Building equal learning opportunities for differently-abled children in Malawi: An interview with Patience Mkandawire on the evolution of Fount for Nations (Part 2)

In part 2 of this interview, Patience Mkandawire talks with Thomas Hatch about Fount for Nations recent evolution, work during the COVID school closures, and next steps. Part 1 of the interview focused on the origins and initial challenges in developing an organization that has developed school, hospital, and community programs to support the education and development of differently-abled children in Malawi. In addition to being one of the founders of Fount for Nations, Mkandawire was selected as an Obama Scholar at Columbia University during the 2021-22 year.

Gaining control of the program and focusing on schools
Thomas Hatch: You’ve told us about the origins of Fount of Nations in the activity center you established at a hospital; about the first two years after you established Fount of Nations with work in activity centers in several hospitals and in resource centers in schools. What was the next step? What was the next big transition point?

Patience Mkandawire:  At that point, we expanded to include more attention to community engagement, which also has its own set of challenges, but we also closed the hospital program. We narrowed our focus to working with schools and community engagement. At the same time, we realized that because we didn’t have our own space we operated basically on the whim of the schools and the teachers; we had no control over our programming. We started thinking that to really control our own program and maintain fidelity of our programs, we needed our own center, like our model school. We started planning for that and that opened in 2020, which was bad timing, of course, because that’s when the pandemic hit.

But when we started doing more work in the community, we realized the economic barriers that many of our parents faced, which was not something we had focused on. We started doing home visits and found that a lot of our parents had come from a village, left their land, and come into the city and were living in areas with very poor economic conditions. That started us thinking that we should develop an economic empowerment program. Initially, I was not too keen on this, but my field team insisted that we really had to do it because the parents weren’t listening to us. There was a time that one of the counselors went out for a group counseling session and when she came back her face was gloomy. “What happened?” I asked her, “Was the turnout not good?” And she said “This is by far the best turnout. I had close to 40 parents come to the session, but all of them are on my neck saying things like ‘words can’t help us because all you do is talk to us. We want money, we want a livelihood.’”

“This is by far the best turnout. I had close to 40 parents come to the session, but all of them are on my neck saying things like ‘words can’t help us because all you do is talk to us. We want money, we want a livelihood.’”

I was opposed to that because it’s not an area we knew anything about. Nobody on our team was an expert on it. But we began to do some research on micro-finance, and we tried a partnership with another organization that was already doing business and economic empowerment for mothers.That partnership however didn’t last long enough to yield results. We were stuck on logistics of how to train parents that often had to take care of their kids full-time. I am not sure what it really was but most organizations we tried to work with weren’t really willing to make adjustments to take into account the unique needs of children with disabilities or their families.  But we soon learned about Opportunity International. They had been training farmers and other populations in financial literacy, and we were able to get them to do financial literacy training for us. Then, once the parents were trained, we realized we needed to give them access to money…so we reached out to some of our funder friends, the Segal Family Foundation who connected us with a funder that was willing to give direct social cash transfers to some of our parents. We linked the cash transfers to the child’s education. In that way, we created incentives for increasing children’s attendance at school, and it turned out great.

TH: You said the economic impact program was successful, but what was your measurement of success? 

PM: We measured academic indicators such as attendance, progression and parent involvement in learning. We also measured social indicators like how many meals do the children eat a day. For example, before the program (and during the pandemic), 76% of the parents said their child ate once or twice a day because they just didn’t have any money. After the financial literacy training, the numbers flipped. Over 80% were able to eat three times a day. In addition, close to 70% of the businesses they started with the initial social cash transfers are still running.

The Pandemic & Beyond

TH: Can you talk a little bit about how the pandemic affected the development of your program. What did you learn and how has that influenced how you think about developing and sustaining the program in the future?

PM: The pandemic is why I am here in the US, as part of the Obama Scholars program. When the pandemic hit, schools closed. And that was the first time we had ever imagined that anything would happen to our schools, I just can’t describe the feeling… All our programming happened in schools; our teacher training happened in schools; our parent convening happened in schools; many of our community convenings happened in schools. Schools are central in almost every village so they were very easy access points for us to meet people and to convene people, and suddenly, schools were all closed. And our teaching was all paper and pen. We had started doing some digital data collection, but our teachers across the country still taught on the blackboard 

I remember one of the first things I did was give a break to the entire team. We just decided “Okay we’re all going to go home, and we’re going to take a two week break to think about what we’re going to do. Can we survive without schools? Like what sort of work can we do? How can we support our participants? Our community members? Our champions? Our advocates?” 

“Can we survive without schools? Like what sort of work can we do? How can we support our participants? Our community members? Our champions? Our advocates?”

Over that break, the Government started to respond. They said “We’re going to have remote learning programs and we’re going to have TV and radio programs.” But I was thinking, “How is this going to reach a child who learns differently? Who cannot process? Who cannot hear?” Fount for Nations needed to respond too, but at that point, our team was also at risk and there was a lot of fear that we might die. But the team realized “if we are this scared, imagine what our parents are going through?”

It was really a team effort, and my husband and I would check in with individual team members and ask, “How are you doing? What are you going through?” But one by one, they said things like “We need to come back to work.” First, we said “We’re going to support the government in doing remote learning, and our parents are going to be teachers.”  That was a gamble, but we brought back our volunteers and decided they would provide the support because teachers could not go in the homes. We had the volunteers meet with the teachers and learn about the typical lesson plans for the week and then the volunteers would call the parents, and the parents taught the children. Fount for Nations led a coalition of 4 education partners of the Segal Family Foundation to deliver remote learning to 3000 primary school learners across the country. One of our other long-time-partners, Rays of Hope ministries, released a handbook for teachers to support the school radio programs, and we used that to train our volunteers. Then we just started deploying SMS texts and phone calls, and that’s how the kids learned during that period. All this is happening on the phone. It was a surprise in some ways how well parents responded. Our volunteers would set appointments with the parents, and if our volunteers were late, we’d receive a phone call, “I just wanted to check with you because I’m looking at the time, and she hasn’t called yet. Is everything okay?” 

The second thing was the counseling sessions. We also did that on the phone. Our counselors set up a protocol for mental health screening, and we started calling all our parents.  They’d get a call – “How are you doing?” – to check in.  If the parents’ needed extra support, the counselors would refer them or consult with them. We were also taking a gamble because this was the first time we’d ever called the parents for counseling sessions. Our counseling sessions had been in person. If the parents needed to cry, the counselor was there to just feel that with them. Now the sessions were not only over the phone, some of them were with a person the parents had never met because we had to increase the number of volunteers to make all the calls. It was a much higher volume. 

It was crazy, and I was just upset at how in 2020, we still didn’t have any digital options for kids with special needs to learn in Malawi. In 2020, we didn’t have any psycho-social or mental health support for parents. In 2020, we didn’t have any therapists that could offer mobile services or online services. In 2020, Fount for Nations was one of three, maybe four organizations in the country that focused on education for kids with special needs. I just felt “I can’t do this,” because clearly people were not convinced that our work was as important as we think it is. That’s when the opportunity to come to Columbia came up. Joseph, my husband, said “Go. You need inspiration. You’re stuck. I think you need to go and meet awesome people. Meet experts. Get inspired. Come with ideas and then we’ll continue.” So I did, and I’ve been studying things like comparative policy studies at Teachers College, non-profit policy and advocacy, learning how international education policy is formulated. So now I’m thinking Fount for Nations is much more than a direct service provider. I’m thinking of Fount for Nations as a critical player in the ecosystem for inclusive education: as bringing all these stakeholders together to define and sustain the ecosystem and to inspire more actors to care about this issue.

in 2020, we still didn’t have any digital options for kids with special needs to learn in Malawi. In 2020, we didn’t have any psycho-social or mental health support for parents. In 2020, we didn’t have any therapists that could offer mobile services or online services

That’s been a big shift in terms of our plans and in our overall strategy. For example, in our training, we’re thinking of using a “train the trainer” model and focusing on being really, really good at that. We could offer that training to a wider range of organizations that can support learning and development for teachers and for children, particularly those who have learning difficulties. I’m also thinking about how to get back to the health care system because there’s still a role that they play, especially in assessment and diagnosis.  I’m also thinking more about research now. How do we collect action-oriented data? How do we apply evidence-based research and implementation? Now merging those three things – advocacy, training and research – is becoming the core of our future plans. We are now working towards Fount for Nations becoming the Center of Excellence for Inclusive Education in the country and bringing together all these elements to really reduce the inequalities that exist in access to quality education for these children. I want to acknowledge that from our journey we’ve learned that the child’s education has not really been what the child is taught, but who else is around them that supports their learning. If the teachers’ perceptions are wrong; if parents’ perceptions are wrong; if community perceptions are wrong; if healthcare is not supported; if research is not adequate; if the government does not fund social services, then, no matter how creative our approach is – which was our initial idea – kids still won’t be learning. They still won’t be succeeding.

“We’ve learned that the child’s education has not really been what the child is taught, but who else is around them that supports their learning.

TH: You really tied up that story beautifully and transitioned into where you’re heading. One thing you didn’t mention, though, that kind of brings you back to your initial experience with your brother, is your interest in growth monitoring because you’ve identified early screening and assessment as critical factors moving forward. Can you just say a word about your strategy with that? 

PM: Yes, it was like a light bulb moment when I realized we could build on that. Like I said before, children in Malawi go to see a community health care worker for the first five years of their lives. From birth up to five, every single month, they have to go for growth monitoring. They are just going to get their weight checked; they’re going to get their height checked. And it’s mostly for nutrition screening, deworming, vaccinations, but they never get screened for developmental delays or learning difficulties. But I realized it’s a great opportunity because we could intervene early. The project I’m working on right now is, first of all, to adapt the assessment tools that are recommended so they are simple to screen for developmental delays and learning difficulties. And then we’ll train the healthcare workers to administer those assessments at the regular checkups that the kids come to anyway. That way we’ll get to see how many kids are at risk of developmental delays or at risk of learning difficulties. Then we can design workshops for the parents, because, with the pandemic, we’ve found that they can teach and help support their kids. For example, now that we know a child is struggling to sit up, how can we support the kid early on? And how can we intervene early? For most of these issues, parents would not know or understand that their child has something like epilepsy or even cerebral palsy until they were in primary school or even later. For example, I remember Elisa, whom I met when she was 17, and she had to drop out because she was just too big to be in primary school, and no one knew she had epilepsy until she repeated the same class 4-5 times!  I wonder if we had met Elisa when she was six months or a year old? What difference might that have made? Could she have coped with her condition and been more successful?  We want to make sure that these kids have a strong start by giving parents the information about what conditions their children have and the information that they need to help cope. Hopefully this generation of children will have a much better start.

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