Two years ago, Ashley Malloy bought a one-way ticket to Africa.
After several mission trips to Malawi, the nurse practitioner from New Palestine agreed to a more long-term assignment, seeking to help expand access to medical care for people living in remote areas of one of the world’s poorest nations. She works at Blessings Hospital and its mobile clinics.
Over email, she caught up with the Daily Reporter about how the journey has gone so far.
Describe what you are doing there and your role.
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My days in Malawi are as varied as the weather in Indiana in the spring. I have a desk in an office I share with Harold, our hospital administrator. Some days I am able to sit there and enter data collected from our four mobile clinic sites to track disease and medication trends, but many days I spend responding to the various things that arise.
We try to start our mornings by reviewing the patients in our “HDU,” which stands for High Dependency Unit. There are very few true ICUs in Malawi, so many hospitals have a ward with oxygen supplementation available and where nursing care is more focused. Ours was recently renovated and has six beds, all with oxygen available. We are currently working to get some bubble CPAP machines that will also be used in that room to help babies with respiratory support when they need it. After we visit those patients, what the day holds is anyone’s guess!
My role is as varied as my days. I joke sometimes that in a day or a week I can be a nurse, a clinical provider, an ambulance driver, an administrator, an assistant pharmacist, and dabble in some facilities management as well! We’ve recently undertaken a big hospital renovation, so in recent days I’ve also been learning about leading a construction project!
However, with all of that said, my initial prompting to move to Malawi was to serve on our mobile clinic units in the rural villages. While our administrative needs at the hospital don’t allow me to take part in those as often as I would like in the season we are in, I enjoy every chance I get to go with our mobile units and spend time with our community members in rural areas. This year we are planning to expand to a second unit and hope to establish some additional rural ministry services, so I’m excited and hopeful that those expansions will provide more opportunities for me to spend some time in the field and less time in the office.
I’ve also developed a passion for capacity building/professional development within the realm of nurse and clinician education. Our staff truly desires to provide a higher standard of care than they have previously experienced or were trained into, and watching their eyes and minds be opened to their true capabilities and all they have to offer our immediate community through their health-care skills is a great blessing and honor for me.
What’s the timetable for your work?
I’m afraid to put a timeline in print! My initial commitment to service here was three to five years. As I close in on the end of Year 2, all I know for sure right now is that three isn’t going to be enough for God to accomplish in and through me what He brought me here for. The road to transformation within me and the external progress around me are just starting to bear their first fruits, so I’m waiting patiently at the feet of Jesus for His direction and timing.
What might the average American might now know about daily life there?
The beauty of life lived in community. It’s hard to imagine real daily life here until you see it and learn it. Even after a few short-term trips, there was so much I didn’t know, and so much I am still learning all the time. One of the most beautiful things about Malawian culture is the way it is lived in community.
The traditional family nucleus is expanded to include aunts, uncles, and cousins all referred to as moms, dads, brothers, and sisters. When someone is sick in the hospital, many people are involved in caring for them. When someone has family in a rural village with a need, those in more urban areas with jobs and more resources give what they can to help — often to their own sacrifice. It’s truly beautiful.
What have you learned so far from this experience? What have been the spiritual lessons?
What I’ve learned already in these nearly two years I think could fill a book — maybe a book only I would be interested in reading as a personal journey, but the lessons come in abundance, daily.
I’ve learned people are far more physically resilient than I believed them to be from my learning experiences within the walls of my hospital in America.
I’ve learned that the paradox of medicine is that it is far more complex, but also far more simple, than I learned it to be in school.
During a period of prolonged electricity shortages during the hot season I learned that I don’t need electricity for as many things to maintain my happiness as I had once thought … but I also learned that I will always at least need enough electricity for a fan if I have any hopes of sleeping and being a kind human when it’s hot.
I’ve learned that living in a community of people is a beautiful picture of how I believe God intended us to live.
I’ve learned that the cliché answer of “I came to help, but I was transformed” is more true than I ever expected it to be.
I believe that every time I’m frustrated with the Malawian health-care system or resources we don’t have, or the injustice of not being able to save a life because we don’t have something readily available in most places in the world, that God must be grinning at my frustration with how big the problem in front of me appears in comparison to the problem/work He faces inside my heart as He works out His transformation within me. I’m sure He often thinks, “You think YOU’VE got it hard, you should see what I’M trying to work with IN YOU!”
I’ve learned that Malawians are some of the most kind and gracious people on this planet. Many of my Malawian colleagues have been a living and breathing example of God’s patient love for me as they continue to patiently endure my struggle through personal and spiritual growing processes, always more quick with forgiveness and grace than with bitterness or resentment. I’ve learned that I hope to be much more like my Malawian family when the time comes for God to call me back to America.
And I’ve learned that I will ALWAYS be learning; that things are seldom as I first perceive them to be or first understand them to be and that holding loosely to how I understand a new lesson in life, heart and cultural matters saves a lot of heartache, embarrassment and regret down the road.
What was the biggest daily life adjustment when you got there?
Solitude. When I first arrived I hadn’t lived by myself in nearly 10 years. Evening solitude and quiet was the hardest adjustment for me. People had told me before that it seemed I was a verbal processor of my feelings, and I didn’t understand how true that was until there was no one nearby to verbally process with. I believe wholeheartedly that it was intentional timing by God to put me in a house by myself for a season to learn how to be comfortable alone and alone with Him.
There were many physical adjustments as I learned to navigate water and electricity outages, language barriers, cultural differences, new foods, etc., but the most challenging of them all was learning how to live in solitude. However, now looking back, I will forever be thankful for that season as it was profoundly transformative and impactful.
In this second year, though, He has answered my prayer and blessed with me with a very like-spirited roommate, and the verbal processing has resumed and been good for my spirit!
What convenience/comfort food/etc. do you miss?
Easiest question — Mexican Food. Hands down, no question! Some friends have brought and sent some jars of queso, but I’m certain one of my first stops when my feet hit Hoosier soil will always be El Jaripeo!
What’s been a memorable story/event during your time there?
I have been so touched and shaped by many stories in my time here already. However a name that was just mentioned as recently as this week, Shakira, continues to shape not only my daily practice but had a great influence on our entire hospital staff.
Shakira was an 18-month-old child admitted in February of last year with severe malaria. She arrived just as malaria season was kicking into full gear, and I didn’t know much at all yet about the progression of the disease or just how devastating it could be. Shakira, though, she presented with all of the signs of a very severe and complicated infection, and today her time with us is a part of my malaria evaluation skill set. She required multiple blood transfusions, endured seizures, her kidneys were damaged, and a few times she scared us in to thinking we might lose her.
During that time I sent a text message to a physician Stateside and asked if this is the part where we wait, watch and pray because I wasn’t sure I knew how to do that. I wasn’t sure what to do when I couldn’t order another lab, or test, or try a different medication. Learning that I did not have the power to heal that little girl was a big paradigm shift from my American medicine background.
We decided as a team to keep her at Blessings because we were able to provide such good nursing care and there wasn’t anything else another facility could offer her than what we were at that point. He told me yes, this is when all you can do is wait and pray. And we did.
And she recovered. She finally turned a corner, and the day she started responding to her name, the spirit of the entire hospital staff was lifted. Every clinical person on our staff was involved in her care, and because we made the decision to keep her, to love on her, to pray over her, and to stand with her and her family … our staff saw what they were capable of. Through Shakira, God gave everyone at Blessings a glimpse of what we could do when we came together, and every day since, the care delivered in our HDU is a fruit of that journey.
How can those interested support your work?
As far as support, prayer support is critical. There is so much happening here in so many areas that knowing where my focus and energy should be on a given day requires the wisdom and discernment of the Holy Spirit. I am easily distracted by all the needs and places I COULD invest my energy, but knowing where HE wants my energy invested and HOW, that is a powerful way people can be praying for me. And for endurance within my own personal and spiritual growth.
We use the phrase growing pains for the physical growth of the body, but I would argue the growing pains of meaningful and lasting spiritual and personal growth can be pretty intense as well!
Financially we can always use support. My being in Malawi full-time is 100 percent donor supported, so one-time and monthly partners are always a great blessing to my time and ministry here. Blessings Hospital is supported by a Stateside non-profit organization, Chikondi Health Foundation. Chikondi’s sole purpose is the development and running of Blessings Hospital. Both avenues of giving utilize the same platform on www.chikondihealth.org/donate. If someone desires to donate to the Chikondi Health Foundation general fund they can select the general fund option. If someone desires to donate toward my funding they can select the “missionary fund” and put “Ashley Malloy” in the memo section before submitting.
