Anna Slingerland (far right) testing their fabric face masks with her colleagues, Evelyn and Esther in their office.

It’s Tuesday morning, 06:00 and the hospital entrance of Nkhoma Hospital is crowded. As in every place around the world, everyone entering the gate has to wash hands first. White stripes on the floor mark the places where patients have to wait for screening and triage. A small team, fully covered in protective wear checks the temperature and asks about travel history and signs of possible infection. Nkhoma Hospital is prepared for COVID-19!

Jaco and Anna Slingerland from the Netherlands are working at Nkhoma since January 2019, ( Anna works as Projects & Development manager in the hospital and is busy preparing the hospital for COVID-19.

Where to start?

Anna: In March we formed a Disaster Response team. There wasn’t any corona case confirmed yet in Malawi, but although the African continent was slow in discovering cases, we still felt we had no time to lose. Partners were offering help and we needed a plan. But what was our plan?

After our first meetings, we realized soon that educating our staff was a priority. Some had very different ideas about the risks of COVID-19 like thinking that having Ebola around it would be easier to handle COVID-19. After education from Dr Christina Miller and Dr Catherine Hodge (both US, Family Medicine), we started to set up a screening system at the entrance, installed handwash stations, introduced a system of only one guardian per patient, and started handing out protective wear to our staff.

World wide support

Most of my work was focused on communication with partners. We were surprised how many partners are working with us on (public) health programmes – World Renew, PCUSA, Difaem, GIZ – were reaching out to us with the question: ‘How can we help, we have 10,000 USD available for your hospital to prepare for this pandemic’. Heartwarming! My colleague and I wrote 6 grant applications within 2 weeks, which was definitely a new record for me. Weekends off didn’t exist during this month, but we really experienced God was in our midst and He would lead us through.

After all these weeks Covid-19 still hadn’t arrived in Malawi and we sat back for a while: what if we have more time? What if we can prepare the whole area around Nkhoma for this pandemic? World Vision supported us and we started a project to teach 20,000 households how to make a tipi-tap: a small tent construction of wooden sticks with a bottle hanging in it. When you put your foot on the stick, the bottle tilts, and water mixed with soap comes out to wash your hands. In some projects we used this method already to reduce diarrhea cases, now suddenly a whole nation makes an effort to improve hygiene.


During all these weeks we knew that when the crisis would start, the skills and willingness of our staff would be crucial. We received thousands of dollars for PPE (protective wear) and 12 new donated oxygen concentrators were shipped in to equip a new treatment ward, but when the staff wouldn’t want to work, all would be in vain. And all the time when something new appeared: the first case in Malawi, an increase of cases and suspected cases in our own screening, staff showed fear. Last week we had our first confirmed case in Nkhoma: the pregnant mother was very sick and was transported immediately to the nearest treatment center in town. The first two staff members had to go in quarantine for two weeks and new problems appeared: relatives and roommates were very afraid of the virus and abandoned them from their houses and we had to find other homes for them. Sometimes this is disappointing, but sometimes it helps us to understand their situation better. Where we come from a world with all medical care we need just around the corner, here they are used to situations where many around them died from tropical diseases. We ask our partners to pray for us. For not letting staff be overcome by fear but to increase their empathy and calm their distress – for God to lighten their burdens so they can provide compassionate care for those in need.

Squash Ball

Personally we are very worried about the situation about us but we don’t fear for our own lives. We have to leave our lives in God’s hands like we have to do every day and trust God that he is the one caring for us. We are happy that we can be in a place like Nkhoma during these crisis times to help out and are thankful that the situation is still peaceful for us to continue our work.

We play a little more often squash in the squash hall across the street to release our stress and realized that working at Nkhoma is a bit like keeping the ball up: it often changes speed and direction, and a lot of balls go over the line or out of control. And that is also what we learn from this: sometimes we don’t feel in control, or we don’t see the result of our work. But after all, God is in control and He will be the one leading us through.


Kobus Odendaal