were some of the key methods which the British used to manage their imperial possessions. These methods have had a longlasting impact on the political situation in many ex-colonies. And Britain was by no means the worst of the colonising nations. Which was the worst? Well, in a competition for lowest ranking, it would be difficult to find any colonialists worse than the Belgians,with the blood of 8 million Congolese on their hands.

The role of the Big Man

An important element in these post-colonial African conflicts is the role of the Big Man, which is how we started this post. I have explained in a separate post how I was surprised by the respect with which Kamuzu Banda is still held in Malawi, despite acknowledgement of his failings. He is rightly seen as the father of his people. He is also respected because of the way in which he stood up to British bullying. In the 1950s, Southern Rhodesia proposed a federation with Nyasaland (now Malawi) and Northern Rhodesia (now Zambia), a highly unpopular move. The latter two countries rightly believed that the white settlers in Southern Rhodesia were hoping to lead the federation and, hence, Central Africa. Banda said that under colonial government, the relationship between Africans and the authorities was that of 'ward and warden', but under Southern Rhodesia it would be one of 'slaves and masters'. Nevertheless, Britain gave way to Southern Rhodesia.  Following violent protests in Nyasaland, a group of young radicals asked Banda to return to lead the resistance and support the independence movement. 

Sadly, the promise of the new country of Malawi was never really fulfilled. Despite the action taken to support ordinary people, the presidency of Kamuzu Banda was characterised by increasing corruption. Thousands of pounds were stolen during his incumbency and even more during those of succeeding presidents. Similar examples of excessive theft from national coffers can be observed in Nigeria, Kenya and, of course, Zimbabwe. Partly this dishonesty may be because the skills required to build a country are not the same as those required to achieve independence. Partly it may be because the traditional role of the Big Man is incompatible with that of a modern head of state.

Many of the first presidents of newly independent African countries were freedom fighters, larger than life characters who could fight for independence but did not necessarily have the skills required to lead their people into a new era. President Museveni of Uganda, another Big Man, is in this mould. He has exploited his reputation as the leader who defeated the regime of Idi Amin and won the subsequent Bush War in order to persuade his people to re-elect him decade after decade. Development, however, has stalled and corruption has become entrenched.

Idi Amin himself was a quintessential Big Man. During our very first week in Uganda, Stuart and I were lectured about what an impressive leader he was by a young man we met in the Kampala market. Amin was nicknamed Dada, or Daddy: another father of the nation. This young man really wanted us to know the respect in which he was held by many of the population, despite his cruel regime. Again, he was held in high regard because of the way he stood up to the British.

The strong man who achieves a position of importance and then provides for the friends, family and community who helped him to get there - 'eating' - is a familiar figure in some African countries. Key values relating to mutual cooperation within the family or social group may undermine the wider social contract expected in modern democratic societies. Our turn to eat by Michela Wrong describes how this pattern of obligations and favours has influenced and damaged political life and society in Kenya. When one considers how new most countries in sub-Saharan Africa are, it is hardly surprising that there are conflicts between the traditional culture of the Big Man who helps his people to 'eat', and modern political systems based on civil codes and legislation.

The role of education

Finally, we need to remember how recently secondary education has been developed in most African countries. Colonial authorities were only too pleased to leave it up to missionaries to provide education, with colonial officers simply supervising rather than managing schools. In Uganda, for example, which has had an established education system for longer than most other countries, the government only founded its first secondary school in 1924. By 1950, the number had increased to three secondary schools, supplemented by mission schools, one or two of which date back to the 1890s.

In Malawi, government financing of schools only began in in 1963 and supported 22 primary schools. Only 35% of children received primary education. The proportion receiving secondary education was infinitesimally small. In 1949 the colonial administration provided two post-primary years for those men who had undertaken military service during the war.  Secondary education was neglected throughout the colonial era and left up to missionaries. In 1963, there were only two church-funded secondary schools, at Blantyre and Zomba in the far south of the country. By independence in 1964 there were four secondary schools, two of which had previously been primary schools, which educated pupils to certificate level. The governments of almost all new African countries had to set up and fund education systems for black children from scratch, a policy preferred by their erstwhile colonial masters, it was said, to ensure that less money was available for defence, particularly in the white minority regimes in Zimbabwe, Mozambique and South Africa.

In Rhodesia, publicly-funded education was segregated and favoured white pupils. Whites comprised less than 5% of the population, while their schools received more than half the annual education budget. The teacher-pupil ratio in white schools averaged 1:15. In black schools, the ratio was 1:44. Education for black pupils was mainly provided by missionaries. It was primary education designed to provide the basic literacy and numeracy skills for reading the Bible and becoming effective workers. The secondary curriculum for Africans was restricted to basic vocational training designed to support white society, principally as farm labourers: training in agriculture, carpentry and building. In South Africa that situation persisted with the establishment of separate Bantu education (as described in Down 2nd Avenue).

The  British failed to provide proper secondary and tertiary education for generations of young Africans because the colonial authorities did not consider the possibility that these young people would become the leaders and civil servants of the future. Too much education was considered dangerous as it raised expectations. The British Empire was one on which 'the sun would never set'. But, set it did, after the Africans and Asians who had helped the British to win World War II demanded for themselves the democracy for which they had fought and for which their compatriots had died. However, the result was that these new countries came into being without many of the educated civil servants and politicians which western societies take for granted. Their leaders, people like Banda and Mugabe, had had to struggle for an education. Many of those who wanted to train as doctors or other professionals had to find funding to study abroad.

In Zimbabwe, the right to a free public education was one of the key issues of the seven-year guerrilla war that led to the collapse of white rule. It was a major campaign plank for Mugabe in the 1980 preindependence election. After independence, Mugabe's government increased education funding by 356%, spending more on education than on defence. The number of schools doubled and the number of teachers and students tripled. Many teachers, however, were unqualified and schooling was provided through double-shifting. As in most African countries, families had to pay for fees, uniform and educational materials, a heavy burden for the desperately poor. 

Zimbabwe, already more than twenty years behind those African countries which became independent in the early 1960s, was inevitably going to find it difficult to catch up. Reporting in Britain's tabloids focuses on how the government under Mugabe has mismanaged the country's natural and financial resources. This is true. However, we British have to be careful in our criticisms. In all these sub-Saharan countries we have to ask ourselves how effectively we prepared them for independence. Those leaders whom we humiliated - Banda, Mugabe and others - ended up being enthralled by the power they gained once in office. They burned with the injustices of colonialism and of their rejection by whites. They surrounded theselves with sycophants and became more and more paranoid. They made gross policy errors which they were unable or unwilling to address. Mugabe did not start off as a dictator. Once, he was an African hero. During his first 10 years in power, he transformed the lives of ordinary Zimbabweans. 

As Olusegun Adenyiyi puts it, "At the end of the day, whatever may be the other sins of Mugabe, it was the mismanaged land reform, not the fact that he stayed too long in power or that he was a dictator that accounted for the challenge of his last two decades in office fuelled largely from Britain." 

These Big Men may have become monsters, but they were our monsters, British monsters. We made them.

Other posts you may be interested in 

Remembering Hastings Kamuzu Banda - an account of his life and work

Let the people speak - an account of the political make up of Uganda and the European decisions which created the country at the end of the nineteenth century

Promoting girls' education in Kigezi - about the impressive educational work of missionaries in south west Uganda during the early twentieth century


Pictures of Robert Mugabe are being torn down all over Zimbabwe, The Economist, 23 November 2017

Mugabe and me, A personal history of growing up in Zimbabwe, Petina Gabbah, BBC News 25 November 2017

Zimbabwe: If Mugabe had failed, he would be a world darling, Yusuf Serunkuma, Pambazuka News (Weekly forum for social justice in Africa), AllAfrika, 23 November 2017. The article compares the post-colonial histories of Zimbabwe and Uganda, and Mugabe with Idi Amin.

Uganda: After Mugabe, all eyes are on Museveni - how long can he cling on to power?, All Africa, 23 November 2017

Africa: Mugabe, Like Mobutu and Gaddafi, Clung On Knowing He Had to Go, Dauti Kahura, Daily Nation 22 November 2017

Zimbabwe transforms school system, Glenn Frankel, the Washington Post, July 1985

Zimbabwe and the African tragedy, Olusegun Adenyiyi, This Day, 23 November 2017

African literature and history

Africa: Altered States, Ordinary Miracles, Richard Dowden, 2009. A masterly overview of individual countries and of the continent as a whole.

Our turn to eat: the story of a Kenyan whistleblower, Michela Wrong, 2009, an account of bribery and corruption

Don't let's go to the dogs tonight: an African Childhood, Alexandra Fuller 2001, an account of settler life by someone whose family actually settled in Zimbabwe during the war of independence. Her parents had come from colonial backgrounds and the writer describes almost unintentionally and without critique their inherited racism.

A Grain of Wheat, Ngugi wa Thiongo, 1967, Kenya's foremost writer. The novel is set in 1963, just before Uhuru - independence day. It describes the impact on villagers and rebels of the Mau Mau uprising.

Down 2nd Avenue, Es'kia Mphahlele, 1959, an autobiography depicting the struggles of the writer to gain a proper education and then survive as a teacher in apartheid South Africa.

King Leopold's Ghost, a story of greed, terror and heroism in colonial Africa, Adam Hochschild, 1998. A history of how 8 million Congolese were killed by the colonial ambitions of King Leopold of Belgium and the methods the Belgians used to exploit the local population through forced labour, in order to drain the country of its resources.

The Scramble for Africa, Thomas Packenham, 1992. A historical account of how the continent of Africa, still largely unexplored in the 1880s, was carved up by five European countries over a period of 30 years: Britain (which got most), France, Germany, Belgium and Portugal.

The African Child, Camara Laye,1959. A wonderful autobiographical account of a child growing up in Guinea in the 1930s and 1940s.

Things fall Apart, Chinua Achebe, 1958. One of the great African novels in English. The clash between the values of traditional Nigerian culture and those of the colonial rulers. It contrasts pre- and post-colonial life.

Malawi - History background - Education Encyclopaedia educationstateuniversity.com

Friday, 20 October 2017

Are you a vampire or just a bit different?

Nobody who keeps up with the news from Malawi can have failed to notice that the biggest story around just now concerns 'blood suckers'. No one quite knows what triggered the associated mob action, though some have suggested that accounts of medical staff taking blood for research may have given rise to wild and unfounded rumours of witchcraft. In various rural areas across Malawi, but principally in the south - in Mulanje, Phalombe, Chiradzulu and Machinga, all places where I have worked - these stories have resulted in horrifically violent acts against harmless individuals, perpetrated in an atmosphere of mass hysteria. One of the results has been the withdrawal of UN agencies, Peace Corps volunteers and other aid workers from the areas affected.

Witchcraft is still a powerful element in Malawian culture. Most months there are media accounts of old men and women being stoned to death or burnt alive following accusations that they have caused children or animals to die, crops to fail or lightning to burn down houses. These murderous acts do not necessarily take place in particularly remote areas. It is quite disturbing to realise, as has happened to me a couple of times, that the village where you spent the previous couple of nights has been the setting for some such horror. Indeed, yesterday's lynching of a disabled man happened on the main road in Blantyre. Just as in Europe a century or two ago, accusations of witchcraft may arise from envy of other people's success, ignorance about the causes of natural phenomena or misinterpretation of the conduct of the very old, those on the autism spectrum, or with epilepsy or other similar physical or mental disabilities.

You might expect that the arrival of nineteenth century Christian missionaries would have put paid to such beliefs. Far from it. If anything, modern Christian missionaries may have entrenched them. Deeply held beliefs in witchcraft can exist alongside conventional churchgoing and, indeed, apparently fervent adherance to the tenets of religion.

My personal view, and I may be wrong, is that such beliefs are particularly apparent in evangelical sects. Charismatic fundamentalism and Pentacostalist practices have become powerful social and indeed political forces in many parts of Africa, including Malawi. They have often emanated from other countries, for example Nigeria, South Africa and, of course, the United States. 'Prophets' perform miraculous cures in exchange for money. They may have a great deal of finance behind them from their countries of origin but they also make a lot of money from the poorly educated and gullible people who attend their gatherings. A modern form of 'indulgences'.

Whereas the Catholic Church and, perhaps the Church of Central Africa Presbyterian (CCAP), appear to take a more pragmatic approach to supporting and fulfilling the needs of local communities, providing valuable social and medical services and taking a lead in combating climate change and improving agriculture - living the Gospel in other words - other newer sects may focus instead on conversion, often employing very effective and persuasive tactics. Talking in tongues may be the least of it. At least it's relatively harmless. 'Casting out demons' from people whom we would regard as having physical disabilities, language and communication difficulties and emotional problems can have a much more negative impact.

Central to the deployment of psychological persuasion is the impact of literal readings of the Bible, with particular emphasis on the vengeful behaviour described in the Old Testament. and references to demons and the casting out thereof in the New Testament. While modern educated Christians will tend to interpret such Gospel miracles as spiritual 'healing' by Christ of traumatised and disturbed individuals, a way of bringing them 'peace', fundamentalists may believe that demons actually did leap out of someone's mouth when Christ spoke, enter a herd of swine and cause them to jump off a cliff. Literal readings of the Bible cannot cope with symbols, imagery or psychological, ethical or poetic truths: everything is - of course - 'literally' true. The situation is exacerbated by the very poor educational levels of many 'pastors'. Uneducated pastors may be self-identified, untutored and semi-literate. They will certainly not have had any education in critical analysis of the texts to which they refer. Expression of their beliefs may rely on decontextualised quotations.

Modern media-savvy conversion methods build on centuries-old traditional beliefs. Christianity may no longer replace a belief in demons, as it did in Mary Slessor's day. Christianity, or some branches of Christianity, may have absorbed such beliefs, certainly in Malawi.

And so we have blood suckers, what the newspapers have called 'vampires', using the European term. And there is nothing funny about them. Can you imagine the sheer horror of being torn apart by a demon-hunting mob? Of being stoned and then burnt alive, as happened yesterday to the young man with epilepsy at Chileka? The murder took place in the middle of the main road to Blantyre airport, in broad daylight. It was filmed on a mobile phone and loaded onto Facebook by means of a well-known newsfeed: Malawi Breaking News and Gossip. No doubt other newsfeeds also carried it and footage of other such murders as well. I reported the footage to Facebook as, I am sure, others did also. The video was eventually removed this morning, a full twenty four hours after it happened, by which time it was old news.

Now I am not saying that all murders committed by these mobs come about because of a belief in Christianity. What I am saying is that belief in Christianity and belief in witchcraft occur in many of the same people. There are still a small percentage of people in Malawi, about 5%, who are animists only, and do not believe in Christianity at all. Ten percent are Muslim. A few are Hindu. That leaves about 85% who are Christian and not just nominal Christians, as many are in our country, but church attenders. Atheism and agnosticism are as good as unheard of. Even the middle class embezzlers and thieves are church attenders, as in nineteenth century Britain. It is hardly surprising then, that many of those believers in witchcraft are also Christian.

Reflecting on these circumstances, various issues come to mind. One such issue is the sheer fear of the authorities in the face of recent communal violence. Yesterday's lynching took place at a police road block. The police initially took the victim into their building for safety. Once the mob attacked, they then ran away. To be fair to them, they wouldn't have had a hope of protecting either the victim or themselves. By midday today, the police had taken back control and arrested 140 people. The army has now been deployed to keep the peace in Chileka, Kachere and other areas of Blantyre.

There have been calls for some time for the President to take action. It has taken a long time for him even to speak about it. The government's first reaction was that it was the fault of Opposition politicians, hardly a constructive approach. Bizarrely, the President,  once a Harvard professor, publicly avowed his belief in vampires by saying he would protect people from them. One assumes that with local and by-elections imminent, he did not want to lose the votes of bloodsucker hunters. So much for the writ of national government! Eventually the President pronounced that it was the job of the traditional chiefs to deal with the blood-sucking rumours and resulting civil disorder. Although he visited the region, he did not travel as far as the actual areas where the events took place, or, indeed, speak to those caught up in them. The fear of the educated and powerful when faced with the visceral and demonic is quite remarkable.

Another issue, of course, relates to the role of education. The education system in Malawi is quite inadequate. In many rural areas, only a third or even a quarter of children who start in Primary 1 make it through to Primary 8. Tiny numbers make it through secondary school. The curriculum is heavily knowledge-based and relies on rote learning. Aspects of critical thinking and reasoning are pretty much absent.

What children should be learning and practising is consideration of cause and effect, discussing consequences, focusing on problems and coming up with different ways of solving them. They need to learn that there are often not single solutions or explanations to scientific, ethical or other issues.

Above all, what are needed are not just more effective approaches to teaching the physical sciences so that young people understand the world in which they live, but genuine emphasis on the social sciences, with debate and discussion of social issues, not just lists of things to learn. Learners need to think about and debate moral and social issues, how people relate to each other, not just be given readymade lists of political structures and summaries of Christian beliefs with little if any reference to reasoning or evidence.  Of course, there will be schools which do far more than this, but they are mostly private schools for the elite, not government-funded schools for rural communities.

Poorly educated people who do not understand the world in which they live, will tend to rely instead on magical explanations. Feeling helpless in the face of increasing poverty, totally inadequate medical care and an inability to feed and clothe their families, these people may feel the only action available to them is by means of demonic interventions. Blood sucking is said to make one wealthy. Killing albinos and child sacrifice are also said to do so. Both of these crimes are regularly reported and, indeed, said to be increasing in frequency. Only effective education can address such misconceptions. Only giving hope to people that they themselves can take practical and effective actions to address the circumstances in which they live will put an end to attempts to improve them through witchcraft. Danger to community cohesion comes from both the practice of witchcraft and the fear that others are practising it.

Mob violence of the kind observed in Malawi over the last few weeks is similar in many, though not all, respects to sectarian rampages elsewhere. Think of cow vigilante attacks in India, the burning of villages and attacks on Rohingyas in Myanmar and lynchings and other actions by American racists. Though the victims in Malawi may be fewer in number, the violent emotions unleashed are similar.

These violent emotions relate in part to the difficulty many communities have in accepting differences. In rural communities in particular, people may fear the 'other'. Some of those killed in Malawi have been 'outsiders'; others have been mentally or physically incapacitated. All are treated as scapegoats for the circumstances in which communities live and the unrelieved drudgery of their lives, fuelled, of course, as in our own country, by alcohol. Prejudice against homosexuals and those with unconventional lifestyles has also been nurtured by unscrupulous leaders and, sadly, by the Christian Church. Us and them. A focus on differences.

It is not all that dissimilar in our own country, though matters rarely get as far as lynchings. However, attacks have been carried out on Asian shopkeepers, loners suspected of being 'paedophiles', people with learning difficulties, refugees and European workers. The demonisation of the 'other', exacerbated in some cases by recent referenda, has led to a recorded increase in hate crime. We just don't put such crimes down to 'blood suckers'.

It has been interesting to read the online reactions of Malawians to recent events. Many are educated and westernised. Many, I guess, belong to the diaspora. Almost without exception the reaction has been one of embarassment, anger and shame. Naturally, educated Malawians do not like this image of their country being shared abroad. Neither would we.  Few have expressed views as to the causes of the problems, however, though some have mentioned ignorance. Interestingly, a fair number have put the events down to witchcraft. Witchcraft is therefore both cause and effect.

I dislike the sentimental cliche used of Malawi: the 'warm heart of Africa'. Yes, Malawi is an 'easy' place for westerners to visit. However, there are layers below the surface which are far more complex than the cliche implies. I wonder how many Europeans buying into the 'warm heart' ever scrape far enough below the surface to find this out.

So, after weeks of reading about vampires, it now seems that the authorities are bringing the situation under control, though only time will tell how successful they will be. It is a pity it has taken international media interest to persuade them to take events seriously. Not just the BBC but also the Guardian carried articles! One guesses that though the furore over blood suckers may die down, soon there may be other victims. As in Britain, there will always be someone who is 'different'.

You do not have to be accused of being a 'vampire' to be vulnerable.

You may also be interested in the following posts on our Ugandan blog:

Demons, ghosts and evil spirits
At last a conviction for child sacrifice!

Friday, 15 September 2017

Making aid work

In 1990, one in four children in Malawi died before the age of five. By 2016, the proportion had fallen to one in 16.

I was totally unprepared for that astonishing statistic, quoted by Melinda Gates in her article on progress against the Sustainable Development Goals. In Ethiopia, deaths under five dropped by a half in just eight years. Across the world, since 1990, the lives of six million under fives have been saved, the equivalent to the whole population of children in France.

How did this happen? Through:
  • implementing vaccination programmes against polio, measles and so on;
  • distributing bed nets to guard against malaria;
  • providing better access to family planning which enables mothers to have fewer children to whom they give better parenting and care; and
  • preventing and dealing with ordinary, but potentially lethal, childhood illnesses like diarrhoea. 
Not 'rocket science', as they say.

In Ethiopia, between 2011 and 2016, the proportion of women giving birth in health facilities rather than at home increased from 20% to 73%. Fewer maternal deaths results in fewer orphaned and neglected children, and fewer babies and toddlers being suddenly denied the breast milk essential for survival.

In Senegal, only 3% of women had access to contraception in 2011 . Today, the figure is 15%, nowhere near high enough but a huge improvement over five years.

In India and Kenya, microfinance provided direct to women themselves, often through mobile phone technology, has helped many to enter the labour market for the first time (not work, women have always worked). Women with their own earnings spend them on food, healthcare and education for their children.

Across the whole world, the proportion of people living in poverty has halved since 1990. In 1990, 35% of the world's population lived in 'extreme poverty' (on less than $1.9 per day). Today the figure is 9%.

How did these extraordinary improvements come about?

Well, some of the developments which contributed to these impressive results have been initiated by national governments. Countries such as China have made enormous strides. In 1990 two thirds of its population lived in extreme poverty; today just 2% do. While China has achieved this success largely through its own sometimes ruthless policy decisions, other developing countries have been more dependent on outside sources. Development aid has been provided by governments like our own, for instance, through DfID/UKAID or USAID. Aid has also come from the European Union, the United Nations and the World Bank. It has come from large charities and non-governmental organisations (NGOs), such as Oxfam and Christian Aid, from Foundations like the one established by Bill and Melinda Gates and from partnerships like the Global Fund.And many smaller NGOs and charities, both local and international, have made their own contributions.

Put more simply: the taxes which you and I pay and the pennies we contribute to collection boxes have saved the lives of millions of children and enabled countless men and women to provide more effectively for their families.

And yet, despite the acknowledged successes of international aid, its existence can still give rise to passionate, entrenched and conflicting views. And there is good reason for this.

Last year, the Economist published an interesting analysis of aid distribution, entitled Misplaced Charity. Just as the positive article by Melinda Gates started off with reference to Malawi, so did the Economist's rather less positive piece. It opens with reference to the enormous amount of aid which Malawi has received over the years.

"In 2012 Western countries showered $1.17 billion on it, and foreign aid accounted for 28% of gross national income."

The article goes on to state:

"The following year corrupt officials, businessmen and politicians pinched at least $30m from the Malawian treasury. A bureaucrat investigating the thefts was shot three times (he survived, somehow). Germany said it would help pay for an investigation; later, burglars raided the home of a German official and stole documents relating to the scandal. Malawi is no longer a donor darling. It now resembles a clingy lover, which would be dumped were it not so needy. It still gets a lot of foreign aid ($930m in 2014), but donors try to keep the cash out of the government’s hands."

The Economist makes the point that aid is more likely to be effective if it is given to well governed countries, not countries like Malawi. And yet, it is in countries like Malawi that the need is greatest, if only because of the impact of political and social dysfunction on ordinary families. Nevertheless, as the first sentence of this post demonstrated, aid has significantly improved life for the citizens of Malawi, despite the extreme levels of corruption. The issue is not easily resolved. After all, it can be our money which is stolen, though not exclusively.

I spent the month of August working in Malawi. These are some of the stories I picked up from newspapers at the time. Some are about theft, some about incompetence and poor management. All are about the inability (or reluctance) of the government at national and local level, its key national agencies and individual institutions to provide efficient and effective public services for its citizens.

1. The Public Accounts Committee is to set up a forensic audit of ESCOM (the Electricity Supply Cooperation of Malawi), MACRA (the Malawi Communications Regulatory Authority) and other public bodies, because of the 'plundering' of resources, the audit to be carried out by donor countries. Malawi already suffers from power shortages caused by the impact of reduced rainfall on hydroelectric plants. Only about 9% of residential housing has acces to electricity. The effect of outages on public services and business can be little short of catastrophic. Mzuzu's Central Hospital has had prolonged blackouts and, with no backup generator, staff are concerned about the bodies in the morgue. In many health centres, it is common for midwives to deliver babies by the light of their mobile phones. It is not only public services which are affected. Malawi's precious fledging industries find it difficult to operate consistently and their machinery keeps breaking down because of the insecure power supply.

2. Dishonesty may also be a problem. Staff at Queen Elizabeth Central Hospital in Blantyre have been charging patients for free services such as blood transfusions and surgery, and pocketing the money.

3. Fractured sewage and water pipes which were due to be replaced long ago contaminated the water supply and flooded Area 18 in Lilongwe, the capital. Burst pipes happen in every country. The issue, however, is how long it took Lilongwe City Council and Lilongwe Water Board (LWB) to do anything about it: more than a month. Eventually, the Parliamentary Committee on Agriculture, Irrigation, Natural Resources and Climate Change gave the Malawi Housing Corporation four days to sort the problem out. In the meantime, local residents either had to use filthy water or pay for prohibitively expensive bottled supplies. Both ESCOM and LWB have continued to provide illegal connections for houses built in contravention of planning guidelines. Sewage pipes, including those from hospitals and industrial sites, empty directly into the rivers from which people collect water and in which they do their laundry and bathe, contaminating the water with pathogens and poisonous metals. About 50% of urban families use untreated sewage to grow their crops. Some of the manure from sewage is illegally sold to farmers as fertiliser by water board staff, leading to warnings about eating salad crops.

4. The Central Internal Audit Unit of the Ministry of Finance, Economic Planning and Development has stated that district councils have abused 21% of their development budgets. Abuse includes misappropriation of funds, poor value for money in procurement and district commissioners who, when caught stealing funds, are simply moved to other districts.

5. The ruling Democratic Progressive Party (DPP) has been holding 'Blue Nights' to which they invite state companies. Each of the guests 'voluntarily' donates large sums of money. Among the guests was the LWB, who handed over K5 million  (£5,200) of public funds despite being unable to provide an essential public service to its customers in Area 18. (The rumour is that LWB was actually asked for K10 million). Blantyre City Council donated K5 million of its taxpayers' money to the DPP while the poorest city council, Mzuzu, paid over K3.5 million. Civil Society Organisations have challenged the DPP about these payments.

6. The Minister for Health and Population announced that an independent study had shown that 30% of the country's publicly-funded drugs are stolen before they reach healthcare professionals. They are then sold back to health centres.

7. Dowa District Hospital, which serves a population of 800,000 people, has had no running water or toilets, though the problem seems eventually to have been fixed. However, similar problems have affected other health centres.

8. The Anti-Corruption Bureau and Fiscal Police have launched an investigation into 250 missing passport books, a situation in which immigration officials working at the highest levels have been accused of selling them for over K10 million each. Some passports have been found in the hands of foreigners. The newspaper article from which I took this information concluded, without irony, "The Malawian passport is highly preferred as Malawians are viewed by many outsiders as trustworthy and unable to commit fraud or terrorist attacks." The bit about terrorism is almost certainly true.

9. MANEB (Malawi's Examination Board) has withheld examination results from 250 secondary schools which failed to send it the fees they had already collected from candidates (K30,000 or £31 pounds for each pupil - a lot of money.) Last year, when the same thing happened, school directors were arrested for embezzlement. It was doubtful whether the unfortunate students would be issued with the certificates essential for their future careers.

10. The Ministry of Foreign Affairs and International Affairs has told the Public Accounts Committee that officers at the Malawi Embassy in Ethiopia syphoned off K293 million and paid it into personal bank accounts. Overall K538 million was mismanaged.

And so it goes on: endemic corruption at all levels, including at the very top of government. The notorious Cashgate scandal to which the Economist's article refers, drained K236 billion of public funds, and was already underway in 2009, long before the years 2012-2014 to which the legal charges refer. Bingu Mutharika, previous President and brother of the current President, declared assets valued at K150 million when he assumed office in 2004. He amassed wealth valued at K61 billion during the eight years he was in power. Such plundering of the public coffers does not just affect the obvious victims. International donors contributed to Malawi's national budget using taxes collected from their own people.

And there are other forms of dishonest practice which affect the work of development agencies at far lower levels. One that I find immensely frustrating is the 'allowance' culture. In most countries, civil servants are paid a salary and expected to carry out their assigned tasks without further payment. In Malawi, in contrast, civil servants receive salaries but expect to be paid additional money for every meeting they attend or visit they make. If you submit a paper for discussion, there is an immediate request for payment to 'facilitate' discussion and comment.

Attendance at meetings and active partnership working are often contingent on the amount paid in allowances, not the relevance and usefulness of the support provided. You often end up doing the work on your own as your colleagues have found something more lucrative to spend their time on. It can be unnerving to have them get up and leave in the middle of a meeting because they are off to another meeting sponsored by a different organisation which provides a more generous allowance. Development partners (donors) have laid down guidelines for such payments but they are frequently ignored. Indeed, some unscrupulous agencies, including some well known NGOs and international organisations, deliberately pay inflated allowances in order to attract participants away from work initiated by other organisations.

Senior civil servants working in education are doing particularly well at the moment. They are being paid very generous allowances to 'monitor' a programme funded extremely generously by the USA. Whole sections of the education system appear to be grinding to a halt while civil servants add to their take-home pay, all in contravention of the Civil Service Code which, as in other countries, forbids civil servants from supplementing their salaries with fees from additional work for other organisations.

Yes, you can no doubt tell that I find this very irritating, and not just me. Indeed, sometimes I have seethed when, having flown half way across the world to work on a project or to carry out training, the people I am supposed to work with have disappeared off elsewhere to earn an extra bob or two.

And yet, it is not that straightforward. Salaries of even senior officers are extremely low, even taking into account the low cost of living. While this may partly be because of the lack of resources at the centre, it is also because it is a requirement of the International Monetary Fund that debt-ridden developing countries like Malawi keep the wages bill down. Remember, unlike in the UK, professionals such as teachers are deemed civil servants. Ordinary teachers may be paid as little as K40,000 per month, about £41. Primary headteachers may receive only K60,000. Even senior officers will be paid far less than is necessary for them to feed, house and educate their own children. Hence the desperate attempts to acquire extra allowances from whomever will pay them.

Even worse, officers' substantive salaries are often paid late, as happened in August. The announcement came that there had been a delay in transferring the necessary documentation between government departments, a somewhat unconvincing excuse given that this routine activity is done every month. However, then it was reported in the press that the money for salaries had been diverted to the DPP to support its campaigning in the forthcoming parliamentary and ward by-elections to be held on October 17th. The Nyasa Times claims that the government is panicking about the elections because of accusations of underperformance. This claim was denied by the Secretary to the Treasury. Still, it is an interesting perception.

A senior accountant in one of the departments claimed that all paperwork had been submitted on time, but that the money was, in fact, diverted to pay striking teachers. They were striking because yet again their salaries hadn't been paid.

He went on to say, “We are also reliably informed that some money has been used to pay outstanding payments to DPP functionaries who do business with government to enable them comfortably help the party in the by-elections.

The paper concludes the article with the following statement, "Due to lack of fiscal discipline, Government has of late been caught failing to fund essential activities such as health and education while a number of its ministries, notably the Ministry of Education (teachers), have been failing to pay their employees on time."
And so it goes on. The impact of government dysfunction on education is irrefutable. While these days more children are being kept alive in Malawi, as the Gates Foundation's figures show, the education they receive is pretty dreadful and has been getting worse. Here are a few facts and figures published by the Borgen Project.
  • Only 35% of children finish primary school and only 8% finish secondary school.
  • The teacher-pupil ratio in Standard 1 is 1:130.
  • 83% of learners in Standard 1 are unable to read a single syllable, and 92% cannot read a single word. 
  • Malawi is ranked the weakest for its performance in English reading and second weakest for mathematics against other southern African countries. (Southern and East African Consortium for Measurement of Educational Quality - SAQMEQ)
  • Pre-school education is run mostly by unpaid volunteers and most centres are unregistered. 44% of pre-schoolers are undernourished.
In the past, international donors provided 40% of Malawi's expenditure on education, but since the Cashgate thefts, have suspended their contributions. They may now support individual projects but they no longer pay into the country's coffers to support public services as such.

The Malawi government currently allocates 18% of its budget to education, more than most other African countries. This figure is encouraging as at least it demonstrates that the country values education and recognises its essential contribution to improving most other aspects of life for its citizens, for example, health, agriculture, industry, business, farming and the ability to combat climate change.

The Borgen Project article concludes, "However, when comparing the educational quality with other countries, it can be noted that Malawi does not allocate its funds efficiently."


Many a time I have come to the end of my stint in Malawi utterly convinced that the only solution is for development aid to be withdrawn from the country and for the people and their country to accept and take responsibility for their own future. I know I am not alone in thinking this. I have often heard resentment expressed in the African media and, sometimes in my presence, of the continued involvement of ex-colonial countries like our own in providing aid and other forms of support. There can be a feeling that developing countries are being bullied and manipulated into taking action which they would not themselves choose.

People may question why consultants like me are being paid generous fees to do work which local people could do. This does, of course beg several questions. Sometimes people whose only experience is from within their own setting may not know what they don't know. Often what is needed are new ideas not more of the same. People may also be unaware that fees which seem so generous compared with their own salaries are sometimes well below what consultants might receive working for commercial organisations or even other development agencies.

The organisations for which I have worked do not donate cash; they share skills. However, it is cash which sometimes seems to be valued far more highly than any knowledge or skills that people like me contribute. Yet, as soon as I start thinking in this way, usually at my lowest point when I am tired and keen to go home, something happens which contradicts that point of view. For instance, during my most recent visit, my colleague and I provided training for senior educationists which they all attended without the incentive of an extra allowance. Not only did all participants attend for the full programme, but they took active roles and were animated and enthusiastic about the workshops provided. We have good hopes that practical outcomes would result. Yes, it was definitely worth doing.

We also have to consider the real costs of even a reduction in international aid, let alone discontinuing it altogether. The Gates Foundation report notes that, "... projections for HIV suggest that a 10% cut in global donor funding for treatment—a not unduly pessimistic assumption—could lead to 5.6m more deaths by 2030 than if spending remains on track." 

Each of those unnecessary deaths is likely to be that of a parent who then leaves a family unsupported, or of a child who became HIV positive at birth through maternal transmission. In Malawi almost all treatment for HIV/AIDs is provided through American aid.

And while countries like China and India are showing significant progress in reducing poverty (though the gap between rich and poor may still be unacceptable), the continent of Africa still has major problems in achieving something similar. The birth rate in many African countries is still very high: in Nigeria each woman gives birth to an average of 6.4 children. Many of the poor in Africa exist far below even the definition of 'extreme poverty', an extraordinarily low baseline. Infectious tropical diseases such as malaria exact a huge toll from its population.

Africa has the world's youngest population. In 2015, the number of young people aged 15-24 was 226 million. This figure is expected to double by 2055. While the average age of an African president is 62, the median age of Africa's population is 19.5 - the world's largest gap between governors and governed. In 2015, 12 million young Africans entered the labour market, but only 3.1 million jobs were created. Poor education and skills development coupled with a lack of jobs threatens not only economic performance, but could almost certainly give rise to political and social unrest and increased crime. Bright young people and their parents and communities know this, of course, which is why so many are risking their lives in the Mediterranean and ending up in terrible detention centres in Libya or sleeping rough in European cities. Those who migrate are those who are seeking self-improvement - just as young European colonialists, our own ancestors, did in the nineteenth century.

So tempting though it may be to think that the days of supporting poverty-stricken countries through the provision of international aid are over, the real costs of letting down hundreds of millions of young Africans are too overwhelming to contemplate. On a practical level, well-targeted aid provided within their own countries may prevent so many of them migrating and dying.

Sadly, however, the USA under President Trump has already slashed foreign aid budgets, particularly those used for family planning. While Britain remains one of the most generous providers of aid, this status may not survive the changes in attitudes brought about by Brexit or the economic downturn which may result. Already, support for refugees in a number of countries including Britain, is being taken from the aid budget, a decision which reduces support to some desperately poor countries.

The Gates Foundation Report while recounting so many positive stories of progress supported by so much hard reliable data, also contains a plea for aid to be retained at least at the current levels. The Foundation itself has been responsible for saving so many young lives, for enabling so many women to take their futures and the futures of their children into their own hands, that we should listen to it. However frustrated transient people like me may become, they and other similar organisations are in it for the long haul. We, our fellow taxpayers and our governments shouldn't let them down, nor, above all, the people that they serve. And if that means that we have to hold our noses and stomach the greed, self-centredness and corruption of politicians and civil servants, so be it, if by that means we provide hope and sustenance for the millions of young people they are letting down.

Sources for this post

Misplaced charity, the Economist, 11 June 2016

Goalkeepers: the stories behind the data, child mortality, Melinda Gates, Bill and Melinda Gates Foundation, 13 September 2017

The 10 most important facts about education in Malawi, the Borgen Project blog, 20 August 2017

The Gates Foundation is worried about the world’s wellbeing, the Economist, 14 September 2014

Great strides have been made against disease and poverty, the Economist 14 September 2014

Africa's defining challenge, by Mohamed Yahya, the Africa Regional Programme Coordinator for the United Nations Development Programme, UNDP blog and also published in The Daily Times 7 August 2017

Articles from the following newspapers:

Weeked Nation 5 August 2017
The Nation, 7 August 2017
The Nation, 11 August 2017
The Nation 24 August 2017
The Nation 29 August 2017
The Nation 1 September 2017
Malawi News, August 5-11, 2017
Malawi News August 12-8, 2017
Malawi News, August 19-25 2017
The Daily Times August 7
The Daily Times August 11
Nyasa Times August 23
Nyasa Times August 24
Nyasa Times August 29

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