The Chikwina Health Center Maternal and Child Health Building Project, Or Not.

November of last year began the struggle to build a new wing at my Health Center. As I think I’ve said before, my current Health Center is falling to pieces. It will literally fall if you look at it wrong. There’s no running water, no electricity, one co-ed patient ward (NOT ok in Malawi), one examination room (where everything from wound dressing to consultations to drug dispensing occurs). There’s no privacy, no patient-doctor confidentiality, and no transportation to get someone to a hospital that does have these things. It’s a sad little place. So once this building project was introduced, there was a huge surge of support and approval from the community and I knew this was going to be a successful and legitimate project. I fell in love with it. It’s my Peace Corps Salvation, the project that makes the whole thing worth it.

The Health Center staff and I went around to the surrounding villages and got approval for the project and a promise to contribute from all the elders. The villages nominated two representatives from each village to form a committee and draw up plans for the building and help write the proposal and budget (huge budget, $12,000 budget). The building would be wired for electricity and piped for water and would include an antenatal examination room, a labor room, a men’s specific patient ward, a Youth Services Office, a Volunteer HIV Testing and Counseling office, a drug dispensary, and an open air lecture area. We identified a contractor, secured the land for the new building, and got the villages to start molding bricks. I spent some time editing the proposal and sent it The Powers That Be. Everything was coming together. Until the Peace Corps office said that the scope of the project didn’t fit into any of their funding categories.

What? It’s a health project. It fits under the Health and Development category, as I indicated in your annoyingly format-specific proposal template.

Yes, but within that category, it doesn’t fit into a category.

Oh! Of course. I’ll go ahead and burn down your office, then.

They said they could consider it if I cut the budget in half and fit it into a “category” – HIV/AIDS, Maternal and Child Health, Sanitation, whatever. Fitting it into a “category” wasn’t difficult. I could easily word the proposal to fit the Maternal and Child Health option. So now the project is called “The Chikwina Health Center Maternal and Child Health Building Project”, which squeezes neatly onto no dotted line in any proposal template, but whatever. However, cutting the budget in half was out of the question. I wasn’t about to cheat our beautiful and wonderfully beneficial project out of anything. Ok, we’ll cut out one of the rooms, but the rest are absolutely necessary. We NEED electricity and water. We NEED to separate the gender wards. We NEED a confidential space in which people can discreetly go and be tested. We NEED an adequate room for labor, not just a metal bed frame covered by an over-used foam mattress in the co-ed patient ward. I will not cut the budget!

So I brought the case to our district government. They loved the idea and recognized Chikwina’s desperate need for an adequate health center. The District Planner took the proposal to the funding committee, promised to push it through personally, and said he’d call with the developments. Three months go by, and nothing. I brought the proposal to NGO after NGO. World Vision came close. They accepted the proposal and then lost it. I went all the way to Lilongwe to their headquarters to get to the bottom of it. There I was told they already did their budgeting for the year, resubmit next year. The U.S. Embassy said something similar. Then inflation hit hard, the kwacha was devalued, and our budget changed. It would now cost $16,000 to do the same project (more than a third of which is being provided by my community, FYI). So, great.

That brings us to this month, July. I called the District Planner at the government offices in Nkhata Bay to talk about resubmitting the project and to find out what went wrong in the first place. Also, let it be known, it is impossible to get this guy on the phone or catch him in the office. He said, “oh, didn’t we talk about this? Chikwina is benefiting from the new hospital being built outside of Nkhata Bay boma. So the proposal wasn’t passed.” Insert Scooby-Doo-style whaaaaaat? here. First off, that hospital just started being built in earnest about three months ago. Second, that doesn’t change any of the problems we face here in Chikwina. That hospital is only about 5km closer than and just as unreachable as the current one.

Time to take this to the Big Boys. I place a call every hour on the hour for two days to our Member of Parliament (MP), Mr. Chiumia, who is even more impossible to get on the phone than the District Planner (who I’m pretty sure has blocked my number). Mr. Chiumia said he knows Chikwina and knows that it very much needs a new health center and he was unaware of a previously submitted proposal. He will personally support our project. Insert Scooby-Doo-style whaaaaat?!?!? Well hot damn! Of course, in the paragraph preceding that last one, I demonstrate just how unreliable such a sentiment is. But still, this is a huge step to get the Nkhata Bay Head Honcho in on this. I’ve reworked the budget of the proposal and my current hope (riding high!) is to get the Peace Corps office to contribute a third and the government to contribute a third to supplement my community’s already securely promised third. Of course, I have my backups. I’ll still resubmit to the U.S. Embassy next year and there’s one Australian pro-bono construction guy who is interested in making Chikwina health center his next major project. Unfortunately, these options would place me square in America when the project is completed. But, by God, this thing will happen. It will happen if it kills me and burns down the office to boot!