Doctors without borders

Philanthropy Fredericton physicians join team working to save the lives of Malawian children

The retired physician is engrossed in thoughts of a place he has never been, an African country in crisis, ridden with abject poverty and rampant disease. In a few short weeks, Hart is set to arrive with six other Atlantic Canadian medical staff in a remote village on the shores of Lake Malawi, where they will spend two weeks living among the local people, teaching and healing.

Central to their work will be an effort to help control the raging malaria that kills an estimated one million African children each year. Millions more have been orphaned as HIV/AIDS and tuberculosis wipe out generations. Together, these are known as the 'Big Three' killers.

"In that society, the middle-aged people are mostly gone," says Hart, his face gentle, but his voice rough, gritty. "Grandmothers sometimes raise children from three or four of their own children, different families.

"Children don't only lose their parents. They lose all the other people who would be an influence when they're growing up - schoolteachers, leaders, everyone in society that helps you grow up."

Hart has done similar outreach work in Jamaica, but this will be his first time in Malawi.

In a population of 11 million, an estimated one million Malawian children are orphaned or homeless. Nearly a third of the country's young adult population is infected with HIV, and the average life expectancy is around 30, according to Lifeline Malawi, a Canadian aid organization.

Malaria is especially pervasive in the villages along Lake Malawi, where the air is alive with a deadly blanket of disease-carrying mosquitoes. Pregnant women and children are the most vulnerable. At night, the danger intensifies as the masses of insects thicken.

On Aug. 30, Hart and colleague Mark Messenger, a pediatrician who is also set to make the journey to Malawi, plan to set up shop at the Fredericton Market to collect money to purchase mosquito nets. Hart's team will distribute the nets, simple devices that hang from the ceiling and enshroud the bed, along with vital prevention information to Malawian families.

The cost of one net is $5, and because they would be purchased in Malawi, the local economy would also benefit, Hart says. Between the Fredericton fundraiser and a similar drive in P.E.I., the team hopes to raise $10,000 to purchase 2,000 nets.

"One net could save the life of a child," Hart says.

To Westerners, the problems in that region of the world seem overwhelming, almost unsolvable, he notes - but every bit of help is critical.

"Poor health care, poor water supply, poor nutrition, all related to poverty - some people look at the enormity of those problems and say they need big answers," says Hart, who recently received the Order of New Brunswick for his work in promoting public health issues.

"But my honest sense is the answer will come by everybody contributing small amounts; $5, $10, $20. I think the world is recognizing that it should happen, and there is enough will in the world to do it.

"There will come a time when we can't sit back and wait for the United Nations and Bill Gates. It's going to be individuals who solve it."

When he arrives in Malawi, Hart plans to work closely alongside team leader Hendrik (Hank) Visser, a doctor who has been practising in Crapaud, P.E.I., for more than two decades.

Visser, who has been to Malawi twice - once in 2005 and again last year - says many children in the region are severely anemic, suffering from chronic malaria, which destroys red blood cells. Another common type of the disease is cerebral malaria, in which parasites invade the brain, causing high fever, convulsions and potentially death, Visser says.

Though the team will bring its own medical equipment, members should be prepared for "very primitive" conditions in the makeshift clinics, Visser notes.

"You're basically examining patients in a clinic under a thatched roof and mud walls, built by villagers," he says, noting anywhere from 50 to 100 people a day typically stream through.

Visser recalls being deeply affected by a Malawian family he met in 2005, which spurred him to become more involved in the region's cause. A grandmother, whose own five children had died from AIDS, brought two grandchildren who were in her care to a local clinic. The two children were suffering from swollen glands, and after being tested for HIV, one was found to be positive.

"So there's this grandmother - five kids and their spouses all gone - looking after her grandchildren, and one's already infected with the AIDS virus," Visser says. "That really struck me. There's a whole middle generation that's gone from AIDS. The needs are great."

The team will work with Lifeline Malawi, a group founded by Calgary doctor Chris Brooks, whose first mission to the country was in the late 1990s and who now bases his regular operations out of Malawi. In addition, the team will be sponsored by the Evangelical Medical Aid Society (EMAS), based out of Stouffville, Ont.

Barbara Mikus, Lifeline Malawi's vice-president of Canadian operations, says about 70 staff working in two clinics see about 10,000 patients each month. The group, funded by grants, donations and charities, encourages volunteer teams to join them for short-term missions.

Mikus says the mosquito-net program will be beneficial not only in practical terms, but also as an awareness tool.

"Things we take for granted here, you can't take for granted there," Mikus notes. "A mosquito bite can be deadly."

EMAS sponsors two volunteer teams each year in Malawi, where malaria has become a "public health disaster," according to administration director Ellen Watson. Mosquito nets are the cheapest, simplest solution, she says.

"If every person in Africa was kept under a net, Africa would be able to get malaria under control," Watson adds.

Both Visser and Hart say the most rewarding aspect of missionary work is seeing the vital difference it makes in the lives of so many people, not only physically, but also spiritually.

"There are people who are hungry and poor and need support, but they also want to be guided, to be accepted, and to know other people care for them," Hart says. "That's the most valuable thing you can do for them."

Visser points to the close connection he has developed with patients through his work in the developing world.

"They learn from us and we learn from them. You see how people who have so little are so deeply grateful, and truly happy."

Returning to Western society after experiencing the severe third-world conditions in Malawi was a "major reverse culture shock," Visser says.

"There's such extravagance here, and yet people are so quick to complain."

The team plans to document its two-week journey, which starts on Sept. 12, through a live blog. It is available online at http://malawiteam.blogspot.com.