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Länderinfo Malawi


The country

Malawi is a small landlocked country in south-east Africa. Neighbouring countries are Zambia, Mozambique and Tanzania. The capital of Malawi is Lilongwe which is with 650,000 inhabitants the biggest city in Malawi. 24,400 of the 118,480 km² of Malawi consist of Lake Malawi, the third larges lake in Africa. The country is characterised by huge differences in altitude: 37 m up to 3,000 m on the Mulanje mountain.

The climate

The country has a sub-tropical climate with the rainy season in November to April and the dry season in May to November. Smaller hills are running through the whole country with some mountains in between, but very little natural ressources that could be used for boosting the economy. Nevertheless there is some uranium that is up to now more or less unused.

The history

The history of Malawi was, compared to most other african countries, most of the time quite peacful. The former british colony became independant in 1964. Until 1994 Malawi was ruled by the dictator Hastings Kamuzu Banda. In 1994 the first democratic elections were held and in 2004 Bingu wa Mutharika took over presidency for the country until today. Although the economy stabilised and developed under his rule, there are still huge problems that need to be solved in the country especially because of the rapidly growing population, the high HIV prevalence and the persisting corruption.

The population

With 13,6 million inhabitants and a population density of 115 people per km² Malawi is one of the most densely populated countries in Africa. Especially in the southern part of the country where the population density increases up to 125 people per km² this is an important factor with regard to food security. In spite of this difficulty the population is still growing by 2.4% every year which, together with the high mortality rate caused by HIV / AIDS, results in a kind of „children`s state“ with 48% of the population being below 15 years of age. Also kind of special in Malawi is the population distribution between rural and urban: currently only 17% of all Malawians are living in cities. There are 4 major tribes in Malawi: the Chewa, Yao, Tonga and Ngoni. But the Chewa represent by far the largest tribe of all and their tribal language Chichewa is, beside of English, the national language and is spoken in almost the whole country.

Education and health

The literacy rate is currently estimated to be around 63%. In 1995 free primary education was introduced which lead to a rapid increase in the number of pupils in schools. Nevertheless the number of teachers was not increased accordingly and also the teachers available are very often not trained well. As a result the quality of the education has suffered tremendously and classes especially in schools in the villages are often overcrowded with more than 80 children. Also the possibilities for secondary schools and higher education are very much limited and often not affordable for the poor population. Consequently the country has far too few qualified employees and academics. In addition there is the so-called „brain-drain“ which means that well qualified people trained in Malawi (especially doctors) are going abroad after having completed their training. Apparently there are more medical Malawian doctors in England than in Malawi itself.

The average life expactancy is currently at 44 years. 600 inhabitants have to share one bed in a hospital and each doctor stands for about 50,000 people. For one dentist there are even 450,000 inhabitants and most of the time they are only available in cities. Malaria, bilharzia, AIDS and malnutrition are the most commonly seen diseases in the country. The official rate for HIV infection is currently about 12%, but showing significant regional differences between the different regions in the country with up to 17.8% in the south. Every year about 70,000 people in Malawi are dying because of AIDS.

My working field: Zomba Central Hospital (ZCH)

During my three months in Malawi I stayed in Zomba, which is with around 80,000 inhabitants the forth largest city in Malawi. There is a governmental hospital in Zomba, which means that all examination and treatment costs are covered by the government. The hospital is a third level referral hospital, where patients from smaller hospitals and health centres are transferred to if they are severely sick or cannot be treated elsewhere because of other reasons. Therefore ZCH has somewhat more possibilities for diagnostic and treatment than smaller hospitals and is with 500 beds quite large. During peak times the paediatric ward alone has sometimes up to 500 children admitted as in-patients. It seems to be impossible to keep an overview and the mortality rates in the hospital are high. Beside of the general paediatric ward there is also a nutritional rehabilitation unit where children with severe malnutrition are admitted and rehabilitated. The program works according to the community-based therapeutic care (CTC) approach. This means that children are in the ward only for few days until they are fairly stable. Then they are allowed to go home with a two weeks ration of a special therapeutic diet called „plumpy-nut“ (based on groundnut paste). Every two weeks they have to come back for clinical review and for collection of the next plumpy-nut ration until the child has reached its target weight. 8 health centres in the district are participating in this program so that mothers can be transferred to a place nearby to their home village. Unfortunately, the rate of HIV infection in the nutritional rehabilitation centre is terribly high: sometimes more than 40%. Thus also the general mortality rate in the nutrition program is quite high.


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