Vain diagnosis for the poor
When healthcare workers prescribe medication for an ailment, the expectation is that the patient will access medicines to get better.
However, for at least 52 percent of Malawians with no private medical insurance, they cannot access medicines from public hospital drug stores due to shortages chiefly caused by erratic funding.
Miriam Ndau and Mavuto Msiska can testify to this. They went to Mapale Health Centre in Mzuzu City in pain, hoping to get quality treatment, but returned home empty-handed, dejected and in more pain.
Healthcare workers at the public facility could only ask them to buy drugs from private pharmacies. The pair is worried about the deepening shortage of essential medicines, which leaves poor Malawians at risk of dying from treatable conditions.
Ndau, a 32-year-old single mother of twins in Mzuzu City’s Salisbury Lines, has been in pain since June when she was operated on her left arm.
When the pain surged, she rushed to the nearest health facility for free medical assistance.
The off-pocket payment for drugs deepened her agony as she has been raising the twins single-handedly since her husband migrated to South Africa in 2017. She now stays with her mother, selling vegetables to meet her everyday needs, including medical care.
“After the operation in June, I couldn’t wash my clothes or bath. I need my mother’s hand to do things I used to,” she explains.
Ndau was asked to buy K1 500 painkiller called diclofenac from a private drugstore as the health centre reportedly had none.
She wonders what remains for poor Malawians if public facilities cannot dispense painkillers.
On the other hand, Msiska, 30, from Sonda on the outskirts of Mzuzu City, limped to the public facility on Monday this week after stepping on a rusty nail last Friday.
However, he was told to go back on Tuesday after receiving Ibuprofen painkillers and ‘requested’ to buy fragile worth K1 000 from a private pharmacy.
“My boss gave me K300 to buy a health passport. I hoped to get all medicines for free, but I now have to go back and ask for more money because I am in pain,” said Msiska.
A similar drug shortage plays out at Karonga District Hospital where a man was spotted rushing to private drug stores around 11pm to buy cotton, syringes and tubes for his pregnant wife.
The woman was waiting to deliver their third daughter through Caesarian section.
“I had to run up and down to source these medical items. Luckily I found them around 1am. I spent about K37 000,” said the sweaty man.
For pre-childbirth checkups, the couple also needed out-of-pocket spending for services public facilities dispense free of charge.
Last week, the drug scarcity in Karonga compelled Mary Mkandawire to buy a syringe and Diclofenac after a scorpion bit her. As the hospital had none she spent K10 000, enough to buy her relish for five meals.
“My husband was also compelled to buy plaster of Paris for a boy who fractured his leg while playing football. His parents couldn’t afford K3 000,” she said.
In an interview, Karonga District Hospital senior medical officer Dr Clara Mhango said drug shortage in public hospitals is rife because “the Central Medical Stores Trust [CMST] doesn’t have them. Second, we cannot purchase enough due to limited finances”.
She said the financial squeeze makes it almost impossible to refer patients to Mzuzu Central Hospital, more than 200 kilometres away.
“The burden falls on the patient and guardians to source about 70 litres of fuel to be transferred to Mzuzu,” she explained.
For the trip, the ambulance burns fuel worth K134 400, more than twice the K50 000 minimum wage prescribed by the government.
Mhango appealed for adequate funding for public health facilities.
During a recent Sleep Over Challenge under Nation Publications Limited’s Mother’s Fun Run at Chintheche Rural Hospital in Nkhata Bay, Melifayi Mhone decried the deadly delays experienced by patients and pregnant women told by helpless health workers to go and buy essential drugs from private pharmacies.
“Where will a pregnant single woman get instant money for drugs? Most of us cannot even afford usipa on the shoreline,” lamented the guardian.
Meanwhile, the 2023 global monitoring report by the World Health Organisation (WHO) shows that Malawi is off track to ensure that by 2030 everyone accesses quality health services close to where they live without experiencing financial hardship.
Seven years to the deadline, the Universal Health Coverage dashboard shows that 52 percent of Malawians are excluded.
During a meeting with the private sector captains, Minister of Health Khumbize Kandodo Chiponda recently conceded that Malawi is failing short of the WHO requirement to spend $86 (about K89 000) per person every year.
