‘A good road saves lives’

Sickbeds at Chitipa District Hospital were mostly deathbeds when Fraction Sinyiza was born in 1975.

“The hills and valleys comprised thick bushes, where a bumpy, narrow road was the only sign of civilisation,” recalled Sinyiza.

The narrow road tore through the natural forests, where accidents and breakdowns were frequent.

“It was not strange to see people giving birth and dying while travelling or waiting for vehicles to Chitipa or Karonga,” he recalled.

The grower of maize, cassava and millet was coming from his crop field when we met near Mwapu Bridge on the Chinese-built Bingu Highway.

Until four years ago, he farmed not knowing where he would sell his yield as the rugged road hampered transportation of his yield to viable markets.

“It is incredible a journey to Karonga takes just an hour or less,” he says.

Certainly, this constitutes a huge saving on the time and money he used to spend travelling.

Some Chitipa residents are using the saved hours to attend to their crops, livestock, businesses and their other economic activities.

But Sinyiza reckons the major savings are happening on the healthcare front following cutbacks on time spent travelling to health facilities, and deaths that used to be experienced.

“Health facilities were far away and ambulances mostly inaccessible. Patients were dying in overloaded lorries while women in labour were giving birth on the way, with no skilled health worker in sight.”

Long travels to clinics remain a major setback to ensuring no woman dies while giving birth.

The Ministry of Health reports that the birth of every 100 000 live babies in the country culminates to the death of 574 women.

“Reducing the distance and time pregnant women take to reach clinics and ensuring every woman delivers with the assistance of skilled health workers would lessen maternal mortality rates which are still very high,” said former Minister of Health Peter Kumpalume in an interview in Neno District a couple of months ago.

Chitipa, Neno and Likoma were the only districts with no tarmac road five years ago.

Following commissioning of the Karonga-Chitipa Road in 2013, Minister of Transport Jappie Mhango says the government of China has set sights on bankrolling the construction of a tarmac from Neno to Tsangano Trading Centre on M1.

As the wait continues, health workers at Chitipa District Hospital say patients pronounced dead on arrival and women suffering severe maternal complications are getting fewer.

This year, the Ministry of Health named the district hospital as a ‘centre of excellence’ in terms of reproductive health and infection prevention.

“The road has drastically reduced the time patients used to take to get to the hospital. This has increased survival chances of critical patients referred to Mzuzu Central Hospital [MCH],” says Seleman Kondowe.

Before the tarmac road took shape, ambulances were taking almost four hours to get to Karonga—notwithstanding incessant breakdowns.

Now they take almost an hour.

The 75 percent cut on time spent on the hilly stretch means patients in life-or-death situations can make it to Mzuzu Central Hospital alive.

On the 93-km road, we met an ambulance carrying six critical patients on referral.

As the ambulance sped to the Northern Region’s largest hospital, Kondowe put the savings in context: “By saving three hours on the Chitipa-Karonga leg, we have cut back on referral time by half.”

Also dipping are the costs of running the ambulances.

“Currently, each ambulance needs 40 litres of fuel to get to Karonga. Previously, we needed twice as much as the vehicles were using low gears to beat the bumps and steep slopes,” says the nurse.

The emergency cases dispatched to Mzuzu often include patients hit by heart attacks, kidney failure, lung complications, head injuries and bowel obstruction.

“These patients often require oxygen ventilators, so reducing travel time is part of saving their lives. Most of them end up in the intensive care unit (ICU). If you run out of oxygen on the way, you will lose them. The bumpy road of old posed a big risk,” says Kondowe.

The health worker is convinced that a good road is a vital ‘life-saver’.

But only the minority living by the roadside could be reaping the fruits of the Chinese investment in the district, he says.

Chitipa—with a population of almost 230 000—is served by two ambulances and 10 health centres which are far apart and marked with rugged dusty roads.

Kondowe said rural patients will keep dying of treatable conditions unless roads in rural areas are improved too. Two thirds of the country’s population live in rural areas.

Throughout the country, rural populations are haunted by high disease burden and low numbers of health workers.

Of the far-flung health centre, only Msumbe, near the sprawling rice fields of Ngerenge in Karonga North, is easier reached using the Bingu Highway than a shorter, unpaved road via Misuku Hills in Chitipa.

By contrast, Nthalire Health Centre is located 115 kilometres off the Chinese-built road. Critical patients from the countryside use a jagged earth road to get to the District Hospital.

Traditional Authority Nthalire wants government to fulfil its promise to upgrade the Rumphi-Nthalire-Chitipa Road, which has become “a political song’ as was Karonga-Chitipa Road before the Chinese intervened.

He laments: “We have been crying for this road for many years, now we are not sure if those in power know it is as important as we think. When ambulances are not around, people pay extra cost to ferry the sick to Chitipa.

“When they die there, it becomes costly to transport the corpse. Last year, I had to intervene when minibus operators held on to a corpse because the bereaved family had no money to pay for it.”

In interview, Minister of Transport and Public Works Jappie Mhango said government, with funding from the Arab Bank for Economic Development in Africa (Badea), is conducting studies to come up with costs, designs and social impacts of the Rumphi-Nthalire Road.

“The construction of Karonga-Chitipa Road mirrors the good relationship between the peoples of China and Malawi. Government is determined to open up rural areas. This is why we have paved roads to Misuku Hills and Nthalire, which were almost impassable. The upgrading of the road from Rumphi to Nyika National Park will be extended to Chitipa via Nthalire,” he explained.

But Chitipa District Council chairperson Isaac Mwape aptly captures the mood along the Bingu Highway.

“As we wait for more roads, we commend China for coming to our rescue. China did well. China has liberated us. The road is saving lives,” said Mwape.

This work was produced as a result of a grant provided by the Africa-China Reporting Project managed by the Journalism Department of the University of the Witwatersrand.