- Category: Health
- Written by James Chavula
The security lapses in border districts which culminated into the murder of two Nsanje residents last month, has raised more questions over rural health facilities’ ability to retain skilled staff.
In what could be a security check for Sankhulani Health Centre near Malawi’s border with Mozambique in Nsanje, unidentified thugs stormed Zhugi Village in the neighbourhood on January 17, hacked businessperson Edward Gela and killed a guard on the spot. Gela later died at Trinity Catholic Hospital at Fatima in the district.
As police are searching for the thugs, one medical officer and two nurses on site say they cannot help asking themselves: How safe are we when we go on duty at night?
“We request the district health officers to rethink our security before we leave, like some ward attendants have already done,” says nurse-cum-midwife Melenia Mukongwa, flanked by her counterpart Loveness Msusa and medical assistant Alinafe Zaina.
The hospital may be fenced and guarded all day, but, like the surrounding settlement, it is engulfed by the bushy banks of the roaring Ruo River. From its midst, ears hear the hiss of the river, a leaky boundary with Mozambique. There is no police post. All cases are referred to Trinity Hospital, about 20km away. In a blow to rapid response, the wireless message facility is no longer functioning. Whereas townspeople have an alternative in four mobile phone networks, the mobile phone networks in the locality are erratic.
“A police unit would help reinforce security and protect lives, patients as well as the health centre from robbers,” says Msusa, who has worked at the hospital for four years during which thugs attacked Trinity Hospital and got away with bags of soya flour meant for malnourished children.
The security flaws will further frustrate the health personnel already burdened by an influx of patients, malfunctioning solar electricity system, poor roads, lack of ambulances and high costs of accessing banks.
During the payday visit, each of them spent K1 000 from their salaries on cyclist who ferry them to and from banks at Fatima. In the absence of an ambulance, guardians and concerned citizens have to carry critical patients, including pregnant women with delivery complications, on a stretcher all the way to Trinity.
The noticeboard shows the clinicians’ departure would put at risk lives of 7 223 Malawians who rely on the facility. The staff say the health centre also serves a population almost double as much from Mozambique.
A blow to provision of quality healthcare services would also affect safe motherhood, as they say women usually deliver on the way to Trinity and others, especially Mozambicans, have pregnancy-related complications because they delay to seek medical attention.
For every normal birth, there are two pregnancies with complications referred to Fatima, they say.
While assuring the health centre of a serious security review, district health officer Dr Medson Matchaya says his office stationed an ambulance at Masenjere Health Centre to cater for Sankhulani and, Makhanga where patients used to travel about 56 km to Nsanje via the flood-prone, potholed East Bank Road.
Still, shouldering stretchers evokes the scene Chikongwa admittedly encountered as a relief nurse at Sankhulani in 2005.
Says she: “I am at Sankhulani because I was touched by the plight of pregnant women. One of them left around 10am only to arrive at Trinity around 3pm. She had a successful operation, but the baby died. It is sad she lost the baby after all the struggle.”
Masenjere Health Centre in-charge Ian Kalonga says the ambulance is usually off-road due to lack of fuel and maintenance.
“We only get 80 litres per month when the vehicle needs about 200 litres. When well-wishers are not forthcoming, guardians hire private vehicles to take their patients to Trinity,” says Kalonga.
Matchaya says the district is heavily underfunded. And Zodiak Broadcasting Station recently reported that church-owned referral hospital had stopped serving cases from public hospitals because the district council owes it K6 million.
Matchaya says plans are underway to upgrade Makhanga to a public referral hospital, insisting that Trinity is admitting poor patients because the debt is being seriously looked into and the service level agreement with government still stands.
But also begging serious scrutiny is the security of health services in border areas. At Chapananga in Chikhwawa, Chang’ambika Health Centre is almost closed since skilled medical workers left amid fears for their lives in a valley which runs between their houses and the clinic.