When 14 Union College students, two instructors left for a semester abroad, they knew they were going to serve the people they met. They didn’t realize how great the need would be. The team from Union’s international rescue and relief program are joining the disaster response in southern Malawi, one of four countries in southeastern Africa ravaged by Cyclone Idai last week. More than 2.6 million people live in the affected area, and the flood waters have displaced more than a half million people, including 80,000 Malawians. The death toll currently stands at 395 and continues to climb.
According to the United Nations, Idai may be “one of the worst weather-related disasters ever to hit the southern hemisphere.”
The group left home in Lincoln, Nebraska, for Malawi in January. For more than two months, they have been studying global health and development while assisting in medical care. The Union College team was at a clinic in northern Malawi’s higher elevations when the cyclone struck, and the students were safe through the storm.
As the Malawian government has worked to support its citizens impacted by the cyclone, disaster management officials asked the IRR team to provide medical care to flood victims in the southern part of the country.
“The Malawian government knows we are here and knows the medical work we have been doing throughout the country,” said Kalie Saunders, who leads the semester-long international experience along with her husband, Andrew. “This is an incredible learning opportunity as our students put their expertise to work. We’re glad we’re at the right place at the right time to make a difference.”
The team made the five-hour trip to the affected area on March 21. According to Saunders, the team spent Thursday afternoon and evening scouting for clinic sites with the Malawian Department of Disaster Affairs. Team leaders visited difficult-to-reach rural villages where flooding has damaged subsistence farms, homes and roads.
Upon determining which region could be helped the most, the team worked in coordination with a local chief who commands 22 villages with more than 3,000 households. The chief directed Union’s team to areas with the most urgent needs and gave them access to a structure to house a temporary clinic. With the help of the government, the team has procured sufficient equipment and medications to open the clinic at 9 a.m. on Friday morning.
About the international rescue and relief program
The overseas semester is part of a comprehensive four-year degree that prepares students for careers in public safety, global development and health care. Each student becomes an emergency medical technician and earns a variety of certifications in disaster response and rescue. The curriculum includes rigorous coursework with a five-week survival and rescue training session in the Colorado wilderness along with the overseas semester for global health training.
Since the program’s launch in 2005, IRR students and employees have responded to a variety of disasters around the United States and the world—including an ongoing commitment to flood victims in Nebraska.
If you would like to support this and future Union College disaster relief efforts, please make a gift at ucollege.edu/give then select “International Rescue and Relief Disaster Response” as the designation.
Mphuka—March 22
We woke up bright and early in order to get out to our clinic location this morning. After packing up all our medications and gear, we drove for a couple of hours out into the remote flood-affected parts of Malawi.
As planned, we arrived at the village of Mphuka after an eventful drive across multiple washed out and flooded roads. Mphuka, although not one of the worst damaged villages, had been one of the most neglected. The roads have been impassable since the start of the rainy season, which means they had not had access to health care or medications for several months. The arrival of Cyclone Idai only exacerbated the already difficult situation of the residents.
We were honored and thankful to be able to attend to the medical needs of the villagers as asked of us by the Malawi Department of Disaster Management Affairs. The response team attended to nearly 200 patients during the day, a record for our team thus far.
“Today we treated a patient who had sustained lacerations and a crush-related injury during the flooding.” said Taylor Deddens, a junior paramedic emphasis, IRR major. “The injuries were so badly infected that it was likely if he had gone only a few days more without treatment, his foot and leg could have been lost. The wound cleaning and antibiotics provided him by the response team likely saved his leg and possibly his life.”
by Kalie Saunders, IRR expedition coordinator
Phalombe—March 23
What an amazing day! We started very early but it was very much worth it. Our clinic location assigned by the Department of Disaster Management Affairs (DoDMA) was in a very remote location not accessible by road.
To overcome the accessibility barrier we met up with the South African Defense Force at 7:30 a.m. to have our team transported by helicopter. Upon arriving at the village of Phalombe, the first thing we noticed was the thousands of people waiting for us. Somehow word had spread that we were coming and four of the surrounding villages had come to wait for us. Unfortunately, we didn’t have enough medical staff to accommodate everyone who came, but the team worked hard and straight through to ensure we saw as many patients as we possibly could.
Malawi has done a fantastic job working to mitigate the possible outbreak of malaria that can be caused by the breeding of mosquitoes on stagnant flood water. The Department of Health came with us to the village to distribute hundreds of free mosquito nets and fumigate the highest risk areas.
Later that evening as part of the debrief meeting held by the DoDMA and the Malawi Defense Force, the Department of Health praised our response efforts and thanked us for being one of the best prepared and best-supplied response teams in the area. One particular DOH officer said aloud to his superiors that more teams should work to replicate the efforts put forth by the international rescue and relief team. It was a proud moment for us and we are so proud of the students who are here to make this response as professional and successful as possible.
by Kalie Saunders, IRR expedition coordinator
Nsanje District—March 24
Today the team headed out by road again. DoDMA sent us out to a displacement camp in the southernmost Nsanje District. Specifically, we went to a displacement camp that includes thousands of both Malawians and Mozambiqans.
Interestingly enough, the displacement camp is easily accessible by road, but that is precisely why no aid is being sent there. All the response agencies are assuming they’re being attended to because it’s easily accessed, so DoDMA sent us to go assess the situation at the camp and provide medical care. The Malawian Defense Force also sent two of their officers with us, a PA and a nurse, to help support the mission.
What we found when we arrived was both what we expected but also nothing like what we could have imagined—thousands of people living in open-air pavilions. Each family staked a small claim on the concrete ground with no privacy and nowhere else to go.
As we examined the makeshift displacement camp, we discovered evidence of flooding even there. The few permanent structures that still stood had water lines up three or four feet along the walls.
With nowhere else to set up a clinic, we did so right out in the open in one of the “corners” of the pavilion. However, this made privacy difficult for doctors conducting examinations and also caused problems in the way of crowd control. People could press in around us on all sides, which made it difficult to tell who had been to triage and who had snuck in through the side.
After a while we were able to arrange our vehicles in a way that helped hold the crowd back, and we acquired a few tarps to help with privacy. Although it took us a while to get going while setting up a clinic from thin air, we finally found our groove. With the help of the two Malawian medical officers and a small group from the Department of Health, our team was able to attend to 255 patients! That is the most we’ve seen in one day ever and broke our old record by about 60 patients.
After hearing about all the work IRR has been doing every day, the South African military commander in charge of medical response asked to have a meeting with us before we demobilize. He said he wants to go over lessons learned and talk to us about ways to improve the response of his own medical team for the future. I’d say that’s a pretty fantastic compliment to be given to anyone, especially a team of college juniors and seniors from the U.S.
by Kalie Saunders, IRR expedition coordinator
Worst flooding yet—March 25
Today we pushed on farther south, farther than we've gone before. We went to a village that had been completely cut off by the rising flood waters and continues to be cut off even now by flooding that refuses to recede. As a result, we had to be flown in once again by helicopter.
In fact, the water made landing the helicopter very difficult. The pilots put us down as close to the clinic as they could, but with the standing water everywhere, the closest we could get was about two kilometers away.
We hiked our way back deeper into the village, carrying our supplies to the nearest clinic structure. Once we arrived at the building, we set up a sort of canopy outside for triage and got started. One thing we noticed early on in the day was how different this particular patient population looked. Many of people in the villages and displacement camps we have visited had a wide mix of diagnoses, including more chronic ailments like diabetes or hypertension. But it was immediately apparent today would be different.
Today we dealt mostly with acute cases associated with flooding—malaria, intestinal parasites, schistosomiasis, dysentery, lots of cases of diarrhea and gastrointestinal upsets—but there were also two confirmed cases of mumps. We reported this immediately to the Malawi Department of Health so they can work on a plan to help keep it from spreading.
We worked in 96 degree heat, and by the end of the day we were all very exhausted and dehydrated despite all drinking three to four liters over the course of clinic. Our team members have been working hard and very long days and they have been doing an amazing job. Each day we get better, more organized, and more confident in the skills we've been trained to use.
by Kalie Saunders, IRR expedition coordinator
Chigwamafumu—March 26
Today our team decided to go out with a bang.
As per our new normal, we headed out to the airport at 8:00 a.m. sharp and immediately boarded the helicopter. Again, we were taken out by the Malawi Defense Force to the far south where the water level is still not receding. Accessible only by air, the village of Chigwamafumu has become an internally displaced persons camp.
We set up a clinic in two rooms of the local elementary school house—one for patient consultation and one for the pharmacy and lab. Since the team has found an efficient groove over the past several days, the day went by quickly and smoothly.
At the beginning of our response efforts, our clinics would only be able to see around 175 patients per day, today we saw 248 patients! It felt great to know we were functioning at a high level of efficiency and effectiveness.
Tomorrow the team will be officially demobilized and the semester will return to business as usual. While we are sad to be leaving behind all the amazing people we've been working with—our new friends from the Malawi Department of Disaster Management Affairs and Department of Health, along with the Malawian and South African militaries—we are all very ready for some rest. The team has given 110 percent every single day and we as IRR staff couldn't be more proud.
This is international rescue and relief. This is what we train for, this is what we teach, this is what God has called us to do. When their classroom became a disaster zone, they didn't even hesitate to help. These students are strong, steady and capable. They can handle the stress with grace and the hurting with compassion. God put each one of them in this program and brought them here this semester for such a time as this.
by Kalie Saunders, IRR expedition coordinator
Saying goodbye—March 27
This morning was bitter sweet. We said goodbye to our new friends and had one final briefing.
In the briefing, we handed over the remainder of our meds and supplies to the Malawian Military. Colonel Langa of the South African Military, and our colleagues at DoDMA said a few words of thanks for our efforts. They thanked our team for the willingness put everything on hold and respond to this disaster, and they thanked us for the hard work, dedication, compassion and kindness our team showed to our patients.
Colonel Langa said it best, "Keep up the good work, IRR. I'm sure we'll cross paths again someday."
by Kalie Saunders, IRR expedition coordinator
[Editor's note: The Union College IRR team will spend a few more day in Africa on a previously planned excursion before heading back to the United States on April 3.]
