My physiotherapy elective was spent in Malawi, working with a local non-government organisation "Malawi Against Polio" (MAP). This charitable organisation relies on external and local aid. MAP has 4 separate mobile units, based in 4 of the larger towns, each comprising a team of 2 physiotherapists, 1 physiotherapy assistant (trained by MAP) and orthopaedic technicians, with 2 orthopaedic surgeons located in the capital city. These teams travel to outreach clinics (about 250 in total) covering the whole of the country. The clinics have been operating on a monthly schedule but, due to financial restraints, it has just been reduced to every 2 months.

The original aim of MAP was to give assistance to patients with polio, but now the service has been widened to include patients with any type of disability - burns, cerebral malaria, amputations due to trauma or crocodile/snake bites and congenital disabilities. Orthopaedic aids and appliances (such as tricycles, CP chairs, crutches, callipers and boots) are made in the workshops and provided to the patient free.

I worked with a VSO physiotherapist, spending 2 or 3 day at a time per week at clinics. We saw patients at rural health centres, (which sometimes had no running water), but often stopped at the side of the road (and once in the middle of a market!) to see patients who were unable to get to the designated centre due to disability or lack of money. There was limited equipment and the physiotherapy offered was often basic, due to the need for its completion by relatives, and the patients being seen once every 2 months, (if they attended each clinic).

Malawi is a relatively safe, beautiful in places, and uncornmercialised country and I felt privileged when going into the small towns and villages to see the "real" Malawi. I was able to work alongside Malawian people who, together with workers from other countries, were able to offer a much needed rehabilitation service.

It was an invaluable experience in Malawi and gave me an insight into working in a developing country - a generic therapist's role rather than just pure physiotherapy. Language and cultural barriers were difficult to overcome, especially as the people (particularly the women) are quite reserved; increasingly so around white people. The hardest aspects with which to deal, were daily seeing babies and children with AIDS and seeing the simplicity, but harshness, of day-to-day life. It certainly made me appreciate how fortunate we are in this country and how much we take for granted.

Editorial note MMA links with Malawi Against Polio are going to continue as two of the present Council move to Africa in March 1996. Chris and Vicky Lavy, who have been on the Council for two years, will be working in Blantyre with Christoffel Blindenmission and have been seconded to Malawi Against Polio. Chris will work in the government teaching hospital in Blantyre for part of the week and will also travel around the hospitals in the south of the country working with the district medical and clinical officers, concentrating particularly on orthopaedic problems. Vicky, who is currently looking after three month old Jonathan, aims to work part time work in the field of mother and child health or HIV related care.