Late in 2007, Benson Chabwera was hired as a security guard by Partners In Health, not long after PIH had begun its partnership with the Malawi government to strengthen the health system in Chabwera’s home district of Neno.
Chabwera was in his late 20s at the time. He had been married to Vaida Zilozo for about four years and they had a 3-year-old daughter, with another baby on the way. Chabwera started on the night shift for PIH, known in local Chichewa as Abwenzi Pa Za Umoyo, or APZU.
About five months into the job, Chabwera got an additional opportunity. The National Statistical Office of Malawi wanted him to help with the country’s population and housing census, conducted once a decade. Because that work would be in the daytime, Chabwera reasoned, he could do it while continuing to work his PIH security shifts at night.
Sleep was not a factor in his reasoning.
“I slept on the weekends,” Chabwera recalled.
The decision to take a grueling second job reflects a work ethic and drive that has propelled Chabwera through a series of achievements with PIH, and life, in the 10 years since. Now 37, Chabwera is one of the most well-known and well-liked faces around Neno District—and has transformed himself from a security guard with a high school education into a manager of more than 600 health workers, a graduate with advanced degrees, a pillar of local access to health care, and a strong advocate for PIH’s patient-first model and community-wide impacts.
Basimenye Nhlema, community health director for PIH in Malawi, described Chabwera as “completely hilarious and friendly,” and a compassionate, respectful supervisor.
“Benson is a pure joy to be around, a ball of energy, always ready to move and work,” said Nhlema, who joined PIH two years ago. “From the time I have worked with Benson, I have found him to be quite committed, dependable, hands-on and considerate.”
Since 2013, Chabwera has been a community health worker (CHW) program officer, one of two for PIH in Neno District. He oversees nearly 100 senior CHWs and more than 500 CHWs, who go home-to-home in their communities to visit families, provide access to services and serve on the frontlines of health care delivery.
CHWs are the foundation of PIH’s work in Malawi, and in the 10 countries where PIH works. In Malawi’s Neno District—a region so isolated that native Malawians will tell you, “If you’re not from Neno, you don’t know Neno”—PIH supports two hospitals and 12 health centers, working to reduce high rates of maternal deaths, HIV, malaria, malnutrition, and more.
Henry Makungwa, CHW program manager for PIH in Malawi, said CHWs in Neno are selected in their communities, by their communities, to serve among their friends, family members and neighbors. More than 1,200 CHWs in total work across two Neno regions—upper and lower, or the district’s mountains and its flatlands.
Chabwera’s position in upper Neno regularly takes him across rugged, mountainous terrain, where dirt roads are rock-filled and steep at best, and flooded or downright impassable at worst, depending on the season.
His position also requires him to navigate complex interpersonal relationships, a challenge familiar to any manager of a large staff, anywhere.
“We have an army of over 1,200 CHWs, so conflicts, issues and grievances are always on the table,” Nhlema said.
She said a particular situation stuck in her mind.
“I remember when I had just joined and we were deciding what to do with community health workers who did not meet the new selection criteria,” Nhlema said. “It was clear that based on the needs of the program, we had to lay off those CHWs who were unable to read and write, and I remember vividly the pain and emotional struggle that Benson went through to accept that decision.
“I recall him trying very hard to negotiate other ways out for CHWs,” she continued. “I see this attribute in him a lot, where he shows tremendous concern for the welfare of CHWs. If I had to summarize his role in the organization, I would say he is a defender of CHWs and the work they do—and I find this totally reassuring.”
Limiting people’s employment opportunities because of a lack of education—likely stemming from a lack of access and other ingrained societal factors—struck close to home for Chabwera.
He said he had only a certificate of education, equivalent to a high school diploma in the U.S., when he first joined PIH in 2007.
“Initially, I did not know really anything about computers, like the difference between a laptop and a desktop,” he said.
The stability of his job at PIH empowered Chabwera to pursue higher education on weekends. He and Makungwa traveled to the city of Blantyre every Friday for months, taking classes on Saturdays and Sundays before returning to Neno for the work week.
They initially paid for their own food and transportation, while urging PIH to rent a house in Blantyre for employees attending school. PIH eventually agreed to the arrangement, which is still in place.
“We were among the pioneers to advocate for support from the organization when we wanted to pursue higher education,” Chabwera said. “If you go to Blantyre, you will see that there still is a guest house. A lot of people have benefited from that house. A lot of people are still going to school.”
PIH’s investment has paid off for numerous staff members, including Chabwera.
“Right now, as I am speaking, I have a certificate in accounting plus an advanced diploma in rural and community development—I don’t take that for granted,” Chabwera said. “It wouldn’t have been possible without PIH. It took me from point zero to maybe point 100.”
And he's still climbing. Nhlema said Chabwera is one of many PIH staff members, including several supervisors, who have signed up for an online course this spring through the University of Washington, called "Leadership and Management in Health." The 12-week course runs from April through June.
"I believe this is a huge milestone and will propel him even further," Nhlema said.
Over the years, Chabwera's responsibilities with PIH have grown with his education.
Makungwa said when Chabwera joined the community health department in 2009—ending his tenure as a security guard—he was posted at Magaleta Health Center, where he supervised CHWs in that facility’s catchment area.
“His interaction with the CHWs as well as the facility’s leadership was superb,” Makungwa said. “He cultivated a very good working environment with different stakeholders, including village chiefs, faith-based organizations and village health committees, just to mention a few.”
His strong performance at Magaleta earned Chabwera a transfer to the Neno District Health Office, in the central community known as the “Boma,” with a larger catchment area and greater number of CHWs. His commitment and hard work continued, leading to Chabwera’s promotion in 2013 to his current role of CHW program officer in upper Neno.
Kelly Lue, who recently worked in mobile health and research for PIH in Malawi, said the depth of Chabwera’s experience was evident, for example, when members of PIH’s CHW team in Liberia visited Neno for a training event in March 2018.
“Benson's encyclopedic knowledge of our CHW program was evident from the very beginning. Because of that knowledge and his warm, kind, and hilarious personality, he is an invaluable asset to the CHW team and to APZU,” Lue said. “On one outing, we visited a superstar CHW and Benson translated between her and the Liberia team, so they could ask her questions about her daily work. The conversation was filled with laughter and smiles. It was clear that Benson and the CHW had a great rapport.”
Walking around central Neno with Chabwera, it’s easy to see where that rapport comes from. He’s the kind of person who can’t walk very far without greeting friends and neighbors, and sharing a kind word or laughter with all of them.
“His interactions—especially with community leaders and community members—are always mature and tactful,” Nhlema said. “Since he is originally from Neno, he understands the people and their communities, hence his ability to carefully maneuver through the cultural nuances of our catchment areas.”
Chabwera’s parents moved to Neno from Mulanje District in 1981, the year Chabwera was born, in search of better land for cultivation. Neno has been Chabwera’s home ever since—and he’s continued his parents’ tradition of working the land. Over the years, he’s grown crops including corn; soybeans; Irish potatoes, known as mbatata; onions; tomatoes, and more.
While Chabwera said he’s reduced his farming lately, because the revenue isn’t always strong, another kind of growth has continued all around him. A school, new homes, health facilities, better roads, and a larger market all have sprung up in Neno’s central Boma in recent years.
Chabwera said the cause is clear.
“All these structures you see, it is because of PIH,” he said, citing the local impacts of an influx of PIH staff; expansion of PIH-supported Neno District Hospital; more than 100 homes for impoverished local residents, built by PIH’s program on social and economic rights; and the development of jobs and infrastructure, related to all those factors.
In addition to his wife and four daughters—of whom Chabwera is unfailingly proud—Neno also is home to Chabwera’s five siblings, and their children. Chabwera originally was the sixth child of eight. Two of his sisters have passed away. He now is doing all he can to support his extended family, along with his extended community.
And when the once-a-decade census came around again last fall, adorning homes with chalk-written numbers in villages across Neno, Chabwera didn’t have time to participate.
“This is my home district,” Chabwera said. “Working with my fellow community members, providing support to my fellow brothers and sisters, being able to serve and improve people’s lives—that’s what inspires me.”