Essential Grace Magazine October 2020
Vol. 1 Issue No. 3
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Grace essential for the mind, body, and soul
Counselling and Consultancy Services offered both in person and through the phone. Counselling on emotional and behavioural
problems, spiritual support, identity and selfconcept work, support through difficult life transitions, support for bereavement and loss, and trauma and crisis intervention.
Consulting on work related issues, career guidance and career change, professional and lifestyle coaching, motivation and confidence building.
The Haven Counselling and Consulting Center Old Naisi, Zomba, Malawi.
Email: thehavencenter@protonmail.com 2|Essential Grace Magazine
Call: 0991 938 203
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We join the world wide fight against stigma, judgement and shaming of people with mental illness. Our stories aim to normalize talking about mental illness, about challenges and problems we face as human beings. We also promote local therapists and mental health workers that are trained and ready to help.
We explore nutrition for holistic health, and alternative remedies for common ailments, as well as habits that help in managing chronic illness. We will be exploring local (Malawian) remedies for boosting mental and physical health, uncovering resources that are readily available for use in our surroundings.
Holistic wellness is a particular passion of ours. We aim to promote growth, awareness, and health in your mind, heart, and spirit. Our Summer issues will look into self-care in more detail, particularly as it is towards the end of a difficult and draining year.
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Dear Reader Dear October has been a busy month! Not only was it Mental Health Awareness Month, with Mental Health Awareness day falling on the 10th, it was also Breast Cancer Awareness Month, Down Syndrome Awareness Month, Depression Awareness Month, Liver Cancer Awareness Month, Pregnancy and Infant Loss Month, and Domestic Violence Awareness Month. I am sure there are many more that I have not included. The October issue has included both mental health and breast cancer stories and articles. I believe there has been good progress in the efforts to raise awareness on these issues in Malawi both through media and through direct interaction with the public. Breast Care Ltd is an example of this, reaching out to the public about breast cancer screening and providing a space where this can be done within the country. Most people assume that anything to do with cancer has to be taken outside the country yet we have several interventions within, we just need to know what and where these are. The fight against stigma has proven to be challenging for mental health, so much so that it has become the main focus of the October awareness initiatives around the world. Stigma still exists against some physical conditions such as HIV/Aids and other sexually transmitted diseases. Yet it manifests more against conditions that people cannot see with their eyes, such as mental illness. The lack of understanding, impatience and intolerance against mental illness fuels it further and leads to more problems in our society such as addictions, violence, and even suicide. As we engage in raising awareness, we need to be more knowledgeable, open to learning, and ready to share what we know with others so as to fight stigma and judgement around mental illness in Malawi and beyond. Thank you for your readership, enjoy!
Julie Soko Managing Editor Essential Grace Magazine essentialgrace@zoho.com / @essentialgracemagazine2020
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Meet the team Julie Soko, Managing Editor
Special Thanks to: Mtendere Kishindo: Sub-Editor Naomi Msusa: Editorial Assistant Art and Design Thandi Soko De-Jong: Editorial Assistant Contributors Steveria Kadangwe, Chilungamo M’manga, *Rachel, Jason Finucan, Rudi Jackson
Essential grace Magazine is a registered publication focusing on promoting mental health and wellness in Malawi and beyond. Contact us for information at 0991 938 203 Comments and feedback on any of our articles or contributors can be addressed to essentialgrace@zoho.com or through the contributors personal contact information. Our postal address is P.O. Box 323, Zomba, Malawi 7|Essential Grace Magazine
In this Issue Mental Health Awareness month has in recent years become more focused on fighting stigma. You will find this theme throughout the mental health section.
My Story features a Malawian woman’s cancer journey to raise awareness on cancer issues in the Breast Cancer Awareness month. Read more on page 24
Yes, we love mangoes and its mango season in Malawi. Try the delicious mango and raspberry iced tea recipe on page 45.
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Cover Feature Summer season is here! Most people think of ways to cool off such as visiting places like Malawi’s beach fronts (see our cover page). While temperatures are soaring uncomfortably high, there are several groups of people whose lives are at risk during extreme heat. Here are some examples: •
People aged over 65 years, especially those living alone
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Those having a medical condition such as diabetes, kidney disease or mental illness
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those who are taking medications that may affect the way the body reacts to heat such as:
Club Makokola Beach, Mangochi. Malawi.
o
allergy medicines (antihistamines)
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blood pressure and heart medicines (beta-blockers)
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seizure medicines (anticonvulsants)
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water pills (diuretics)
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antidepressants or antipsychotics
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pregnant women and breastfeeding mothers
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babies and young children
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those who are overweight or obese
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those who work or exercise outdoors
Try the following tips to make sure you stay cool and hydrated during the heat: •
Drink plenty of water, even if you don’t feel thirsty
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Stay out of the sun during the hottest part of the day. If you do have to go outside, wear a hat and sunscreen, and seek shade.
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Wear light - coloured, loose-fitting clothing made from natural fibres like cotton and linen.
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Eat smaller meals more often and cold meals such as salads.
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Make sure food that needs refrigeration is properly stored.
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Avoid heavy activity like sport, renovating and gardening.
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Watch or listen to news reports to find out more information during extreme heat
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Mental Health Awareness Month The first mental health awareness month was in 1949 by an organisation formally called the Association for Mental Health. This initiative is carried out every year in an attempt to bring up issues regarding mental health that are rarely spoken about. Although in recent years the focus of the project has been more to do with fighting stigma. Anyone can get involved with mental health awareness. There are many ways through which this can be done, although it is important to educate oneself on the issues and challenges relevant to mental issues in your part of the world. Once you are aware, you can help others become aware, and live a better life.
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My Story My name is Rachel
*not her real name
It is 10 PM and I am alone in my room with my mind. I have allowed my thoughts to torment me at will. The pain from the past couple of days that I've been pretending doesn't exist finally hits me. And it hits really hard! I hurt deep and I hurt hard. The pain is blinding and as always, I mourn. I mourn heavily for the little girl in me that will not be free, and for the woman in me that does not believe she is enough. Growing up everyone around me thought I was a problem child. I was that child that cried about everything. I have come to believe that in Malawi mental illness is still very much taboo. As a people, we still think that Africans cannot suffer from depression because we have too many problems to deal with, thus we have no time to experience mental illness. It is extremely hard trying to function in a society that will not recognize your illness for what it is, an illness. Instead, people mock you or pretend to care, only to turn around and use your illness against you. What makes it worse is that people do not offer sympathy where mental illness is concerned. Maybe they think that as long as they don’t see blood or bruises then you are not really sick. Instead, you are an attention seeker, or lazy, or crazy, or a cry baby, just to mention a few of the terms that get thrown my way for not being able to function ‘normally.’ In a society like Malawi, having a mental illness can be misconstrued as you trying to be a Westerner with statements like koma nde ndinu achizungu tu or the typical how can a normal Malawian suffer from depression? Well, how can a Malawian not? Especially when we are expected to hide our emotions, to shut up about our pain and only grieve openly during funerals. We carry so much pain and suffering and yet our society seldom allows us to fully express ourselves. It is really hard to be accepted as a mentally ill person in Malawi, this is something that we need to seriously start paying attention to. My diagnosis My diagnosis is clinical depression, anxiety disorder, and post-traumatic stress disorder (PTSD). What does that feel like? Heavy, crippling and dilapidating. My psychiatrist tells me that I also have what is called dissociative symptoms. Dissociative disorders (DD) are conditions that involve disruptions or breakdowns of memory, awareness, identity, or perception. People with dissociative disorders use dissociation as a defense mechanism either as part of a psychological illness or unconsciously. Lately, I have found myself intentionally pushing things to the back of my mind in order not to feel anything in that moment. Although I do this to avoid emotions, this defense mechanism is 11 | E s s e n t i a l G r a c e M a g a z i n e
ineffective because sooner or later we all must feel something. Once I allow myself to feel I get so overwhelmed by all that buildup of emotion, which distresses me even more. Sometimes I really don't know where to put my pain or what to do with it. I don't want to feel. I want to be numb and just completely forget everything. I want to avoid the sadness that hits you unexpectedly. When I get overwhelmed, it feels like all of a sudden a small puddle turns into a whole ocean and I am drowning in it, and that's pretty rough. Going to therapy for me means learning how to swim in that ocean and learning to handle the waves as they constantly attempt to swallow me. I have learnt how to be self-aware these days, to recognize when I am in trouble and when to reach out for help. However, lately, my biggest challenge has been feeling like people are tired of hearing about my struggles. I end up slowly withdrawing into myself, lying about how I feel and crying myself to sleep because I feel like maybe some of my problems are self-inflicted. I second guess myself a lot when it comes to this. There is a little voice in my mind that always tells me that I am not enough. That voice becomes a whole lot louder when someone I deeply care about hurts me whether intentionally or not. All of a sudden I don't know how to react to that hurt. I cannot reach out to them or let them know how much what they have done has affected me because I wonder whether that would be interpreted as manipulation due to the personal battles I am facing. I am now learning that humans are bound to hurt one another and that I should expect those that care about me to hurt me at some point. I have learnt that I should not fear the hurt, for when I am hurt I can control how I react so that I do not spiral down the drain into darkness. Human beings are generally likely to become less and less authentic as they get older. Likewise, I find myself picking up my mask and wearing it every day choosing not to show my emotional struggles with just anyone. I realize that this article is all over the place, that is probably because I am writing from my heart and straight out of a really horrible depressive episode. So please consider this as me wearing my heart on my sleeve and being extremely vulnerable. For some insane reason, vulnerability makes me feel better. Writing all this down gives me a different kind of calmness that I cannot get from therapy or through my amazing support system.
So tonight I stay fighting. Do I feel enough? Not even close. But I feel extremely grateful for the knowledge and awareness of my condition, and that I making progress. That knowledge has helped me grow into accepting and learning how to cope with my illness. 12 | E s s e n t i a l G r a c e M a g a z i n e
*Rachel is a young Malawian woman who is passionate about sharing her story to raise awareness on mental illness. Although she is still struggling with many emotional and psychological challenges herself, her desire to help others shows her resilient spirit and compassion for those in similar situations. If you would like to share your story to inspire, educate, or simply to raise awareness on mental health issues and treatment, please contact us through the details provided.
Did you know that people living with chronic mental health conditions can live a productive and healthy life? With the right kind of treatment, medication, and ongoing therapeutic and social support; people with conditions such as bipolar disorder, schizophrenia, depression, and even learning disabilities can live a healthy and positive life. Contact the counsellors in our Resources List to find out more. 13 | E s s e n t i a l G r a c e M a g a z i n e
Mental Health Awareness Good intentions aside, raising awareness for mental health issues has to be considered with care. If you are going to be spreading awareness on mental health, consider the following: • Have the right information. Do your research properly, ask professionals if you need to. That way you will always provide appropriate interventions for relevant audiences. • Have a genuine passion for your cause, otherwise you will not be able to sustain your activities once you start. • Check your motivation – why are you doing it? Who will benefit from your intervention? Is it coming from a genuine place of compassion and empathy? Make sure your motivation is clear.
Remember, stigma against mental illness remains one of society’s biggest challenges!!
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My Story By Jason Finucan I was diagnosed with a mental illness at 29 years old. Yet, the greatest challenge I faced wasn’t the illness itself. It was the suffocating stigma that came with it. I am speaking of the stigma that still surrounds mental illness, and the lack of empathy and understanding that follows – and that’s at best. At worst, blatant discrimination is the result. Stigma is inappropriate, unnecessary and offensive. But, unlike mental illness, we have the power to overcome stigma. Mental illness can be treated – but stigma can be cured. I came to this realization through the unique experience of being diagnosed with both a major physical illness and a mental illness. The former was a rare nerve defect in my heart that began causing symptoms at 9 years old, and ultimately lead to open-heart surgery at 12 years old. During the entire experience, I was overwhelmed with support, love – and a complete lack of stigma. Who would look at a young boy with a heart problem and think his character was in question? Or ask him to just “try harder” or “get more exercise”? The latter was bipolar disorder, the symptoms of which began appearing in 2002 and progressively worsened until 2005 when I had a 6-day manic episode that resulted in a forced 2-week stay in a psychiatric hospital. During those tumultuous three years, bipolar disorder nearly destroyed my life. 20 | E s s e n t i a l G r a c e M a g a z i n e
It was in comparing these two experiences, both personally and professionally, that I realized the destructive power of stigma, which is very prevalent with respect to mental illness and yet non-existent with other, more known illnesses. The reality was that years after fixing one major organ with open-heart surgery, it appeared another, this time my brain, wasn’t working properly. Despite the similarities of the illnesses – in both cases, a major organ had a biological failure that created dramatic symptoms – there was nothing similar about the two experiences. First, there was the challenge of self-stigma, which was so strong that for nearly two years I refused treatment and actually tried to find my way back to health through the sheer force of will and determination (as though that was a viable option). Stigma also reared its ugly head in a second, external way. This time it came in the form of confusion, discomfort, judgement and at times outright discrimination in the minds of those around me. This happened regularly, and not only with those in my professional life, but also those in my social life and family. It was jarring to realize that all of the support, unconditional love and empathy that came my way when my heart wasn’t working was nowhere to be seen now that my brain was failing. After finally winning the battle against stigma, I began to treat my illness properly – as a medical illness that required my attention, research and, ultimately, treatment. This approach led to a successful return to full health within 6 months of being hospitalized and diagnosed and, for the vast majority of the days since June 2005, I have been living well, free of the worst symptoms of bipolar disorder. I work very hard to manage my illness and maintain my physical and mental health, and it isn’t always easy or perfect, but approaching my illness with zero stigma has helped immeasurably. Once I fully ‘owned’ my illness, I realized I had the opportunity to help others by sharing my experience. Very few people have faced both a physical and mental illness, recovered, are willing to speak about it, and are effective public speakers. My degree in Theatre and Speech Communication provided the final ingredient. So, in 2006, I started talking. From 2006 to 2015, I delivered over 40 keynotes as a volunteer on behalf of AMI QC, a Montreal-based 21 | E s s e n t i a l G r a c e M a g a z i n e
organization that helps caregivers of those facing mental illness, and also provides outreach education. In 2015, after years of seeing the positive impact of sharing my message, I founded Stigma Zero to work towards a future without stigma by helping employers eradicate stigma in their workplaces, so they can better manage mental illness as it arises in their workplace. My message was, and still is, very clear: stigma continues to exist regarding mental illness because of fear and a lack of understanding. It may often be innocent, but it doesn’t belong, and education is the first step toward eradicating it. We should never again speak of mental illness in any other terms than what it is – an illness. If you know someone who suffers from a mental illness (and statistics say that you probably do) or if you suffer from one yourself, be a part of the effort to end the stigma. Stigma is something we have the power to cure. Let’s get rid of it!
Jason Finucan Founder of StigmaZero Author of the book Jason: 1, Stigma: 0 – My battle with mental illness at home and in the workplace. Jason Finucan is a mental health advocate, stigma fighter, professional speaker, founder of StigmaZero and instructor of the programs found within The StigmaZero Online Training Academy. Visit www.stigmazero.com for more information, and www.stigmazero.com/book to purchase the book.
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Breast Cancer Awareness Month, marked in countries across the world every October, helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of this disease. Breast cancer is by far the most common cancer in women worldwide, both in the developed and developing countries. In low- and middle-income countries the incidence has been rising steadily in the last years due to an increase in life expectancy, increase urbanization and adoption of western lifestyles. Currently, there is not sufficient knowledge on the causes of breast cancer, therefore, early detection of the disease remains the cornerstone of breast cancer control. When breast cancer is detected early, and if adequate diagnosis and treatment are available, there is a good chance that breast cancer can be cured. If detected late, however, curative treatment is often no longer an option. In such cases, palliative care to relief the suffering of patients and their families is needed. The majority of deaths (269 000) occur in low- and middle-income countries, where most women with breast cancer are diagnosed in late stages due mainly to lack of awareness on early detection and barriers to health services. Maria's story (see below) illustrates this dramatic situation common to thousands of women in resourceconstrained settings. A situation that can be reverted if adequate public health programs are put in place. WHO promotes comprehensive breast cancer control programs as part of national cancer control plans. The recommended early detection strategies for low- and middleincome countries are awareness of early signs and symptoms and screening by clinical breast examination in demonstration areas. Mammography screening is very costly and is feasible only in countries with good health infrastructure that can afford a longterm program. www.who.int
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My Story By Steveria Kadangwe How the Story Began I was diagnosed with breast cancer in August 2019. It was at a time when I was at somewhat of a crossroads in my career. I was in the process of relocating from one country to another and had gone for routine medical checks. I had been postponing going for medical check-ups (don’t procrastinate! Get your routine checks done!). It was such a shock to me when the doctor said, “What is this?” I think she expected me to know that I had a lump in my breast, but I truly didn’t.
what was happening. Although my friend and colleague kept nagging me about dragging my feet to confirm what exactly was going on, part of me was truly wishing it would just disappear. The diagnosis
What followed was a whirlwind of tests – ultrasound, mammogram, biopsy, FISH test…all of which kept confirming that I had a tumour. It was serious. It was malignant, an invasive ductal carcinoma which was HER2 Positive.
I wept when the doctor confirmed that the biopsy was positive. He let me go home after breaking the news and scheduled another appointment for the following day so that I could discuss options with him. I felt heart broken and at my wits’ end. How could this happen to me? Why now, of all the times it could have happened. Denial was strong, yet it was happening. What kept me strong was talking to my doctor friend who was very supportive. He read my test results, broke down some of the technical terms into digestible bites that I could understand. The internet also helped, but talking to someone else helped more.
At the time all of this was happening, I was in the process of handing over at work in anticipation of relocating. Within a two-week period, I saw three different doctors. The biopsy was done by a particular breast surgeon, a friendly gentleman who conscientiously avoided any potential impropriety by having a nurse present whenever he examined me even during the biopsy procedure itself. The procedures were expensive – thank God for medical aid! Singapore is one of the most expensive countries in the world, but I went ahead with it anyway because I needed to know
I withdrew into myself. I only told my immediate family, the doctor friend and a few friends. Those who know me know that I am the furthest thing from an introvert that you can find, so this was out of character for me not to share what I was going through. I could not deal with the questions, over and over, of what was going on, what is the treatment, I could not cope with people breaking down into tears, I could not handle the pity. I guess my overwhelming emotion was defiance. I had single-minded focus on treatment. When one mentions the word cancer to you, it feels like your death is very
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imminent. And yes, I even wrote instructions about where my bones should be buried for my sister to follow if anything happened to me. I cannot say I was depressed at this time, no. But I guess I kind of shielded myself from the world. The Treatment
horribly drawn ones. I lost almost ten kilograms but could not celebrate the weight loss because I looked sickly. And radiotherapy burns. I had open wounds and my skin went really dark in the affected area. Looking at myself was often shocking and surprising, and sometimes discouraging.
I had to choose whether to The tests related have a lumpectomy or a to breast cancer are mastectomy. A friend violent and invasive. So callously told me to chop my is the treatment. I had breasts off - they were never had a making a suggestion, but I mammogram, since it felt extremely emotional is recommended for about the decision. Do I chop those over forty. I did off one or both of them? What not expect the twisting will I look like then? I know, and turning and many women have pinching that is undergone these surgeries, involved in taking the but I spent quite a significant pictures. Biopsies by amount of time agonizing their very nature are about it. also invasive, as they take a needle and draw In the end, I had a a sample from the lumpectomy which basically Steveria before she began tumour and lymph removed what was left of the treatment. She had decided nodes in the armpits. tumour after chemotherapy to shave her head in Imagine my utter (the doctors were delighted preparation. shock when I finally there was no sign of cancer) identified an oncology hospital in South and a mastectomy was not necessary. It Africa, and they had to do all the tests was frustrating to be dependent on my again because they needed locally run sister and daughter for everything and it tests in their database. Lumpectomies and was painful to do anything at all. I felt mastectomies involve taking off part or all helpless, sad and alone. I could not of the breast tissue. Chemotherapy kills explain to anyone how I was feeling, cancer cells – unfortunately affecting the because sometimes it felt like self-pity. healthy ones too, making more you Instead, I talked about the stages of vulnerable to other illnesses. Hair falls the treatment I was on and, in gross detail out! Although I decided to cut mine in sometimes, what was happening to my anticipation. I still became extremely selfbody. Looking at myself in the mirror after conscious and lost all my confidence when the bandages came off was very strange I lost my eyebrows, and did some really and somewhat upsetting. 25 | E s s e n t i a l G r a c e M a g a z i n e
What happened next After my initial treatments, I started talking to people. I learnt a few things during this time. Sometimes we have to temper our reaction to people especially if we are not able to relate. I got a few accusations about why I did not tell this person or that person. I got “cures”, herbs, and lots of advice. At one point, I started saying, “I am already taking four very strong drugs that are taking their toll on my body. I don’t know how the supplement you are suggesting is going to react or counter their effects.” Sometimes I just ended the conversation. Here is the thing about cancer treatment – your body can barely take it, you are exhausted and going through so many physical sideeffects. For me, it was excessive diarrhea, no appetite, numb taste buds, exhaustion, heart palpitations, chemical menopause including hot flushes and all. So it was not surprising that sometimes I just wished people would shut up! As you can see from above, the litany of emotions is long. When I finished Radiotherapy in June, I felt completely exhausted and depleted. I was sleeping eight hours or more but I was just tired, mentally, emotionally and yes, spiritually. I could barely function. I eventually started seeing a therapist to process what I had gone through. The therapist often referred to it as trauma – which is exactly what it was. With hindsight, I felt I should have started therapy earlier and dealt with each stage as it came. Talking things through with the therapist and processing my experience. We worked through the emotions of each stage and recognized the changes that I had gone through as a person, physically and mentally after 26 | E s s e n t i a l G r a c e M a g a z i n e
being diagnosed with cancer and undergoing treatment. I grieved what I had lost. I celebrated being treated and finding out that I was going to live, cancerfree. I anticipated what I wanted in future. I recognized the trauma and named all my feelings. It was, indeed, therapeutic. One of the other helpful things that I had were people. Some of those I have never met in person but were introduced to me and had been through it or were going through it all. The other was prayer. So many people prayed for me on voice notes, sent prayers, told me they were praying for me. It gave me strength. And to be honest, throughout my treatment, I have seen the hand of God providing, healing, protecting, and encouraging me. My key takes away is this – when you go through something life-changing it is important to go through therapy right away to process it or talk to someone to be able to cope with the effects and aftermath of that experience. Don’t suffer in silence. Don’t suffer alone.
Steveria Kadangwe is a breast cancer survivor who advocates for women’s health issues and cancer screening.
‘Whether you’re a
mother or father, or a husband or a son, or a niece or a nephew or uncle; breast cancer doesn’t discriminate.’ Stephanie McMahon
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Breast Cancer in Males
Have you ever considered the possibility of male breast cancer? Yes, this does happen and it is a life-threatening condition in males as much as it is in females. Detecting Breast Cancer in Males 1. 2. 3. 4.
Changes in breast size A lump, swelling, or thickening in your breast tissue Redness or scaling of the nipple, discharge Nipple retraction (turning inward)
Who is at risk? 1. Men over the age of 65 2. A family history of breast cancer 3. Klinefelter syndrome (males born with an extra Y chromosome, smaller testicles, more estrogen and less androgen). 4. Testicular conditions such as an undescended testicle 5. Liver disease, as this condition may lead to unregulated and imbalanced hormones in the body, which may then influence the growth of cancer cells in certain people. Read more about breast cancer in males in the following links; www.cancer.org/breast-cancer-in-men www.malebreastcancercoalition.org www.nationalbreastcancer.org
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My Story By Rudi Jackson August 2015
When I was 47-years-old I found a lump about the size of a pea just under my right nipple while taking a shower in July of 2012. I waited a few weeks to see if it went away, when it didn’t I showed it to my mom who urged me to go see the doctor. My doctor sent me to see a breast surgeon who performed a needle biopsy with the results coming back benign. All I knew was it did not belong there and I wanted it gone. After discussions with the surgeon, we agreed to remove the lump. The test results came back in about a week and I was diagnosed with breast cancer, specifically ductal carcinoma in situ (DCIS). I was surprised at the results since there was no family history, except for a first cousin on my mom’s side who had breast cancer. I knew men could get breast cancer, because I had heard that the actor Richard Roundtree was a cancer survivor. Now it was time to focus on my treatment options. Within two weeks of learning my life-changing news, I was scheduled for a full mastectomy of my right breast. My nipple and all the breast tissue were removed, but because the cancer was caught so early, my muscle and lymph nodes luckily were not affected. The drainage tube was removed two weeks later and I returned to work as a Community Outreach Coordinator at Virginia State University.
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For me, early detection was what saved me from having to undergo chemo or radiation. I discussed the pros and cons of using Tamoxifen with my surgeon and he felt due to the stage of my cancer being so low (“0”), taking the drug would do more damage than good so we decided against it. I wasn’t interested in the possible side effect which I read included shrinking my testicles, impotence and even hot flashes.
For the most part, life went back to normal…until one morning in March of 2014 when I woke up with a wet shirt because of a discharge from my left breast. I knew not to wait this one out and made an appointment to see the breast surgeon immediately. The surgeon was a bit shocked to see me back again. I knew what this meant for me, again, and my only hope was that I caught the cancer early, again.
I told my friends about my breast cancer from the beginning. I wasn’t embarrassed about it, because it is very important to share this type of experience so that others are made aware. They were as supportive and often called to check to see how I was doing or if I needed anything. I made sure to tell them to check their own breasts too!
My original cancer had metastasized and now there was DCIS in my left breast. Wanting to rid myself of this as soon as possible, a mastectomy on my left breast was scheduled immediately.
It was important for me to tell everyone I knew to check themselves. I became active with the American Cancer Society (Sister’s Network), Susan G. Komen Foundation, and local survivor groups. I was even asked to attend more than 10 events in October 2013. I honestly got to the point where I felt overwhelmed by all the commitments. I didn’t want to make breast cancer my whole life and wanted to move forward. 30 | E s s e n t i a l G r a c e M a g a z i n e
I had genetic testing done and was negative for any mutations. This gave me peace of mind. I am in good health, routinely check myself by feeling around my chest area and other parts of my body for lumps and abnormalities. I go for blood work and ultrasounds every six months just to be sure I’m all clean. My diet has changed to include more natural foods, more organic foods without growth hormones and pesticides. I am still a bit self-conscious when it comes to taking off my shirt. One day while lifting weights in the gym I had a young man question me
about my scars, so I told him what happened. He then showed me a lump he had under his nipple. I told him straight out not to wait to get it checked. I have never seen him in the gym again, so I just hope he took my advice.
My message to men is check yourself. I’m a living example that men can get breast cancer, but if caught early, it can sometimes be cured.
The Male Breast Cancer Coalition (MBCC), a not-forprofit patient advocacy organization, brings everyone together to educate the world about male breast cancer. MBCC shares stories from male breast cancer survivors all over the world. Learn more here and find resources for men and their families navigating through what is usually a women’s only club. MBCC also honours lives lost in the “In Memoriam” section. We want people to be informed. Breast cancer does not discriminate and we want everyone to know “Men Have Breasts Too.” We Are The Male Breast Cancer Coalition! www.malebreastcancercoalition.org
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This year has shown us just how fragile our planet can be. For those of us in the hospitality sector, it is it has been exceptionally hard. But each and every one of you can help. You can spread the word. Our best marketing tool is word of mouth. .
You can help by visiting us - your local tourist spots across the country: Casa Rossa, Kaza Kitchen, The Art House, The Chocolate Factory, Kachere Kastle, Namizimu Forest Retreat, Mvuu Lodge & Camp, Africa Wild Truck, Nanchengwa Lodge, Huntingdon House, The Mushroom Farm, The Norman Carr Cottage, N'gona Lodge, to name but a few.
We all need you :) *background picture is of Mumbo Island, Lake Malawi.
Support local tourism!
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What not to Say to Someone Going Through Cancer Treatment By Steveria Kadangwe Cancer can take a toll on the mental health of someone going through it and their loved ones. It is devastating and confusing. They do not know what treatment will do to their body until they actually start. The body takes a physical beating that is sometimes hard to deal with or look at. Tests can be traumatising especially if treatment does not work. The mind cannot process the ordeal. On top of it all, people just don’t know what to say – and forget that comforting someone can also mean just sitting with them silently. A person going through cancer can end up lashing out at people who: • Do not understand their choice not to share their diagnosis and who accuse them of “not valuing friendship” • Share treatments, cures, supplements and natural herbs that supposedly cure/prevent cancer. This can get overwhelming because so many 33 | E s s e n t i a l G r a c e M a g a z i n e
people feel obligated to do this even when they have not been asked, and forget that they are probably not the only ones forwarding those messages. • Demand updates every day especially when the person is going through chemotherapy, which can be exhausting, sickness-inducing and discouraging. The cancer patient may not feel like taking calls or answering texts and it is not personal at all. A little self-awareness and reflection on the impact of what we say or communicate with people going through cancer treatment can go a long way in being either supportive or a hindrance. In one cancer group, someone asked what should NOT be said to someone going through cancer treatment or is currently battling cancer. It is quite shocking what people say – sometimes meaning well, sometimes unthinkingly, but these things affected cancer patients’ mental health. Below are things that were actually said to women who have or are undergoing breast cancer treatment: • You don’t look sick
The person is definitely sick despite appearances. Effects of chemo include nausea, sores, loss of appetite, exhaustion, dizziness…the list is endless and depends on the medications being administered. Radiotherapy causes burns and skin discoloration. Surgery is painful and recovery is slow.
• Did the doctor tell you how long you have to live? Someone has just found out they have cancer, why are you so interested in their death and not their potential healing? • You will get a free boob job out of it! Deciding whether to cut off your breasts or just the tumour or whether to get implants or reconstruct or not afterwards is not as easy as it seems. It is a very emotional and very personal decision and being flippant about it is not helpful at all • *Crying bitterly and being heartbroken as if someone has died* They just told you they have cancer and they have no energy to comfort you. They are probably already 34 | E s s e n t i a l G r a c e M a g a z i n e
overwhelmed. If you must cry, excuse yourself • Let this be a wake-up call To what exactly? • ‘If I had cancer, I’d rather die than have chemotherapy’ or ‘why are you not having chemotherapy’ Whether someone chooses to have chemotherapy or not is THEIR choice. For some advanced cancers, it can be ineffective. Doctors give detailed advice on the options to enable patients to choose a path, and you need to accept their choices and not make them feel bad for making those choices. No doubt they thought through, agonised, wept and suffered through an emotional upheaval - to make such decisions and people should respect that. • ‘I know someone who had it worse than you who died’ *and then goes on to describe at length how this person died* What??
• I know how you are feeling Unless you had cancer, do NOT say this
• You really should stop eating sugar, or switch to a raw vegan diet, or read this book There is insufficient research and proof that any of these prevent or cure cancer.
• You’re always talking about this Of course, they are. It’s an immediate issue for them
• You better not die before me This response is especially disheartening because it immediately makes it about the other person, and not the one going through cancer and their needs So, what should you say? Try some of these • That’s really awful. I’m sorry you are going through this. Is there something I can do? How can I help and support you? Empathy is important
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• *Do not give solutions or dismiss any concerns* *Instead, offer information only when asked* Unsolicited information can get overwhelming and is useless for someone already going through cancer treatment. Some supplements can interfere with chemotherapy treatments or cause complex problems like liver failure.
• Do you want to talk about it? Allow for silence. Accept no as an answer
• Can I come with you to your next chemotherapy appointment? Chemotherapy infusions can take as long as six hours and the person is surrounded by medical people and other patients. Having a familiar face to talk to helps.
• Can I pray with you? Or I will be praying for you. They need all the prayers! You can even send the prayers as a voice note on WhatsApp to encourage them
• Have you eaten today? What would you like to eat, can I bring you something?
During chemotherapy and sometimes radiotherapy, it can be difficult to eat due to loss of appetite, nausea and other effects. The person may only be
able to stomach a few foods. Asking what to bring or cooking meals for their family is helpful and supportive
• Can I babysit your children?
• Which day works for a visit? Don’t just show up. Their immune system is weak, or they feel sick or unattractive or tired or discouraged or whatever and are just not up to it. And for heaven’s sake do not visit someone with cancer if you have something infectious or contagious!
This list is not prescriptive, but we need to be considerate when dealing with people with cancer (with anything really) and not make it about us. Don’t be that person who contributes negatively to the mental health of someone who is already going through something serious and possibly life-threatening.
Breast Care Limited is a non-profit organization which works to provide help and inspire hope to people affected by breast cancer. This is done through: • • •
Early detection Education Awareness
If you would like to find out more, get involved, or contribute towards this work, visit the Breast Care Limited Facebook page @Breast Care Ltd – Malawi Or call to speak to someone on +265 0998 158 278 36 | E s s e n t i a l G r a c e M a g a z i n e
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people with poor mental health status. As people with poor mental health status are also at an increased risk of a variety of physical health problems, including cardiovascular diseases, obesity and endocrine disorders, the benefits of physical activity not only reduce the risks of developing these types of diseases, but also improves mental health status.
What is mental health? Mental health is defined as a state of well-being in which every individual realises his or her own potential, can cope with the stress of life, can work fruitfully and productively, and is able to make a contribution to their community. Adequate and good mental health is essential to the well-being of individuals, families and communities. Poor mental health has been identified as one of the leading causes of poor quality of life, disability and reduced productivity. There is also a strong association between poor mental health status and individuals reporting multiple sites of pain. It has been reported and documented that physical activity can improve quality of life for 38 | E s s e n t i a l G r a c e M a g a z i n e
The global Covid-19 pandemic has highlighted and emphasised the importance of mental health awareness. Physiotherapists have an important role to play in the management of their patients’ mental health status. Can regular physical activity improve your mental health? The physical health and mental health benefits of regular physical activity or exercise include: •
Better sleep
•
Improved cardiovascular fitness
•
Better endurance
•
A positive influence on diabetes presentation and metabolic syndrome
•
Better mood
•
Stress relief
•
Less tiredness and increased energy levels
•
Reduced symptoms associated with depression, negative mood, anxiety and social isolation
management in the context of mental and physical health problems •
Interventions to address the physical problems of people with poor mental health status which limit recovery and social interaction and participation
What role can your physiotherapist play in improving your mental health?
•
The management of falls, fear of falling and mobility problems for older people
Physiotherapists are deemed as experts in components of physical healthcare and can contribute to improving mental health status by offering:
•
The management of developmental issues for children and young people
•
Improved cognitive functions, self‐esteem and quality of life
•
Pain management without the use of medication
•
The development and delivery of patient-specific lifestyle and weight management advice and programmes, improving self-esteem and body image
•
•
Expertise and knowledge in prescribing patient-specific exercise programmes, which can improve mood, address the risk factors of other diseases associated with poor mental health status and improve overall wellbeing Expertise and knowledge in motivating patients and promoting autonomy and self-
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Mental health and physical well-being should never be considered in isolation from each other. As you look after your mind, take some time to look after your body too. For example, go for regular check-ups, keep an eye on your blood pressure and insulin levels. Eat healthy and clean. Keep your drinking under control, and exercise as often and regularly as you can. Visiting a physiotherapist will help you manage and even treat pain and stiffness that is sometimes related to mental stress and anxiety.
This article is available on the MBW Physiotherapy website at www.physios.co.za
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Email: mentortomentorinitiative@gmail.com Phone: +265 9903 95511 P. O. Box 2348. Lilongwe, Malawi.
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MENTOR-TO-MENTOR INITIATIVE Mentor-to-mentor (MTM) is an initiative that mentors and empowers girls using psychosocial interventions. The initiative consists of a network of female professionals from around Africa that mentors girls. The mission of the initiative is to empower and mentor girls through the use of Psychosocial Interventions and help them become exceptional leaders of different fields. It aims to connect African Female professionals to work together in mentoring and empowering girls for more impact. The initiative aims to create an environment that promotes good mental health among girls in Africa. The vision of MTM is to become the largest network of highly trained and qualified female professionals in Africa who work together in empowering and mentoring youths through the use of Chilungamo M’manga, MTM Founder psychosocial interventions in promoting mental health among youths. Also to become the largest network of African youths who are psychologically and socially empowered to work in Unity in solving social problems. Currently, Mentor-to-mentor Initiative has 600 college girls from 45 different colleges and 200 secondary school girls, from 40 different secondary schools. The number of MTM mentees may go beyond 1 000 soon since more girls keep joining the initiative every day. Mentor-to-mentor Initiative was founded in October, 2019 by Chilungamo B. M’manga, a qualified and experienced Psychologist and a mental health advocate from Malawi. Mentorto-mentor initiative addresses the need for psychosocial interventions and mentorship programs among girls in Africa. Girls need to be empowered and the most effective way of doing it is by empowering them mentally then the rest follows. Role models and mentors in the lives of girls also play a huge role in bringing sustainable empowerment. Youth is a unique and formative stage. It is a time of transitions that foster both challenges and opportunities. Multiple physical, emotional and sexual changes including exposure to poverty, abuse or violence, can make girls vulnerable. It is also a time of decision making. During this period, girls face challenges such as academic demands, difficulty in coping with change, relationship challenges, financial hiccups, depression and many others. Such transitions affect their mental health and well-being in their academic life, ability to form and maintain friendships, realization of their full potential, and their decision-making skills. 42 | E s s e n t i a l G r a c e M a g a z i n e
There are many initiatives in Africa that target girls and provide them with resources such as bicycles, school bags, tuition fees among other things, in order to improve the standard of living among girls. Despite these efforts, girls still have difficulties in meeting academic demands, being resilient toward life’s challenges, and in their decision making that has a great impact on their lives. Others have behavioral problems which hinder them from realizing their full potential and achieving their dreams. MTM Initiative was established to fill the psychological gap that exists in interventions for girls in Africa. The initiative uses psychosocial interventions to empower and mentor girls and provides them with role models who act as the girls’ mentors as they go through different paths of their lives. The use of psychosocial interventions that target the mind of the person can equally be of importance in dealing with the mindset of girls and this translates into positive behavior change, acquired resilience, positive effect on academic achievement and personal growth. Many African schools including Malawian schools do not have school counselors who are able to manage girls’ behavior, keeping up with them academically, and helping them in planning for the future. Teachers and other administration staff are the ones who take up the responsibility of counselling students when there is a need, and usually, they do this without expertise since they are neither experts in the psychological issues or lack training in counseling skills. In addition, Malawi has a handful of female professional networks which provide 43 | E s s e n t i a l G r a c e M a g a z i n e
female professionals with platforms to interact and collaborate with one another for the purpose of impacting the younger generation. Female professionals need to work together to advance mentorship, career development and outreach of young girls in their communities. Although, there are many female professionals who have the expertise, resources, skills and knowledge that would benefit young girls yet may lack platforms to do it. MTM provides female professionals the platform they can use to reach out to girls as role models and mentors and help them in different aspects of their lives. To be wellrounded and become exceptional leaders. The collaboration effort of these professionals will help the initiative to achieve more impact in tackling different challenges among girls. MTM Initiative provides female professionals with an opportunity to interact and share professional experiences, expertise, and skills in contributing to the combined effort in empowering and mentoring girls effectively. MTM Initiative believes that real empowerment begins with an empowered mind. It also believes that empowering girls and women is equivalent to empowering a whole nation. Therefore, it works towards empowering Malawi. Mentor-to-mentor Initiative Structure Currently, Mentor-to-mentor Initiative consists of 7 board members (3 male and 4 female experts), 30 Mentors (female professionals from different fields, a good number of them being psychologists), 30 volunteers (Potential female mentors, supporting and understudying the mentors), 30 support team members (males and females with different expertise to help in the operations
of MTM), 600 College Mentees or MTM Trainees (college girls being mentored at the moment but being trained to become mentors upon graduating from their colleges) and finally, 200 Secondary School mentees. Mentor-to-mentor Initiative Operations Throughout the Pandemic, MTM has been providing psychosocial support to its mentees through the MTM WhatsApp forums which conduct activities twice a week. On Fridays, MTM hosts Guest Friday Sessions where a professional from a specific field is invited on the forum to make a presentation related to his/her expertise. On Saturday evenings the initiative holds interactive activities between mentees and the mentors. During the week, mentees who seek counseling are allocated to a mentor to be assisted. On average, about 6 to 10 mentees seek counselling per week. Many girls have found MTM very beneficial and lifechanging. Post COVID-19 Pandemic, the initiative intends to establish MTM clubs/societies in different secondary schools and universities in Malawi (to serve girls better) and later on establish MTM offices in different countries in Africa for easy access to MTM services by our international mentees.
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Mentor-to-mentor Initiatives Partnerships So far, the initiative has made partnerships with the following organizations a.
Kamuzu College of Nursing
b.
Malawi Police
c.
Yoneco
d. IFENSO: An organization that provides a platform for learners with special educational needs to equally access and benefit from the quality education offered in educational institutions by offering them special support. Mentor-to-mentor Initiative Activities The following are some of the activities carried out by the initiative. a.
Group counseling sessions
b.
One-on-one counseling sessions
c.
Skills training
d.
Knowledge sharing
e.
Self-awareness activities
f.
Mental health-boosting activities
g.
Career guidance
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Wellness tip for the summer heat Mango Iced Tea Author Sara Welch This recipe for raspberry mango iced tea is a light and refreshing drink that only takes 5 minutes to make. Prep Time 1 minute Cook Time 5 minutes Total Time 5 minutes Servings 6 servings Calories 88kcal Ingredients 6 cups of water 6 black tea bags (I used English breakfast tea) 2 cups of mango nectar or juice honey to taste (optional) 1 1/2 cups of fresh mango slices 2 cups of raspberries or strawberries mint sprigs for garnish (optional) Instructions 1. Bring the water to a boil; add the tea bags and steep for 3-5 minutes or until the desired level of strength. 2. Stir in the mango nectar. Add honey to taste if desired. 3. Pour the tea into a pitcher. Add the mango slices, reserving a few for garnish if desired. 4. Chill the tea in the refrigerator for at least one hour. 5. Stir in the raspberries or strawberries right before serving. Pour into glasses with ice and garnish with reserved mango slices and mint sprigs if desired. Both mangoes and berries are in season in Malawi. This is a great idea for keeping cool and enjoying seasonal fruit. 47 | E s s e n t i a l G r a c e M a g a z i n e
The SACAP Story Marc Feitelberg established the South African College of Applied Psychology in Cape Town in 1997. He based it on a similar model to its successful Australian counterpart – the Australian College of Applied Psychology (ACAP). SACAP grew steadily and with the advent of formalised bodies of recognition in South Africa such as the National Qualifications Framework (NQF), the college achieved accreditation as a private higher education institution with the South African Qualifications Authority (SAQA) and the Council on Higher Education (CHE). This was a critical turning point for SACAP as it could package its modules into various diploma qualifications. Another key event occurred when Lance Katz bought the college in 2010. Fueled by his inspired vision of scope and scale, SACAP is now at the forefront of higher education in Applied Psychology, Management and Leadership in South Africa. The college has over 2 000 (and growing) students and has customdesigned campuses in Cape Town, Durban, Johannesburg and Pretoria and offers training to the world via its Online Campus. 48 | E s s e n t i a l G r a c e M a g a z i n e
SACAP’s journey has been – and continues to be – one of positive growth. SACAP offers the following accredited qualifications: •
•
•
Higher Certificate in Counselling and Communication Skills (Contact and Distance) Advanced Certificate in Counselling and Communication Skills (Contact) Diploma in Counselling and Communication Skills (Contact and Distance)
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Bachelor of Applied Social Science (Contact and Distance)
•
Bachelor of Psychology (Contact)
•
Postgraduate Diploma in Coaching (Contact)
•
•
Bachelor of Social Science Honours in Psychology (Contact and Distance) Master of Social Science in Community Mental Health Promotion (Contact)
Study at our Online campus and access a range of Online Courses in: Applied Psychology-Online Courses Applied Social Science-Online Courses Julie Soko, a Zomba based counsellor at The Haven Center, and editor of Essential Grace Magazine is an alumni of the South African College of Applied Psychology training in Counselling and Communication skills as well as Applied Social Sciences. The institution is highly recommended to those interested in becoming mental health workers in various fields of psychology through one of the best applied psychology schools in Africa. 49 | E s s e n t i a l G r a c e M a g a z i n e
Human Resource Management-Online Courses Management & Leadership-Online Courses Online Counselling Courses Contact SACAP: admissions@sacap.edu.za / www.sacap.edu.za
Find us next to Splendor Hotel in Old Naisi, Zomba City. Malawi
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Essential Grace Magazine Promoting mental health and wellness through media Contact us essentialgrace@zoho.com / essentialgrace@yandex.com Call: 0991 938 203 52 | E s s e n t i a l G r a c e M a g a z i n e