Our Permaculture program at Area 25 Health Centre focuses on establishing a safe, nurturing environment for all patients receiving care at the facility, particularly pregnant women staying at the maternity waiting home. The waiting home is a residential program enabling women to receive essential maternal and neonatal care by housing them adjacent to the birth facility for an average of two weeks. For rural, underserved communities, maternal waiting homes are critical in avoiding delayed care and safeguarding a women’s health during childbirth.
Waiting home clinicians and staff members hold daily classes on healthcare and skills development topics. Women are encouraged to take the knowledge and skills they learn back to their village, including the following:
- Family planning
- Maternal and infant care
- Sustainable agriculture
- Home gardening
Permaculture Design at the Hospital
Permaculture design is a method of designing human-centered landscapes in an integrated manner that is harmonious with local ecological, cultural, and social backgrounds. It focuses first on formulating big picture plans in which we identify the major features of what will become the human landscape. The most important features to consider are water, access, and structures.
The first of these features to keep in mind when designing any plot of land is water availability. In Malawi, a country in which rainfall is absent eight months out of the year, water management is vital. At Area 25 Health Centre, we are lucky to have a borehole which consistently supplies us with clean groundwater to support our water needs at the waiting home and irrigating the garden. However, we still need to be strategic about how we transfer water from source to sink to maximize the impact of the water we have. Through observation and understanding the shape of the landscape, we can design a ‘source to sink’ system that will make use of the life sustaining properties of water many times in one system. At the Area 25 Healthcare Facility, this means slowing water running down contour, spreading water throughout the gardens using beds and swales on contour, and finally sinking water back into the ground where it is available to plants in the garden and recharges the groundwater.
Community Outreach and Participation
Community led grassroots movements are vital to achieving agricultural resiliency and opportunity in the face of uncertain weather patterns caused by climate change and dwindling resources. We work towards a more integrated health system every day. We have started initiatives to pull together the entire body of staff working at the healthcare facility to promote unity. One such initiative is our waste management program which encourages patients, staff, and community members to discard their rubbish into three appropriate bins:
- Organic waste for use in our garden compost to improve soil health and crop production
- Paper waste as a carbon source in our compost piles and charcoal briquettes for cooking and plastic waste for recycling
At our facility, we have approximately 5 hectares of arable land to use as a demonstration plot for integrating human healthcare with environmental healthcare. This involves designing a landscape that inextricably ties care for the people with care for the land.
Our plan is to develop a community center within the healthcare facility where community members can learn about practical land care and agroforestry techniques such as water management practices, intercropping, planting on contour, and learning about the roles of different plants in the ecosystem. We have begun to partner with local farming organizations to create an avenue of connectivity between urban farmers and the communities they support within Lilongwe. Our long term goals with our local partners are:
- To establish conservation committees comprised of village leaders and youth organizations to provide the foundation of resilience
- To encourage participation by women at all stages and capacities
- To agree with community leaders upon beneficial land care interventions in their communities and help them with design
- To develop a course of action and monitor progress by regular follow-ups
Youth involvement is essential for future food security and social well-being of Malawi. To this end, we are reaching out to local schools to set up after school education programs which will introduce students to our permaculture garden giving them hands on experience. We encourage students to start their own environmental health clubs, and we help them start growing gardens at their schools.
The permaculture curriculum includes workshops taught every Tuesday and Thursday on a two week rotation, focusing on simple household practices that can strengthen domestic food security and improve household nutrition. The workshop topics include:
- How to make and use compost
- How to plant a tree and care for it as it grows
- How to recycle household greywater for irrigation
- How to design and take care of a backyard garden
- Nutritious recipe development
Our generous partners at USAID have provided 30-meter home drip kit systems to our program. We train and pass on these kits to women interested in starting their own home or community gardens. We use identical kit in our garden as a demonstration for women to learn how to set up, maintain, and use it. During our irrigation workshops, we set up a kits with the women and show them how to recycle bathwater or dish water.
For every baby born at our facility, two trees are planted—one at the facility and one at the new mother’s home. In the next year, our goal is to plant 20,000 trees throughout Area 25 with the help of the community. For more information please see Sustainable Firewood Sourcing.
Adjacent to our maternity waiting home is a diverse and vibrant garden which provides healthy fruits and vegetables on a daily basis to the women staying here. Access to nutritious and dependable food is especially important for expectant mothers to ensure successful deliveries and proper infant development. Typical foods the women receive include eggs from our chickens, a healthy bunch of green leafy vegetables, tomatoes, and a selection from the most recent harvest which may include beans, maize, sweet potatoes, carrots, onions, and whatever fruit is in season. From these foods, the women receive key nutrients such as Folic Acid, Vitamin A, Vitamin K, Vitamin B12, Iron, and protein.
On top of receiving vegetables and protein sources from the garden, the women are also given the option to join our Daily Menu which introduces diversity to their diets and recipe development. The Daily Menu includes a source of protein, one or two vegetable-based sides, rice or nsima (the Malawian staple item, which is a cornstarch based carbohydrate), and fresh fruit for dessert. The Daily Menu is made possible through the generosity of our donors.
Sustainable Firewood Sourcing
Promoting long-term ecologically regenerative agricultural practices is paramount to achieving environmental and social well-being. In Malawi, cooking is almost exclusively reliant upon firewood and coal as energy sources. As a result, deforestation and desertification have become major problems. Our local solution is to plant a diverse woodlot within the 8-hectare facility to be used as a sustainable source of firewood. As our woodlot grows, we will also plant a continuous network of different indigenous trees and shrubs throughout the facility which will help minimize soil erosion, block dust and wind, and become habitat for beneficial pollinators and birds. The land between tree rows will be used for “alley cropping” where we will grow staple food crops such as maize, legumes, sweet potatoes, pumpkins, millet, and cassava which will be given patients and staff.
For every baby born at our facility, two trees are planted—one at the facility and one at the new mother’s home. In the next year, our goal is to plant 20,000 trees throughout Area 25 with the help of the community.
Sewing – women are able to take classes to learn the basics of sewing. They begin with a piece of cloth and a few simple stitches. Once they have mastered the simple stitch, they are given the opportunity to make a pillow case and bag with handles. From the bag, they progress to children’s clothes like dresses, shirts, and shorts. All materials are provided by the instructor. Women take home their creations after their time at the maternal waiting home.
Knitting – women are able to learn the basics of knitting while at the MWH. They use bicycle spokes as a cost-effective alternative to knitting needles. They begin with a basic knitting stitch, then progress to more advanced stitches. By the end of the class, they are able to begin patterned hats, socks, and scarves. Women can take the supplies and continue to work on their projects after the class if they so choose.
It’s not uncommon for women to call our instructor and report on their sewing and knitting projects once they’ve returned home. We are so proud of what they create!
- Davie S. Kamupudo
Davie works for Baylor-Malawi as a permaculture gardener. He was born in Kasungu, and currently resides in Lilongwe. He has been training both at school and Area 25 to become a farmer. He is the proud father of his daughter, who he hopes pursues education like him and perhaps becomes a nurse. He and his wife are dedicated Christians.
- Steven Banda
Steven Banda is a permaculture gardener for Baylor-Malawi. He from Lilongwe, where he currently resides with his wife and child, whom he hopes becomes a teacher one day. He is a dedicated Christian, and working towards becoming a farmer.
- Stanley Kaiiza
Stanley works for Baylor-Malawi as a permaculture gardener. He is from Lilongwe. He, his wife, and their two children live in Lilongwe and are dedicated Christians. His goal is to become a farmer. He wants his children to be graduates.
- Gabriel Kuluwasha
Gabi is a permaculture gardener for Baylor-Malawi. He was born in the Neno District, and now resides in Lilongwe with his wife and child. He hopes to become a farmer and hopes his children take an interest in farming as well.
- Mwamadi Saini
Mwamadi, affectionately called Dyomba on the farm, is a permaculture gardener for Baylor-Malawi. He was born in Balaka, but lives in Lilongwe with his wife. He is the proud father of four children. He believes nothing is more important than education for his children. He and his family are dedicated Muslims.
- Esmie Kachikuni
Esmie is an Administrative Assistant for Baylor-Malawi. She was born in Chiradzula. She went to Chancellor College in Tombe, and received her Bachelor's in Social Science. She hopes to one day work receive a Master’s in Public Health, with a focus in women and child health and education. Apart from work, she enjoys traveling and is a proud Christian.
- Veronica Kalemba
Veronica is a Patient Advocate at the Maternal Waiting Home. She was born in Nshewo, and currently works in Lilongwe. She hopes one day to run her own business. She is married and the proud mother of four children.
- Gladys Saloulou
Gladys is a Patient Advocate at the Maternal Waiting Home. She is from Balaka, and living in Lilongwe. She hopes to become a teacher one day. She has six children, and hopes at least one of them is interested in medicine and becomes a doctor!
- Rose Livata
Rose is a Patient Advocate at the Maternal Waiting Home. She is from Lilongwe. She has four children, and hopes they have their own careers one day.
- Nick Twyman
- Rose Sulentic
- Afshan Omar