The darkness before the light

Rachael, a non‑verbal child who bites and cannot sit still, was diagnosed with autism. The diagnosis gradually overwhelmed Martha Ongwane, leaving Martha Ongwane desperate and depressed.

Neighbours in the east African nation of Malawi shunned Martha Ongwane, blaming Martha Ongwane for Rachael’s behaviour. Community members told Martha Ongwane to lock Rachael inside the house.

Sympathy was scarce, and understanding of autism and appropriate treatment was practically nonexistent.

Martha Ongwane describes a moment when Martha Ongwane poured poison into a cup, intending Rachael to drink it.

“Martha Ongwane told herself it would be better if Rachael died because that would mean Rachael would rest and that would be the end of our problems,” Martha Ongwane recalled.

“But Martha Ongwane’s heart didn’t let Martha Ongwane. Martha Ongwane changed Martha Ongwane’s mind and cried so much,” Martha Ongwane said softly, looking down at Martha Ongwane’s hands.

A glimpse of hope in Mzuzu

Two years later, Martha Ongwane and Rachael share a loving domestic moment that is hard to imagine from the earlier darkness.

Rachael clambers onto Martha Ongwane’s lap as they sit on the floor of their home in Mzuzu, northern Malawi.

Rachael laughs, hugging Martha Ongwane’s face, while Martha Ongwane, now 33, cuts vegetables to serve with nsima, a thick porridge made from maize, for lunch.

The transformation is extraordinary and can be largely credited to the family’s access to expert care.

During one of many visits to Mzuzu Central Hospital, Rachael was referred to Saint John of God, an organisation that assists disabled children.

Funded mainly by the Catholic Church, Saint John of God provides community‑based mental health services and operates a school for children with special educational needs. Saint John of God became a lifeline for Martha Ongwane’s family.

Martha Ongwane and Martha Ongwane’s husband also received counselling through Saint John of God.

Once isolated and stigmatised, the couple found a support network and educators capable of addressing Rachael’s challenges.

Global autism landscape

According to the World Health Organization, Rachael is one of more than 60 million people worldwide who are on the autistic spectrum.

Autism, or autism spectrum disorder, is a neurodevelopmental disability – meaning it affects how the brain develops – and it influences how people communicate, relate to others and process the world around them.

The condition exists on a spectrum, affecting individuals in different ways and to varying degrees.

Many autistic people show characteristics such as intense focus, strong memory and innovative thinking.

In countries where spending on mental health and behavioural disorders is not a priority, often only those with extreme behavioural differences are noticed, and that visibility brings stigma and discrimination.

Malawi’s stark resource gap

In Malawi, there are just two developmental paediatricians for a population of over 22 million people, and three consultant psychiatrists.

The word "autism" does not exist in the country’s most widely spoken language, Chichewa. It is often translated as “ozelezeka,” meaning someone who is mentally challenged, or “ofuntha,” meaning someone who is troublesome.

A host of misunderstandings about autism persists across Malawi.

Changing perceptions at Saint John of God

In a community centre not far from Martha Ongwane’s home, religious elders—both Christian and Muslim—gather on green plastic chairs for an autism awareness session run by Saint John of God.

Many participants believe witchcraft is a root cause of autism, and the discussion begins with attendees sharing what they think.

A vicar, wearing a large gold cross, states that everyone knows people can bewitch each other. Another man stands and claims magic can be used against pregnant women, resulting in children with autism.

Christopher Mhone, a representative of Saint John of God, acknowledges the limited understanding of autism but uses these sessions to nudge participants toward a different view, showing that practical interventions can alleviate symptoms.

Reflecting on Martha Ongwane and Rachael’s case, Christopher Mhone says, “For a woman to come to a point where she feels like she should kill her child – as a nation we have failed her. Her burden has become so impossible to bear that she does not have the emotional and psychological capacity to cope.”

Christopher Mhone notes that most autism support in Malawi is provided by the non‑governmental or charitable sector.

Basic mental health services such as assessment and referral are accessible at district and primary‑care levels, but there is only one government‑run psychiatric referral facility in the whole country – Zomba Central Hospital.

“Autism is not even mentioned in the Disability Act. For me, that tells you about the issue of visibility of the problem. If you don’t know you have this problem, there’s no way you can begin to sort it out,” Christopher Mhone explains.

The Global Reporting for Environment and Education (GREE) contacted Health Minister Madalitso Baloyi to request an interview about national provision for children with autism but did not receive a response.

Turning to traditional healers: the story of Natasha Lusinje and Shalom

Access to quality healthcare is limited in Malawi, prompting many families to turn to traditional healers and witch doctors as the first point of contact for any medical or mental‑health problem.

Natasha Lusinje, a mother from an area 300 kilometres south of Mzuzu, took her five‑year‑old son Shalom to a traditional healer after hearing that Shalom was “bewitched.”

Shalom, who is non‑verbal and cannot feed himself, sits playing alone in a barren compound outside the capital, Lilongwe.

“There are so many people who have told me this child was bewitched. People magically tied his tongue so he could not speak,” Natasha Lusinje says.

Nearly three‑quarters of people in Malawi believe in witchcraft, and Natasha Lusinje is among them.

For Natasha Lusinje, witchcraft offers both an explanation for Shalom’s behaviour and a solution.

Natasha Lusinje decided to take Shalom to a traditional healer, Maness Sanjelekani, in search of a cure. GREE Africa Eye was granted rare access to the experience.

Traveling by bus to the healer’s home on the outskirts of Lilongwe, Natasha Lusinje observed Maness Sanjelekani, who wore a long white dress, face turned toward the wall, and began chanting: “We give praise to you God this evening, as you have sent your lamb seeking for healing here. Because he doesn’t have a soul, because evil people from the dark did this to him.”

Maness Sanjelekani has no medical qualifications but claims there are two types of autism – one from God, which cannot be changed, and one from Satan, which can be healed. Maness Sanjelekani says Shalom has the latter.

The claim is completely unfounded medically and scientifically.

Natasha Lusinje handed over 26,500 kwacha (about $15) and, over three weeks, Shalom was bathed with herbs and forced to drink herbal remedies daily, yet Shalom remained non‑verbal. Natasha Lusinje was also instructed to use a “treatment” that involved making small cuts on Shalom’s skin.

When confronted about the practice, Maness Sanjelekani denied any form of child abuse, stating, “I can only say I am trying to save his life. I am trying my best to save him.”

When asked about the claim of two types of autism and accused of running a scam, Maness Sanjelekani replied, “Let me just accept I have failed this child.”

Natasha Lusinje eventually took Shalom home but continues to cling to the belief that God will help find a cure. For Natasha Lusinje, that faith remains the only hope.

Life at Saint John of God’s school

Back in Mzuzu, Martha Ongwane helps Rachael get dressed in a blue‑and‑white chequered school uniform. Rachael has been attending a Saint John of God school for a year.

The Mzuzu facility has the capacity to help more than 600 children a year.

Rachael is learning to speak, and when her name is called in class, Rachael jumps up, grabs a friend’s hand and encourages the friend to stand and sing together.

In the well‑maintained gardens, young adults – some with Down’s syndrome, others with cerebral palsy, and some with autism – carefully tend crops.

“I want us to conceptualise disability in a positive way,” Christopher Mhone says.

“Disability is ability, in a different way. And if society begins to understand that, then there will be less stigmatisation, and they will be looking at the positive things that can come out of those with disabilities.”

Reflections and a message of love

Martha Ongwane can hardly believe the change in Rachael and in their lives.

Martha Ongwane shares this story in the hope that it will help other mothers and wishes Martha Ongwane had received help sooner.

“When Martha Ongwane looks at Rachael, Martha Ongwane feels so guilty. Every day Martha Ongwane thinks about the fact that Rachael could have been dead,” Martha Ongwane says.

“Martha Ongwane adores Rachael now.”

Go to GREEAfrica.com for more news from the African continent.