The 2013 plunder of public funds, dubbed Cashgate, continues to haunt Malawi’s health sector with several health centres across the country remaining in unfinished conditions for years now.
Mangochi is one of the districts feeling the pinch after one of its health centres, Kanyenga, whose construction was nearing completion, got abandoned after donors pulled out in the wake of the massive theft which also saw direct budgetary support being suspended.
The affected facilities are those which were being constructed under the Umoyo Project, a housing initiative whose object was to construct health centres and healthcare workers’ houses across the country.
Hundreds of millions of kwacha had already been spent on the construction of Kanyenga Health Centre—which was billed to significantly reduce the distance locals in the area cover to their nearest clinic some 30 kilometres away.
Ministry of Health spokesperson Adrian Chikumbe said in an interview that the construction of Kanyenga Health Centre and several others, which stalled after donors pulled out, were revived under the Health Service Joint Fund (HSJF).
“[For Kanyenga Health Centre], the building contractor who had started the works was re-engaged to complete the project.
“However, the Ministry of Health later realised that the contractor had submitted a fake bond. The ministry, therefore, terminated the contract and took the matter to court,” Chikumbe said.
Apparently, the case was concluded last month and “the court provided the necessary directions”.
Chikumbe could not clearly indicate what the directions are but insisted the project is being considered for Motion 2 under the same HSJF.
“However, due to resource constraints, the definitive dates are not yet out. Meanwhile, government remains committed to complete this project and indeed with many other sites that had stalled,” Chikumbe said.
In the Kanyenga Community Clinic project, a source at Mangochi District Council confided in us that the court faulted the government for breach of contract and ordered that the contractor be compensated.
But, Executive Director of Centre for Social Accountability and Transparency, Willy Kambwandira, says beyond government seeking to complete the projects, someone must answer for not doing their job in protecting public money.
Kambwandira disclosed that the Kanyenga project has attracted his organisation, which will be following up with relevant authorities to get to the bottom of what actually happened, adding that there are several other projects that ended up in similar states.
“It is our expectation that appropriate sanctions will be taken against those who got things to where they are today. We demand that the Ministry of Health should put in place processes and procedures that will not be subjected to the same flaws,” Kambwandira said.
He has also called on the government to employ open and transparent contracting processes that include conducting due diligence on the contractor to be hired.
“It is also our demand that money lost should be recovered and appropriate detecting actions taken. We are tired of rent seeking behaviours among public officers at Capital Hill,” Kambwandira said.
Meanwhile, Mangochi District Council chairperson, Scorch Mathews, has implored the central government to expedite the process of completing the stalled projects.
Mathews said in an interview that thousands of people in the lakeshore district, especially expectant women and under-five children, are being denied the right to healthcare services because they do not have facilities within their communities.
“Our hope is that Kanyenga Community Clinic and others whose construction got suspended will be completed soon. People should be able to access healthcare services within their communities. There are deaths that can be prevented if the distance to the hospital is reduced,” Mathews said.
A resident of Jambo Village, under Group Village Kanyenga, Beatrice Mackson, said when we recently visited the stalled health centre that she almost lost her two-year-old son on her way to Nkope Health Centre some 30 kilometres away.
Mackson further claimed that the long distance between her village and the nearest clinic sometimes forces women to deliver in the bush on their way to Nkope Health Centre.
“I lost my sister-in-law after she fell sick at night. The time we arrived at Mangochi District Hospital about two hours later, she was too frail to survive. Doctors told us they would have saved her life if she had arrived earlier,” Mackson said.
Like several other women in her village, she hopes the health centre—which would be serving an average of 40,000 people—will be completed as soon as possible.
At least, postnatal services should be available nearby. Our children even grow up without being immunised against dangerous diseases. Some die young; others survive by the grace of God,” Mackson added.
Some health centres in Mangochi, whose construction was abandoned, are in dilapidated conditions, effectively implying the government may be compelled to restart the construction works.
Billions of kwacha which have already been spent on the projects might have gone down the drain.
Thus, Kambwandira fears that if those who brought about the crisis are not held accountable, the same fiasco might be repeated in the future, further throwing spanners in Malawi’s ambition of ensuring there is Universal Health Coverage by the end of this decade.
“It is clear there was abuse of funds that resulted into the projects stalling. Yet, we have not heard much about anyone being sanctioned. Those who flouted the Public Finance Management Act must face the long arm of the law,” Kambwandira said.
On his part, Executive Director of Malawi Health Equity Network, George Jobe, said failure to decisively deal with the cases such as those that led to the Umoyo Housing Project crisis exacerbates Malawians’ challenges in accessing healthcare services.
Jobe believes, if executed diligently and professionally, the project would have significantly improved access to and quality of healthcare in rural areas.
“The greed of a few people which is demonstrated through theft and abuse of resources, especially in the health sector, affects a larger group of people.
“People have died because of the absence of health centres in their locations. The abuse also scares away donors. The Umoyo Housing Project scandal was a big one and it is just now that we are receiving funding from donors,” Jobe said.
Abandoned facilities such as Kanyenga Community Clinic were expected to comprise facilities such as an out-patient department, a laboratory, a maternity wing, a mortuary and five staff houses.
The Malawi Government says through its Health Sector Strategic Plan 2017- 2022, it aims to move towards universal coverage of quality, equitable and affordable health care to improve health status, financial risk protection and client satisfaction.
But Jobe and Kambwandira argue that such a plan will be difficult to achieve if those who abuse resources in the health sector are left scot-free.
Alick Ponje is a features writer at The Times Group. He graduated from the University of Malawi with a bachelor’s degree in education, majoring in literature in English. Follow him on Twitter @aponje