Lifeline Malawi Field Level 2009

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					     Lifeline Malawi Field Level 2009-10 Year in Review
                                 By: Patrick Laforet April 26, 2010




It has occurred to me lately that many of the people involved in Lifeline Malawi only get to see a limited perspective,
often from the point of view of their involvement. I thought it would be useful and helpful, and hopefully interesting
reading to see a collection of what has occurred on the field in the 2009-10 Budget year. This is the work we all strive
to fund and allow to happen in Malawi.

We also tend to focus on a month to month basis and I believe the reader will be surprised and pleased to see a
summary and results of the hard work from all quarters, Board, Committees and individuals. We have been able to
accomplish these things because we feel we are doing God’s work, and this team has great heart, and it is a privilege
to be a part of it.


Overview
It was an amazing year of results, and the field got to the end of it exhausted but happy and proud of the many
accomplishments we were able to participate in. The saying “rode hard and put away wet” sort of covers the feeling!
No one was as blown away by the patient visit figures for 2009 than the field staff ourselves, including and especially
myself. When it became apparent that our clinics, staff and outreach efforts had seen 200,018 cases in twelve
months we could not believe it. We actually went back and counted again! But, there it was, a figure we had only
hoped to meet at the end of our five year plan. To be there at the end of the third year was just incredible!!

Indicator                                                                                   Ngodzi & Kasese
Total General outpatients' attendance for Kasese and Ngodzi Clinics including mobile
                                                                                            157,608
outreach Clinincs for 2009
Total number of Clients that received modern family planning methods at Ngodzi and
                                                                                            5,943
Kasese Health Centres including Mobile outreach Clinics
Total number of Clients that received antenatal care at Ngodzi and Kasese Health
                                                                                            3,400
Centres including Mobile outreach Clinics
Total number of Maternity unit admissions                                                   321
Total number of Live births at Maternity units                                              236
Total number of clients tested for HIV                                                      11,106
Total number of Clients tested with positive HIV result                                     983
Prevalence of HIV among clients tested for HIV (%)                                          9
Total number of people initiated on ART                                                     206
Total number of people initiated on ART who were under 14 yrs of age                        7
Total number of Children seen at underfive Clinicvs including Mobile outreach Clinics       19,883
Total number of underfive Children with weight below expected for their age                   1,148

We made great progress towards Strategic Plan achievements, and we were all struck by how many of the plans we
made a few years ago had already come to pass. A full report was issued, but it worth noting our progress. In review,
I had at first thought our strategic plan had been an excellent and thorough document. As we work through the years,
it occurs to me it was very first year loaded, and is sort of short of detailed action items in the middle years. No
matter, it has been a very good roadmap and we have made some major progress in completing the steps we have
identified, and we continue to look for additions.

Anywhere you see text in ITALICS these are direct quotes form a report submitted some time during the year, and
then some explanation follows.


Finance
We have replaced Gift Dulla’s truck that was wrecked in an accident. We received 4,800,000 MWK and we
purchased a 2007 model, identical to the one lost for 5,000,000. The top up came from the ICLEP budget adjustment.
--We resisted the temptation to buy him an older version, and maybe be able to afford a cheap town runner as well.
We were smart to get him all the truck we could afford, as it is the most used vehicle in the fleet!

A note from early in the year: We continue to suffer from the very low exchange rate on the Canadian dollar. It was
only six months ago we were getting 137 MWK per CDN $ and it is now as low as 110 MWK. That is a 19.7%
reduction in the Kwatcha per dollar we get on the field, and the pressure is mounting as everything we spend is in
Kwatcha, from salaries to construction. --Update: The Canadian dollar is now at par with the American (Apr 2010)
and we are getting 153 MWK per dollar. I simply wanted to illustrate some of the tension currency fluctuation can
cause by time the money actually gets to the field.

Other excerpt from one of my reports: Our blue van has bitten the dust I fear. Recent repairs have not lasted and the
engine needs to be overhauled or replaced entirely again. It has cost us too much already and is too old to continue
to invest in major repairs. Please keep a “new bus” in your prayers! May 2009 --We REALLY miss this van! Jack
Leuw and the Rotarians are working towards replacing it, but you never know how much you miss something until it is
gone! We used it for everything from STM teams to filling it up with drug supplies from Central Medical Stores.

The new budget recently submitted and approved was developed almost entirely by the field management team,
without Pat or Chris involvement initially. They had to face all of the realities of no NAC funding, prioritize expenses
and programs. They did an outstanding job. Chris and I worked with them the final morning and helped refine and
polish it, but this is a strong statement that the field team is growing in strength and skill to their great credit.




                                                          This is Otto Dzungu and his family. Since working for us as a
night guard, he has put a steel roof on his house, making it dry, safer and a healthier place. He is 54 and had never
seen Lake Malawi, so we went there with all of the staff Christmas 2008. His 15 year old son became suddenly
paralyzed on his right side five months ago, and there is little hope of recovery. He works 60 hours a week, and earns
about $90 Cdn a month, but it is a good job in Malawi, and feeds, and clothes his six kids. He is the pastor of his
church.


Fundraising
As a direct result of our visibility from the Prince of Monaco visit, we were invited to present a proposal to Mota-Engil,
the largest construction company in Malawi. They have committed to 35,000 Euros ($48,000 USD) and they have
decided to fund the fresh water proposal that would have Kasese receive water from the local mountain, solving one
of our most annoying problems at Kasese.

We have also made a proposal to Press Trust, and expect a duplex to come out of it. We will know in three or four
weeks.

Chris has identified a contact at the Irish Embassy who indicates there is likely some support available, but in all
likelihood, small. We are giving them some choices to consider this week.

Chris has also renewed contact with BEIT Trust, who have also asked us for a proposal, and their main focus is in
buildings and structures

We have confirmed that NAC will accept our request for a “No charge extension”.-- Essentially, this means they will
give us the remaining 8 million or so Kwatcha they had already approved last year and give us three more months to
spend it. It was the last NAC money we received and ran our programs up to August 2009

NAC is gone, unfortunately, and there is little hope of it renewing. We actually had high hopes for some time that we
could duplicate our grants to Ngodzi at Kasese, but the money is just not coming. Canada and the field are looking for
replacement, and the current budget is a bare bone approach that has allowed us to keep our well trained staff, but
has virtually eliminate our Ngodzi HIV/AIDS programs until new funds are identified

After three field visits over the last two years, we have received confirmation that Joyce Meyers will fund the Learning
Center at Kasese, for a total of $150,000 USD. They also agreed to pick up the Ngodzi Maternity costs from May
2009 to Feb. 2010. What a great blessing!

Canada continues fundraising and we have received the money to complete the guardian shelter and work will
resume next week and we anticipate completion in less than three weeks. May 2009




                                                        This is Tore Kambalametore’s wedding we attended. Tore
came to us nearly two years ago, having just come back from Australia. We had a crisis in accounting around the
Kasese project and we hired him as a consultant, then full time. He has been a great team player, he now has a six
month old baby girl that he adores. Going to a Malawi wedding is an experience!

The duplex at Ngodzi has been built to the ring beam level by the PEI team, who were a pleasure to have on the
ground. They will consider trying to raise funds for the completion, and it is a very big step towards having appropriate
housing on site at Ngodzi. We still need around $30,000 to finish it in and out. --Here again we broke with tradition.
We had two teams and not enough money to complete the project, but we moved forward in faith. Although it has
been painfully slow this building will be completed in May 2010, giving us another two homes for our key staff in
Ngodzi

We have run into a large roadblock to getting the Ngodzi community housing electrified. However, we were
successful and the community houses that were originally going to be without ESCOM are now electrified, which is a
great advantage for our staff. --This was another, somewhat understated achievement. These six houses were never
planned to have electricity, solar at best. Then the Rural Electrification plan brought power to the edge of our
property, and funds were indentified to bring it to the homes. It makes a HUGE difference, and is a huge blessing for
the staff.
The guardian shelter at Ngodzi has begun, but was delayed as we took all available hands to catch up on the delays
caused by the rains to get the pad for the STM team ready. The Guardian shelter pad is complete and the walls are
up about 40%, and work continues. --This guardian shelter is the compliment to the Maternity ward, and essential.
Once again, a major construction job. I wish I had an aerial view of Ngodzi, as it continues to change and grow.

We experienced a milestone for Lifeline Malawi this month. We sorted out the plans for the Learning center, and
construction has begun. What was unique about it was that, for the first time I know of, we have signed an agreement
to have a contractor build, source materials, hire staff and provide a complete “turnkey” project! This is both a relief,
and a little scary. We have traditionally done all of it, then a few years ago we got to the place we contracted out the
labour portion. This is the first time we have signed a deal and sat back to just inspect the progress. Both the
contractor and management have an insurance policy. This is in the form of a separate engineer who has to sign off
at every stage. This gives us both security and accountability. So, we are on our way, progress reports to follow. If
this works well, it is an excellent model for future construction, that effectively takes us out of the construction
business, praise God! --I think I wrote this in June 2009, and the target completion date for the building was
November 2009 to possibly be available for Joyce Meyers to dedicate on her visit to Malawi. I hope you can
appreciate the irony, as we are still a month away from completion and will be lucky to have it all done by the end of
May 2010!! This contractor has been a HUGE pain! The only saving grace is that we have been ruthless in holding on
to the money and insisting we get what we paid for even if has been so slow. We will complete this, but it is a
testimony to Gift Dulla’s determination that we have survived this foray into contractor use. We have another group
we have used with great success, so we are not deterred, just tired of having to hold on this long!

We have planned some needed renovations at the mission house in Ngodzi and it should be finished by time the
August team arrives. We are modernizing the kitchen, replacing most of the pots and utensils, and have acquired a
small freezer, which will greatly enhance our ability to store goods for teams. The big job is the Bats. This is our fourth
round, and we are confident we will be on the winning side when the dust settles.-- Some comments from a visiting
STM team brought to light how long we have been waiting to do any kind of upgrades at Ngodzi. Focussed effort and
a few thousand dollars made a great improvement and we are working on maintaining it like this.

The Guardian Shelter at Ngodzi will be finished by July 31st. Money is in hand for the Shelter at Kasese, and plans
are going forward to start that construction soon. --Kasese maternity Guardian shelter was finished on time and on
budget and is a very nice looking building and compliment to the AMOR Maternity building




                                                          This is Christmas Carol night early in December at Four
Seasons. Christmas is the toughest time for us on the field. First, it is often about 35 degrees C or 95 degrees F,
turkeys can cost $80 dollars for a mid-sized bird, and you are a million miles from your family. However, we are
surrounded by friends, solid Christian brothers and sisters, and we make the best of it. Many people travel, others just
relax at home or go to the lake.


Short Term Missions(STMs)
Once again, we were greatly blessed by Short Term Mission teams in the year. Some were construction related, and
one was medical, another eyeglasses. In addition, we had two very unique teams visit. One was a team from
Samaritans Purse who worked for two weeks on building pit latrines at three schools close to Ngodzi. I know, it is
hard to believe, but NONE of these schools had ANY latrines and they have between 400 and 600 students. SP built
two for the girls, two for the boys, and one for the teachers at each of the three schools. This was a great contribution
to the local community.
The second unique team was something we agreed to do early in the year. Joyce Meyers was doing a big program in
Blantyre and as a part of the big picture, they wanted to plan to have their Medical team come and work with us.
Sounds easy, right? This was a team like we have never experienced before. There was 35 participants, they had
their own funding for travel, busses, accommodation and provided a generous budget for medicines and supplies.
The challenge was they wanted to move around. The plan was two days in Ngodzi, two days in Kasese and two days
in Lilongwe. It was the most complex logistical project we had ever undertaken, and it all started the SAME DAY that
the Prince and AMOR left the field! I was so impressed with the stamina and determination of our field staff, that
words fail me! (Some may doubt that, given the length of this report!) The following are excerpts from various reports
illustrating the diversity and challenges, and ultimately, the successes we were able to share.




                                                         At any given outreach the crowd averages 200-240. Most do
not speak English; many have come a great distance. They do not know where Calgary or Toronto is, and more than
half of them are kids. What they do know is they get very good medical help and free medicines right here in their
village, which has never happened here in this remote spot before Lifeline came.

We are making plans for the March STM team to start on a duplex on the Ngodzi property.

The STM team is on the ground. They are from the same church that came to build the Church in Chilambula village,
and half are repeat visitors. This makes things quite easy as they know what to expect. They are also hard workers,
and I expect we can get a lot done on the duplex. The money raised will only cover about one quarter of the finished
costs.

The Rockpointe team are preparing for their trip in August with the plan to complete the duplex at Ngodzi

The Samaritans Purse team will be on the ground November 2, 2009 for 13 days. Initial preparations and
reservations are complete, food is in hand and water was delivered today. They have arranged to rent a 15 seat van
for their transport and movement throughout the trip. It will certainly be lot easier when we have our own.

This started out as an idea early in 2009 or earlier when Samaritans Purse suggested they wanted to send a Team in
November. After a lot of discussion, we collectively decided that the team focus would be a community outreach
project centered at Ngodzi. The original plan and budget was based on 15 members and would have as a building
focus the construction of Pit Latrines at selected schools in the area. We developed plans and targets and began
sensitization in June and July. There was a time that Samaritans Purse was unsure if they could send a team at all
because of the low number of people signing up to participate. The decision was made to continue to come on a
reduced outreach plan. Eventually we had a team of seven, including Jack Leuw.

The team arrived and would be working through the period of the Prince of Monaco visit. We did everything we could
to be ready in advance. Gift and Haldon worked with the three community groups at the sites and prepared all of the
aspects of the Ngodzi group to be ready to support the effort. The teams moved from site to site, built relationships
and eventually also built pit latrines. The team had a very successful time, and the completion dinner discussions
were all positive. It was fortunate that Jack was the leader as he brings a lot of field experience to bear. It was also
helpful that two of the seven had come on previous STM teams and were familiar with Lifeline and Ngodzi. It was our
intent to support SP by hosting this team as SP has been a long time supporter of Lifeline and this was us giving back
in a small way. (Did I mention there was a country wide diesel shortage while they were here which required several
shipments of Diesel by jerry can just to keep them moving?)

Joyce Meyers Ministries Medical Team and Video Team Nov. 14th to 21st
These were really two separate visitors occurring during the same time. On the same day Tasha and her team left,
Ashley and her partner arrived to ensure all was prepared for the team arrival two days later on the Saturday. This
was a team of 35 medical and support staff. The costs were all covered by JMM, we had received their money well in
advance, and the team of Gift and Haldon had worked with both Ngodzi and Kasese to sensitize the community to
their coming, and to encourage a good turnout at the clinics. Effectively we were suspending our clinics, and the JMM
team would split, half would stay at the static clinic and half would go on outreach, and then switch. The plan was two
days in Ngodzi, two days in Kasese one day at the JMM Feeding Center in Area 49 Lilongwe, and the final day at an
orphan feeding center supported by the Baptists in Kauma, a village attached to Lilongwe.

They bought over $11,000 worth of Medicines, had four busses to move around, we supplied five local pastors and
about 15 translators for each site. We also provided the food and water for their days and lunches. It was a huge,
rushed, extremely challenging undertaking. The first day or two was a little wobbly, but it all settled down, and at the
end the entire team had nothing short of an excellent and worthwhile trip. Also, they had a tent at the outreach sites,
and there was a dentist on their team, which necessitated sterilizing equipment every day.

There was also a great story, when they were in Kasese. We had a birth, and the baby was in distress, and slowly
turning blue. One of the Paediatric nurses from the team went in for something else and immediately saw the
problem, something she had been trained to watch for and also how to treat the problem the baby had. Within a few
minutes the baby was getting back to pink, breathing much better and well on the way to normal. The nurse and our
staff just marvelled at the coincidence and timing and we all learned a great lesson, that God is sending us where we
belong, and at the right time! The outcome could have been quite different.

Also, at the feeding station in Lilongwe, they had a very young child who was asthmatic, and in serious distress. They
stabilized him, and Limbani and Ashley drove him straight to the hospital. Without that quick work and intervention, he
may not have made it.

The statistics they collected and will report summarizing their six day visit are as follows: Medical Patients-4,226
Dental Patients-169 Extractions-191 Salvations-2,680 Prescriptions issued-16,396 Total patients-4,395




HSH Prince Albert II of Monaco visit to dedicate the AMOR Maternity and
Special Wing
Everyone here on the Malawi Team feel that it was a magnificent success. It has introduced us to important
individuals, and those individuals have seen first-hand who we are and the work we do. Our task is to now capitalize
on these relationships and start stepping up to communicating and being seen at a higher level than we ever had in
the past

This turned into the most challenging event Lifeline Malawi has ever been involved in. I could write a book! Let me
start with the ending; it was really a great success. The Prince came and went, everything worked out, the Vice
President of Malawi attended along with a very impressive list of dignitaries. The Prince was delightful, the clinic was
clean and really ready, we had a great lunch catered, we met a large of number influential people we will follow up
with, we had significant local news coverage, and Tasha had her international reporters and the Prince had his own
team of security and media.
Maternity Clinics
This may represent the boldest steps Lifeline Malawi has ever undertaken to expand the nature and scope of our
services to our rural target audience. Just the idea of opening one Maternity Clinic and going from a “day clinic 7:30
am to 4:30 pm” and becoming a 24/7 facility was tremendously challenging, and truly required a leap of Faith. When
funding became available and we could see that two clinics would be built, the “die was cast”. In addition to the
physical construction, this represented an enormous jump in responsibility and staffing, and scheduling and logistics.
All of these have been handled with grace and patience by our staff, and there is a great sense of pride in the
accomplishment and the ongoing management f the “New” Lifeline Malawi! Here are some excerpts:

The highlight of the month was the dedication of the AMOR maternity clinic at Kasese.Apr 2009

The Really good news is that the flow of babies at Ngodzi continues!! Up to the 19th of June we had delivered 10
babies!!

We plan to open the Kasese Clinic by August 1st,2009 latest with or without ESCOM. Try as we might it is not yet
hooked up.




                                                          This is the view from the back seat of the ambulance going
to an outreach in the rainy season. Some sites are 10 Km off of the main road, the farthest is 23 Km. The roads are
mud, the bridges old and rickety, and getting stuck is an ever present danger. The drivers are great and the staff think
it is all part of a good days work. God bless them!!


Staff and Capacity improvements
The biggest event in this area was that Gift Dulla finished his MBA work and Thesis. His graduation is set for
September 2010. Originally, he was scheduled to follow the Executive MBA plan popular in Canada where he would
be in class every Friday and Saturday, and do course work in between. There were not enough enrolled for this plan,
and the default was to go with a schedule where he was in class three consecutive weeks each quarter. This was a
VERY different plan and was a great strain on the team for the two and one half years to have him absent for such
long periods, but we managed, and he is finished. WOW! That feels good!

A full review with Family Health International regarding program deliverables has been completed. The result is we
need to tighten up our focus on their key issues, improve the detail of our reporting and address a few detail issues.
Over all the spirit was very positive and Haldon is initializing the appropriate responses and plan changes. --This is a
great illustration of how the pressure continues for us to collect and report in an intelligent manor. The shift is
happening very rapidly. Almost all of our donor groups are asking for tighter data, and correlation to objectives and
road maps. Simply put, they want to know that they are getting what they pay for. It is a great step forward that we
are hiring in April 2010 a specialist in Monitoring and Evaluation, who will help us bring accuracy and clarity to all of
our programs. The position evolved from a fully funded position with FHI for a data person, and we have expanded
the scope so it will benefit all of Lifelines programs. A few years ago, we were seen as leaders in the data field, and
the world has slowly caught up to us. This step will propel us into a leadership role once again.




                                                        The kids are one of the most sustaining things for me. They
are very simply happy to see you, always waving and friendly, grateful for the smallest things, and represent the
future of Malawi. Knowing our work is changing some of their lives really helps me keep getting up in the morning!

We began a self-funded medical plan for our staff. Naturally, if services for anyone could be provided by our clinics
folks would go there. However, there were other issues we never covered, like X-rays, maternity services we could
not provide. We started to accumulate some funds to cover these types of expenses, and we modeled the basic plan
from a private supplier. There has been a lot of interest in this benefit, and we have kept claims down to a very low
level as we accumulated a base from which to begin. It has been a great success and the staff feels they have
broader coverage and more security about their families health. This is another “growing up” step for us as an
organization.

We have hired a STM Coordinator, and Limbani has proven to be a very good hire. Her focus on the details of the
team on the ground has been a great contribution and freed some of us up considerably

We are testing methodology for an MBO program, starting with core leaders and spreading out to all field staff in the
next budget year. This will also lead to a much more robust and accurate performance appraisal process, which we
have been lacking.

Normal replacement of staff continued throughout the year.

We are well along in the interview process for the nurses and Lab Tech, as well as the data person for Ngodzi.

We have had an ongoing challenge with our administrator at Kasese, and unfortunately, have had to release him. It
was a tough call, but necessary. We have involved the full management team, done due diligence and we proceeded
with fairness.
                                                          These are the men from Ngodzi who built the community
housing over three years. You will also not see their families, or their children, but donations that paid for the
community housing also employed these men and fed their families. The work has made their lives better, and they
are happy.


Events
We received a full container of medical supplies from Canada. The container was also included and is now precious
safe storage at Kasese. This was the most efficiently packed container you could imagine, and it was a great blessing
to receive

As Chris mentioned in his report, the container was delivered with surgical precision. This is so appropriate give our
medical focus!! It contains nearly all goods destined for our clinics, where some in the past have been quite mixed
with books and clothes and other good but not all medical related things. We will unload it in stages over the next few
weeks.


LM Trust
We had arranged a meeting for the LM Trust on February 19th, 2009. Unfortunately, two expected members could
not appear, and we did not have a quorum. He attended in August and it was very profitable all around

We invited George Mkondiwa to Calgary to meet the Board and see Lifeline in action. George has now a much
greater appreciation of the dedication of the Canadian office. He was really blown away with the heart everyone had
for his country and its needs. He was really impressed with our practical approach to the Canadian office and how we
spend our resources to support the field. He also LOVED the white cowboy hat!

Malawi Fundraising and the LM Trust

I called an informal meeting of the LM trust to brainstorm over lunch possible ideas we could pursue to identify and
acquire funding here in Malawi. All but one Trustee attended as well as Chris, Gift, Haldon and myself. It was an
animated conversation and I have developed a list of those ideas, who will action them and by when. It has been sent
as a separate report and Barb will have it if you would like to see it.


Visitors, including Donors
Barb came for her annual two weeks to moderate the Audit

Tasha had also arranged for a photographer and journalist to come from Paris Match to cover the event itself, but
more than that, to get a broader scope of Tasha and AMOR involvement in Africa.

Kim Veness returned to us to be involved and lend his skills to the process and I think it was a benefit to him and to
us to have him present. He has learned a lot in a short time and I think he will contribute well to our ongoing plans.

The day before Tasha left, we hosted the group from Visionledd including the president and founder Jim Cantelon.
Chris and Jim are old friends and that made a lot of difference to the trip. Jim clearly acknowledged that Chris’ Dream
is becoming a reality and he is very impressed with what has been done in the last few years. We went up to Kasese
as a group on Saturday and they were extremely impressed with the entire program. Jim said there and then “there
needs to be an MOU between us so we can get going on working together”. Kim will be in touch with Karl in the USA
to start the program going. Good news indeed.

On the following Tuesday we had the team from Joyce Meyers Ministries here. This included David Meyers, Ron
Martin, African Director and Dave Van Rensburg, the local project manager. This was also a very successful trip,
animated questions, good communications, and they left with what appeared to be very serious intent to consider
funding something, possibly the “Learning Center” ( read mission house) for Kasese.

Tasha De Vaconcelos is coming back to Africa with a team of people who will be filming a documentary about her life.
She will be in Lilongwe for one-day early August to do some pictures at Kasese and an interview with Chris

Mike Hetherman was on the field when the Prince of Monaco was arriving, and his summary of his visit is a testimony
to the challenges we had to overcome to get that to work. Mike Hetherman from the Canadian Board was a visitor
from November 8th to the 13th. He has submitted his own report about those hectic days, and I am certain he will
encourage all of the Board members to visit the field at their very first opportunity. You are always welcome; it is your
“home” too!

Please forgive me if you found this too lengthy, however, I felt that it was an amazing and productive year for us all,
and with all of the help and support from Canada, many great steps were taken. I hope it has given you a more
complete picture of what the field was up to, the challenges faced and problem overcome, so you may more clearly
see what the organization is doing here on the field. We on the field would like you to know that we could not do this
without your work, involvement and support, and we are truly grateful.

Very best personal regards


Patrick Laforet
Patrick Laforet

VP Malawi

Lifeline Malawi

				
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