A crowd of hundreds had gathered outside. Some people had been waiting for an hour and were pressed up against the glass. As the door was unlatched at 8.30am, they surged forward, the men using their strength to get to the front. Once inside they ran to secure a place.
This is a scene replayed every morning in towns and cities across Malawi. But the crowds are not racing to get the front seats at a concert or sports match. Instead they are rushing to find a seat in their local library and get hold of one of the country’s most scarce and precious resources: a book.
”We are desperate for more books,” said Patrick Achitabwino, public relations officer at the National Library Service. ”For most people there is no internet access and books are the main source of information. Without them there is no knowledge. Without knowledge this country cannot develop. People talk about hunger and disease — but without books we cannot even start to tackle these problems.”
Most of the books are bought with donations, and many come from Book Aid International. Their journey begins in a London warehouse, where they are sorted, boxed and transported to the docks. From there they are sent on a long boat ride to Durban, South Africa, and on by lorry to the capital of Malawi, Lilongwe.
The books are then loaded into cars and carried over bumpy roads snaking deep into the countryside. They finish their journey in the hands of grateful teachers and doctors, giving them new knowledge to save lives.
But the donations fall desperately short of what is needed. Some rural hospitals receive just five new medical textbooks a year.
In the Malamulo Mission Hospital, in the Thyolo region, a young doctor was treating a woman who looked frail and weak. He said he desperately needed more knowledge to help diagnose patients’ illnesses.
He explained how they viewed books: not simply as paper and words but as the path to improved healthcare. Books, he said, had taught them how to administer anti-retroviral drugs to help HIV sufferers live longer. They had provided the information that syringes should not be re-used and dirty surgical equipment needed more than soap and water when it was cleaned.
Treatment for Malawi’s most prevalent diseases — HIV, malaria and tuberculosis — is constantly changing with new drugs, tests and methods being discovered almost daily.
In the medical college attached to the hospital, the library feels as if it is in a time warp. Dark wood shelves are covered in tatty books with peeling corners. As the librarian pulls them off the shelves, each is older than the last: 1962, 1950, 1932. Even the newest books are 10 years old.
”Someone said knowledge doubles every 10 years in medicine,” said James Misiri, from the college. ”We are using books from 1995, so we are twice as far behind. So many lives could be saved if only we had the latest books.”
Workers from the college carried out an inspection of a number of medical schools in Malawi and found the same problem everywhere. Yet despite the lack of resources, the government wants the medical schools to double their intake. They have no idea how they can do this at Malamulo.
But more health workers are desperately needed. Everywhere you go people mention the ”Aids/HIV pandemic”.
They talk of people dying every day, and rows of graves appearing at the roadside. They describe losing loved ones to malaria because they went to hospital too late, and speak of the horrifying maternal mortality rate.
Midwives trained at the Kamuzu College of Nursing in Lilongwe say their main challenge is to cut deaths in childbirth. Stella Ngopola, a student midwife, said new books would help a lot: ”We learn everything we know through books. We have found new ways to deal with pre-eclampsia, haemorrhages and caesarean births. The profession is dynamic and old books tell us to use the wrong drugs.”
It is a world away from the experience in Britain. Pat Bassett moved from Plymouth University in Devon to the Malawi College of Health Sciences. ”There is no comparison,” she said. ”In the UK there was constant access to the internet and the newest books.
”Here it is a different story. In sociology there are no books. In psychology there are no books. In clinical medicine there are books, but they are all out of date, and one is shared between 800 students.”
Bassett put a book list into the hands of Gray Nyali, the national librarian for the National Library Service, who is in charge of distributing Book Aid International’s donations. ”We desperately need these books,” she told him. ”These colleges are the backbone of the health of the nation.”
Nyali admitted there was an acute problem over medical books: ”We have a real shortage of them.”
If hospital staff treating long queues of patients, many of them desperately ill, ”have the wrong information they could make the situation worse,” he said.
”If you give food we say it is not an investment because people eat it and that is it. But if you invest in a book you are investing in the health of our nation and the future.”
Nyali said local people could not afford to buy the books they needed so desperately. Health books which cost up to £50 in the United Kingdom would be converted into Malawi’s currency, the kwacha, and then sold with a mark-up. ”That could be a quarter of someone’s annual income for just one book,” he added.
Those who get the chance to study do not take it for granted. This was illustrated by the atmosphere at the University of Malawi’s annual graduation ceremony this month. It was like a football match, with hundreds of friends and relatives of those receiving their degrees packed into the hall, clapping, singing and ululating. Some took off their tops and spun them round their heads.
On the radio and in newspapers a key topic for discussion is the country’s reading culture and what can be done to improve it. Back at library service headquarters in Malawi, Jonathan Chingwalu — who runs the outreach programme to get books delivered to rural locations — summed up the feeling in the country; ”If you don’t have knowledge you are as good as dead.”
Giving money for books is not something many people think of doing; food or clothes seem more urgent. But this durable gift of knowledge could not be more important to aid the development of Malawi and others among the world’s poorest countries. – Guardian Unlimited Â