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Malawi: The good, the bad and the hopeful in health care

In this post we highlight some of what Malawian bloggers are writing about the country's health care issues. We look at bloggers describing developments in eye care, reflecting on midwifery, expressing shock over negligence in hospitals and government waste, and we end with rare good news about the HIV/AIDS epidemic.

Dr. Kalua examines Malawian kids. Photo: Vision2020 IAPB

Dr. Kalua examines Malawian kids. Photo: Vision2020 IAPB

We start with Dr. Khumbo Kalua, an eye care specialist, university professor and researcher. Dr. Kalua informs that The University of Malawi's College of Medicine has recently introduced a graduate training program in Ophthalmology. The number of ophthalmologists in the country has also increased, with three new ophthalmologists trained within the last two years. One of them is Dr. Khumbo Kalua himself. The new Minister of Health, who is also a new member of parliament, Dr. Moses Chirambo, is himself an ophthalmologist, and for many years was the only one in the whole of Malawi.

The new developments in the training program and increase in specialists are a result of a program known as Vision 2020 Right to Sight, which Malawi has been pursuing for a number of years now. Dr. Kalua writes:

Malawi has been active in VISION 2020 activities since 2000, and has successfully organised VISION2020 workshops for Malawi, Zambia and Zimbabwe.

Malawi completed the VISION 2020 five year Eye care plan in 2004, and progress has been made towards achieving goals to eliminating avoidable blindness by the year 2020 in Malawi.

Based on the 3 pillars of VISION2020, in terms of disease control, Childhood blindness was set as one of the major priorities and a Paediatric Ophthalmology unit was planned to be developed in Blantyre.

Another Malawian blogger also blogging about health care issues is Stabbily Msiska, a Malawian nurse currently studying in Norway. Stabbie, as she addresses herself, started blogging in March this year after arriving in Norway. Her 15 years as a midwife-nurse, she writes, have taught her about the simple, free things that matter to women whether in Malawi or in Norway:

As an experienced para 3, i really missed the support of a midwife who could greet me and put herself in my shoes during antenatal, labour and postnatal periods. Having travelled miles away from my home and live in this scandinavian country, i have really appriciated that there are some things that cost nothing but are important for all midwives to do in the whole world. A smile, greetings, giving of comprehensive information, explaining procedures, respect, empathy, sympathy.With these little non costly commodities, our hospitals will be wonderful places for women.

Malawian Nurse-Midwife, Stabbie Msiska

Malawian Nurse-Midwife, Stabbie Msiska

But health care in Malawi also presents difficult problems especially to ordinary Malawians who cannot afford expensive private doctors. Joe Mlenga writes about a distant relation of his who recently hanged himself to escape deep financial problems he was ensnared in. According to Mlenga, the man was still alive when people found him. They quickly took him to the hospital, where they found nurses and other medical personnel having their dinner.

They reporterdly went on with their business of eating the evening meal as Rogers lay in poor condition. By the time the medical staff had finished enjoying dinner and started to check on Rogers, he was no more.

Sadly, Joes writes, such stories of negligence are not uncommon in Malawian hospitals, as per an incident he personally witnessed.

On one occasion I personally saw a mother holding a very ill young son rush into the hall of the referall hospital in Blantyre, QECH, to alert medics about the need for a trolley or a wheel-chair. Nobody seemed to care and the woman ended up handling the trolley herself…she was later assisted by a minibus conductor whose vehicle had kindly agreed to make a diversion to the hospital!

Another blogger, Kondwani Munthali, expresses his frustration with a Government plan to study the feasibility of turning an old ship on Lake Malawi, the MV Chancy Maples, into a mobile hospital. According to Munthali, the idea has been proposed by some Scottish donors, who want the Malawi government to pay for the study at a cost of MK50,000,000 (US$357,143).

As much as I have respect for the Ministry officials K50 million can do a lot. Train at least 10 doctors, 200 medical assistance and 100 Nurses. Or better still can equip Lifuwu Hospital with drugs for five months.

How we lay our priorities should reflect the poverty and needs of Malawians. I find it very sick to spend over US$300,000 to conduct a feasibility study of a ship and may be another US1 million to rehabilitate and equip a vessel when there many urgent needs including a need for a cancer machine.

This sickness mr. president should be stopped. Save the lives of the poor first and let the Scots pay for their own pet projects without invloving the poor. How many people will the mobile hospital on the lake serve, how much will it cost to operate and how will it generate sustainance income. In the end we will spend more on maintaining this odl vessle over peoples lives.

The plight of the health industry in Malawi is making one blogger skeptical of the entire image Malawi is building about its economic gains in the last few years. Alick Nyasulu, an economist, raises questions about the much-touted economic growth Malawi is said to be experiencing. He argues that the economic growth is not benefiting ordinary people, especially the poor, as indicated by socio-economic ills which appear to be on the rise, including cases of armed robbery and domestic abuse. He particularly cites problems in health care as evidence.

An emergency case in Ntchenachena, Chididi and Mposa are a death sentence though the economy is growing.

Their is a health and education crisis in this country. Rich folks go to those elite facilities to access health services and education for their families. I am not being jealousy wish for the riches. Over 80 per cent of Malawi’s population lives in rural areas whose health centres are often manned by an enrolled nurse without adequate medication. Distances to such facilities plus the state of rural roads complicate the situation. I am not being sadistic but to say that health services are equally bad as education especially in the rural areas. Unfortunately, this is where the majority of our people live and resigned to a life that offers no hope and future.

For Mzati Nkolokosa, HIV/AIDS is still on the rampage, but there is light at the end of tunnel. He starts with the devastation the epidemic has caused:

I have lost friends and relatives to AIDS. This condition has devastated us. AIDS has killed professionals who will never be replaced.

Those of us with some knowledge of the University of Malawi understand that AIDS has devastated the education sector. As students we could see a professor losing weight, his hair becoming pale, missing classes, or a course being missed by students because a professor (the only one who can teach that course in Malawi), is not well.

Hard times. In my village in Liwonde, people with money are gone. Business men who were flourishing in late 1980s and early 1990s, are all gone.

He ends on a positive note:

Now there is hope. Treatment is making parents llive longer and raise their chidlren, kids who would otherwie have been orphans. Awareness is also high. My generation is making brilliant choices. Prevalence is now at 12.5 percent in Malawi.

But the sweeter news is that in the age group 5 to 11, prevalence is one percent. This means that if we can raise this age group with meaningful education that helps them avoid AIDS, we can create an almost AIDS free generation for the future.

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