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Patients die, denied treatment through negligence

On March 23 2024, heavily pregnant Lekeleni Kangola, 23, walked to Nsambe Health Centre in Neno District, expecting her fourth child.

She went into labour while at the health centre, about four kilometres from her home at Chimbalanga Village, Traditional Authority (T/A) Dambe in the district.

Enifa Nyambalo and her husband are left without option following the death of their daughter.

But a few days later, this once sparkling mother of three was pronounced dead on arrival at Neno District Hospital where she was later referred to.

Health practitioners managed to save her baby who was delivered through caesarean section.

But her guardian, Enifa Nyambalo, 42, rues the nightmarish five days her daughter spent at the health centre where her health deteriorated in the presence of health practitioners she claimed had abandoned her.

“Doctors [practitioners at the health centre] told us she was not in labour. I was surprised because it was her ninth month and she had shown all signs of labour, including loss of mucus plug.

“I have given birth to eight children and I know when someone is in labour and it was the fourth for Lekeleni. Doctors kept telling me they know when a woman is in labour; hence, I should not tell them what to do,” she said

Meanwhile, the health practitioners’ passivity and sheer negligence, according to Nyambalo, sucked her daughter’s life out.

“Lekeleni became weak, vomited and lost water. I realised I might lose her. So, I told doctors to transfer her to Neno District Hospital, but all my pleas fell on deaf ears.

“They told me I should find my own means of transport. I went looking for a motorcycle to take me to Neno, but I was charged K12 000 one way. I tried to source money and borrowed K8 000 which was not enough. The kabaza guy did not accept my K8 000. I gave up,” she said.

On the fifth day, Nyambalo said her daughter slipped into unconsciousness and upon hearing about it, the health practitioners rushed to check on her daughter, but it was too late.

“They called for an ambulance and we were taken to the district hospital,” she said.

The next 27 kilometres of tortuous driving to the district hospital, through a rugged road, was depressing for a mother whose life was on edge.

Her baby was six months old at the time Nation on Sunday visited the grandmother.

“It has been a challenge raising her and I feel bad because she will not know her mother. Her death was avoidable and organisations should investigate it,” she said.

Lekeleni’s story represents situations that happen across the country when patients visit public hospitals to access medical services.

The 29th Annual Report of the Ombudsman Office for January 1 2023 to December 31 2023 established that in Malawi, more people are mistreated in the health sector than other departments.

It also established that 27 percent of recorded complaints came from the health sector followed by the education sector with 24 percent.

“Disrespectful addressing of expectant women, demanding of payment for free service, especially on cases requiring surgery and family planning, inadequate health personnel and drugs in health facilities negatively impact the delivery of public services.

Lack of knowledge on the operations of the health facilities on the part of the community members are some cases recorded,” reads the report in part.

Last year, another woman and baby died at Dedza District Hospital and the husband blames hospital officials for the deaths.

However, the husband who is currently staying in South Africa, refused to grant an interview, saying he is traumatised.

In February last year, an expectant woman from Machinjiri, Desire Mulose, 30, went to South Lunzu Health Centre in Blantyre for medical attention.

She said after staying at the hospital for five days, she decided to leave.

When we visited her at about 7pm, there was no doctor around.

“I am in pain, but doctors keep telling me to wait. It’s now five days and I need to find a solution,” she said.

Mulose and her husband returned to her home village in Ntcheu where she gave birth to a baby boy on the second day after arrival.

Frighton Kampiru from Bamba Village, T/A Phambala in Ntcheu claimed his father was sent back from Phalula Health Centre.

“He was unconscious, vomited and had diarrhoea. I was told that doctors had knocked off so I should return the following day. I pleaded, but to no avail. I boarded a lorry to Balaka District Hospital and he was admitted there,” he said.

Kampiru noted that Phalula is their nearest health facility, about 15 kilometres from their village, yet he could not be helped.

Another man, Lupiya Jemba, 41, from Mussa Village in T/A Phambala, Ntcheu, also narrated an incident at Balaka District Hospital on September 25 this year.

“I had a tooth problem which needed to be removed. I tried three times to be helped and on the third day, I was told there was no power. As I was leaving, a hospital official approached me and said he could help if I paid K7 000.

“I refused to pay, but he kept pestering me with calls, reducing the offer to K6 000. I was in pain and had travelled over 50 kilometres. I only had K4 000 for transport,” he said.

Jemba claimed there were at least 20 people at the hospital with dental problems who were offered help at a fee.

Neno District Hospital spokesperson Caroline Banda said there was no need to transfer Lekeleni to another hospital because she was not in danger.

“On assessment, she was in latent phase of labour, meaning it had started, but was not well-established and there was no danger necessitating immediate referral to a higher facility.

“She was advised to move around which helps in labour. A second assessment showed she had developed a fever, her blood pressure was slightly raised and tested positive for malaria,” she said.

Banda claimed Lekeleni was later transferred to the district hospital after being treated.

“Doctors prescribed antibiotics for her, but she died before administration,” she added.

Medical Council of Malawi (MCM) director of professional practice and regulatory enforcement Richard Ndovie said they are not aware about the Neno and Dedza incidents, but promised to investigate.

In November last year, MCM suspended two medical practitioners for one year aand fined and warned others for various offences, including professional misconduct.

Those suspended were Webster Chinkhandwe, a clinical officer at Bwaila Hospital and Symon Kizito Ntholo, a laboratory technician at the African Bible College Clinic both in Lilongwe.implications.

Health rights activist and Malawi Equity Health Network executive director George Jobe said the Neno case needs to be investigated.

“There are good people working in our hospitals, but we have some demanding money, delaying in providing treatment and some women delivering on their own.

“Also, we need awareness to patients aware that old hours are for emergencies. However, health care workers should also not refuse to attend to them because they came late,” he said.

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