A 16-year wait for panado at Mbalama Health Centre


The structure is imposing. It is surrounded by four equally impressive houses which are not occupied. The iron sheets on the roofs have started to rust testifying of the time they have spent unattended to. During the day, the building provides shelter to domestic animals from the surrounding houses. And when the sun sets, wild flies gather around the solar powered electrical bulbs.

For villagers within Group Village Headman (GVH) Mlima in the area of Traditional Author y Bwananyambi in Mangochi, the structure presents them with different stories to tell.

Some of them pass by it everyday while carrying patients on their way to a hospital situated over 30 kilometers. Those who are lucky make it to the hospital, while those who are unlucky fail to make it to the hospital, and die along the way.


As they return home while carrying dead bodies, they again pass through the same structure. In their hearts, some curse it, while others pray for it to continue standing strong until it starts serving its purpose, a purpose of saving lives of many people seeking medical attention.

Closing their eyes they dream for a world where their children will not die of Malaria, a world, which will accord pregnant women an opportunity to start enjoying the benefits of safe motherhood as is being touted nowadays. They hear traditional birth attendants are bad, but they have no choice to abandon them.

Unfortunately right to access to quality and free health services remain a far fetched dream for over 19,000 people of GVH Mlima, who since 1999 have been waiting for ‘authorities’ to open Mbalama Heath Center.


While in most parts of the country people are enjoying the right to heath as enshrined in the republican constitution, the situation is different for people under GVH Mlima who, since time in memorial, have been surviving on natural herbs.

To them, a hospital is something else which they feel are not entitled to due to location of their village. As reports indicate that medical personnel are refusing to be posted at Mbalama Health Center because is it located in remote area.

Situated at 125 kilometers South of Mangochi Township, the area is regarded as remote despite being just less than 10 kilometers away from the tarmacked Mangochi-Njaja Road.

According to GHV Mlima, government through Malawi Social Action Fund (Masaf) completed construction of the heath center in 1999 and since then, there have been different excuses on the side of government why the hospital is not opening for business.

“We have been going to the District Commissioner’s and DHO’s office to enquire as to when the hospital will be opened but they have been giving us conflicting statements. People are dying in my area. They pass through this hospital in an attempt to go to Nkumba Health Center, but most of them do not make it to the hospital,” says Mlima

Mlima paints a gloomy picture for people living with HIV and Aids, saying most of them are not accessing ART because they can not afford to go to the hospital to collect their medication. Pregnant women living with virus have no chance of being on treatment in order to prevent their unborn babies from contracting the virus.

The GVH further blames various DHOs who have been in Mangochi since 1999 for failing to send a clinician at the heath center because it is located in remote area.

“My people have been waiting to start receiving Panado at this hospital. When we ask, we have been hearing that doctors don’t want to come and work here because it is in the rural area. But we are surprised because there are other civil servants who are working here and are not complaining,” she says.

Going around the heath center’s compound, one would quickly equate its standard to most heath centers that are operating in the country. Both the clinic and houses are fitted with solar electricity, piped water, flash toilets and other wireless equipment to enable personnel communicates with their colleagues.

“It is unfortunate that at a time when government is promoting health rights, other people are busy denying the country’s citizen their right to good health. This clinic was constructed to benefit the people of Mlima and I am failing to understand as to why it has taken government 16 years to open the hospital despite it being fitted with all the requirements,” says Councilor Clement Dzimbiri, Vice Chairperson for Heath committee at Mangochi District Council.

Equally puzzled is National Initiative for Civic Education (NICE) Trust which has been holding several interface meetings with the local leadership and Area Development Committee Members for Chipunga Ward to deliberate on ways they can lobby officials to open the hospital as soon as possible.

NICE Mangochi District Civic education Officer Turner Banda feels the district heath officials are letting the Mlima people down in as far as delivery of health services is concerned.

“How can the whole government fail to open a clinic for 16 years? Does it mean they care less for people located in the rural areas? If there are some reasons, why can’t officials come forward and explain to people instead of leaving them in the dark as has been the case? This just shows that our governments have been failing to identify our priorities as a nation,” says Banda

According to the World Health organization (WHO) and other international health body rights, access to health services for most Malawians is limited as only 46 percent of citizens live within a 5 km radius of any kind of health facility.

Despite most public health services being free for the patients, there are often costs associated with transportation to and from a facility especially for rural people who also happen to constitute a bigger percentage of the country’s population.

WHO also says these costs, unfortunately deter many individuals that may be in dire need of care but cannot afford to shoulder the costs of transportation. It further says that additional transportation needs complicate matters when an individual is referred from either a rural hospital to a district hospital or a district hospital to a central hospital.

While agreeing with need to increase access to health for rural people Mangochi DHO Dr. William Peno dismisses claims that doctors are refusing to go to Mbalama clinic because it is in remote area, saying his office is currently engaged in negotiations with Ministry of Health to open the hospital.

“The Hospital was initially built as a Health Post, now we have seen the need to upgrade it to a health center because the population has increased. At the moment we are building a case for the communities to justify why the hospital should be opened quickly,” said Peno.

However the DHO failed to give a time frame as to when his office will open the hospital, urging people to be patient as government processes are slow.

“On our part as a district, we are ready to open the health facility because the population in Mangochi is increasing and there is need to increase the number of health centers in rural areas to reduce the distance people travel to access medical service. We are just waiting for government to give us a nod,” said Peno.

With a population of approximately 16 million people in Malawi, and 1.2 million people in Mangochi, the country’s average national life expectancy from birth is at 47 years, with 44 years for men and 51 years for women. This is in contract to the world average life expectancy which stands at 68 years.

According to health scholars, Malawi’s low life expectancy has been largely attributed to untimely treatment for diseases such as malaria, HIV/AIDS, chronic malnutrition, as well as sub-standard health services and inadequate access to safe drinking water coupled with lack of proper sanitation.

There is however hope that these challenges and many others can improve, if Malawi improves access to health quality service for its citizen especially those residing in the rural areas, which in turn can help in attaining primary Health Care as a strategy endorsed by Sub Saharan countries, including Malawi, to attain equitable access to health services and treatment and prevention of prevalent disease.

Meanwhile government wheel continue to move so slowly at a decision to open Mbalama Health Center which was constructed in 1999 is still unknown. While over 19,000 lives around GVH Mlima remain reliant on natural herbs for medication as their chief reveals

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