‘I adore her now’: Mother learns to cope with child’s autism in a country with little help

‘I adore her now’: Mother learns to cope with child’s autism in a country with little help

In the East African nation of Malawi, where resources for mental health and behavioral disorders are scarce, a mother’s journey from despair to hope highlights the transformative power of care. Martha Ongwane, a 33-year-old woman, once considered ending her daughter Rachael’s life. Two years ago, Rachael—a non-verbal, frequently biting, and restless four-year-old—had become overwhelming for Martha, leaving her deeply depressed and isolated.

Rachael’s autism diagnosis had intensified Martha’s struggles. Her neighbors, steeped in stigma, blamed her for the child’s condition, even urging her to lock Rachael away. Without understanding autism, they saw it as a curse. Martha, on the brink of giving up, poured poison into a cup, vowing it would end their troubles. “I told myself it would be better if she died because that would mean she would rest and that would be the end of our problems,” she recalls, her voice trembling. Yet her heart clung to Rachael, and she wept, abandoning her plan.

Today, the pair share a tender moment in their home in Mzuzu, northern Malawi. Rachael climbs onto Martha’s lap, giggling as she watches her mother chop vegetables to serve with nsima, a maize-based porridge. The shift in their relationship is profound, made possible by access to specialized support. During visits to Mzuzu Central Hospital, Rachael was connected to Saint John of God, a Catholic-run organization offering mental health services and a school for children with special needs. This intervention became the family’s lifeline.

A Journey of Transformation

Martha and her husband also benefited from counseling, which helped them overcome isolation and connect with educators equipped to address Rachael’s challenges. Their experience underscores a broader need: over 60 million people globally live with autism, yet in Malawi, only two developmental pediatricians serve a population exceeding 22 million, and three consultant psychiatrists exist nationwide.

The term “autism” is absent from Chichewa, Malawi’s most spoken language. It is often translated as “ozelezeka,” implying mental disability, or “ofuntha,” suggesting troublemaking behavior. This linguistic gap perpetuates misconceptions, with many locals believing autism stems from witchcraft. In a nearby community center, religious leaders—both Christian and Muslim—gather to discuss these beliefs during Saint John of God’s awareness sessions.

A vicar, adorned with a gold cross, acknowledges that bewitchment is commonly thought to cause autism. Another participant claims magic can be cast on pregnant women, leading to the condition. Christopher Mhone, a representative from Saint John of God, uses these discussions to challenge stigma, emphasizing practical solutions. “For a woman to reach a point where she feels she should kill her child,” he says, “as a nation, we have failed her. Her burden has grown so heavy that she lacks the strength to cope.”

Malawi’s autism support primarily relies on the non-governmental sector. While basic assessments are available at district health levels, government-run programs remain limited. The story of Martha and Rachael offers a glimpse of resilience, showing how access to care can reshape lives in a country where understanding of autism is still evolving.