Waiting for surgical sutures

At 11 months, little Monica Gondwe will have to endure the pain of having hernia until February next year for she cannot undergo surgery until enough surgical sutures are available at the hospital.

Rumphi District Hospital has been hit with shortage of surgical sutures. According to a member of staff at the hospital, the facility has since stopped carrying out surgeries except for Caesarean section on expectant women.

Monica’s intestines are protruding through her belly button, a condition called umbilical hernia. The condition is common in infants and is usually inborn but it may also arise in adults.

The baby’s mother, Ruth Nyasulu from Bondi Village Traditional Authority (T/A) Chikulamayembe in Rumphi, says her daughter was born with the condition.

“When the pain starts, she cries incessantly that I have to stop everything I am doing and attend to her,” says the 36-year-old mother of six.

According to a medical staff who opted for anonymity, the hospital has had the problem for about a month and currently some cases are being referred to other hospitals while other cases are being assigned to later dates depending on their seriousness.

Nyasulu said she was very disappointed when she was told to come back in February for the surgery as she wants her daughter to get better and to have a normal childhood.

“Her condition sometimes makes her the centre of attention in public places because when she cries or coughs, the bulge on her bellybutton gets bigger,” says Nyasulu.

The mother says she has no choice but to wait until February.

Hernia is common in infants, although it does not have serious complication in infancy but in adulthood. In some cases, affected infants may experience pain if the hernia is serious. It is a condition where internal body parts find their way through thin layers of the body, especially intestines that come out through the bellybutton like in the case of Monica.

Rumphi district medical officer Dr Jonathan Chiwanda Banda confirmed that the hospital is indeed short of surgical sutures but said the problem is not too bad.

“We are still conducting surgical operations, but only the elective operations are the ones that are not prioritised,” said Banda, adding that they get some of the sutures from surrounding health centres when they have run out.

The hospital serves a population of over 200 000 people in the district, which has about 11 health centres including those belonging to the Christian Health Association of Malawi (Cham).

“We have not received surgical sutures for the months of November and December from the Central Medical Stores Trust [CMST] and we reported the issue to them and the processes of procuring the equipment is underway,” said Banda.

The hospital expects a delivery of medical equipment between the 5th and 10th of every month.

Banda said complicated cases are referred to Mzuzu Central Hospital because they do not have the capacity to do the operations.

“During the festive season, we experience low staff turnover because most of our staff members go on holiday and it is another factor that makes us to refer elective cases to later dates,” he said.

According to the doctor, the hospital is only doing what hospitals do when resources are limited.

“We said they explain the situation to the patients as per their rights, and the patients are given a choice to go to other hospitals if they have the capacity to,” he said.

CMST public relations officer Herbert Chandilanga said Rumphi District Hospital ordered a variety of surgical sutures and they gave them a few of them because some of the sutures they ordered were out of stock.

“The hospital asked for a variety of surgical sutures and we only gave them the ones that were available. We have placed a special order for the remaining sutures and the procurement processes for the sutures are underway,” Chandilanga assured the hospital.