Visiting the sick

I grew up in the 1980s in Chimwala Village, Traditional Authority Nsamala, Balaka. In the neighbouring village of Chapita lived an old woman, Abiti Kananji. She was one of elderly citizens in the area—and there are still many elders, including my mother and dad aged over 80.

Now Abiti Kananji was chronically ill for years. Until she died in her old age, she was confined to her house near the home of her daughter who had two children. The children were my friends and playmates.

Abiti Kananji’s immediate caregiver was her daughter, a lady in her 50s then. Two or three other women who came to help Abiti Kananji.
The grandchildren, like all of us, were not allowed to get into Abiti Kananji’s house. Sometimes she would feel better and sit outside her house for fresh air.
At such times, we would speak with her if we were passing by. Her grandchildren also spoke with her at such moments.
My mother would sometimes visit Abiti Kananji’s daughter to ask how the old lady was doing, come home and get some flour, sugar and firewood for the caregiver to use in caring for her old mother.

Some women in my village and neighbouring areas did the same.
Why weren’t we allowed seeing Abiti Kananji in her house?
The question remained with me until now, when my interest in indigenous knowledge systems and practices (IKSP) has grown.
After reading about IKSP and paying attention to our cultures, I have made the following conclusion from the granny’s story.
It is in our collective wisdom, in our traditions, not to visit those who are very ill. Instead, we visit the caregivers, to ask them what they need and offer that when possible. Our indigenous knowledge suggests three reasons for not visiting critical patients.

First, the very ill need our gifts more than our presence. Second, restricting visits to caregivers is a traditional way of infection prevention.
Second, it could be infection from the chronically ill to the visitors or from visitors to the ill person.
Third, our indigenous psychology recognises that we are busy people and illness provides us space for rest, space for reflection.
Nowadays, we get admitted to hospitals when very ill.

So, what can we learn from indigenous knowledge that we can apply to our world of hospitals and admissions?
The greatest lesson is that visiting people who are critically ill is not good for the patient, the guardian and hospital staff, including guards and cleaners.
It is important that we give patients space to be alone, with competent hospital workers and caregivers.

In my view, anyone admitted is very ill and needs no visitors. We may not agree on the definition of the very ill, but I know the very ill when we see them.
I would like, therefore, to propose that hospitals in Malawi should abolish visiting hour. Instead, visitors should come anytime during the day, not into the wards, but to meet guardians outside the wards or hospitals. The wards should be for patients, hospital staff and guardians approved by hospitals.

There should a paradigm shift in our urban and semi-urban communities, a move from much visiting of the very sick to much prayer and helping via guardians.
Our parents, who passed on indigenous knowledge to us, knew well that critical patients need rest, not visitors.
Our parents knew about infection prevention, about need for suitable diet for the sick, need for rest and need for light and fresh air for the very ill.
Somehow, many urban Malawians have lost this knowledge and we think visiting the very ill is a demonstration of kindness. Not at all.
We have more to learn from our indigenous knowledge systems and practices. A lesson on visiting the sick is one of many. 