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Government pays price of neglect on mental health facility

Chiwoza Bandawe

Kamuzu Central Hospital in Lilongwe has become a beehive for persons with mental health problems – as numbers of those with mental health disorders rise in the country, according to studies.

But the hospital is facing pressure since government closed Bwaila psychiatric unit about six years ago and has not done anything to repair it or construct a new one.

The facility was a major referral for mental health patients in Lilongwe and the surrounding areas. It was constructed in 1939.

Former Ombudsman Martha Chizuma ordered the closure of the psychiatric hospital in 2017 following findings of poor service delivery and injustices on patients with mental disorder by the Ministry of Health.

The government was forced to allocate two small rooms to operate as a mental health clinic at Kamuzu Central Hospital.

Malawi News can report that the rooms provide no privacy to male and female patients with mental health as they share the same space.

A senior mental health and psychiatric associate at the mental health department at KCH, Tommy Mthepeya, told Malawi News that the rooms are not enough to accommodate mental health patients, and they are not safe for medical officers.

“There are only two rooms which we use when offering OPD [outpatients department] clinics for mental health patients. But the rooms are not enough as a mental health department needs enough space. The rooms are not even safe for other patients suffering from other diseases. The security of medical officers is also at risk,” Mthepeya said.

According to Thepeya, under these conditions, there is no way the country can achieve the 2063 agenda or Sustainable Development Goal 3 that says good health is essential for sustainable development.

A nurse at KCH short stay Ndamiwe Chisi told Malawi News that nurses face challenges as the psychiatric holding room at KCH is close to other treatment rooms.

Chisi said sometimes patients with severe mental disorders turn aggressive and disrupt provision of other services at the facility.

“Patients with mental health disorders do come to disturb patients, nurses and doctors who are taking care of critically ill patients. This sometimes poses security risk to people working in the wards,” she said.

Psychologist Chiwoza Bandawe said the central region needs a mental hospital.

“Mental disorders are a threat to the country if not treated. The country needs to think about investing in mental health services,” Bandawe said.

Senior Mental Health and Psychiatry Clinical Associate at KCH Mental Health Department Solomon Chomba said the department needs a fully functional hospital for mental health patients in the central region.

“There are many cases of mental health but many of which remain unreported and this is recipe for disaster,” Chomba said.

According to KCH records, out of 1,217 patients that were treated of mental health problems at KCH over the past five months, 766 were new cases. The figure shows that the situation is getting out of hand.

Our analysis of the data further shows that most of the patients that are treated at the facility are males of less than 16 years of age.

The surge in cases of mental health patients at KCH is forcing the central region major referral facility to refer other cases to St John of God at a cost.

At the time of our visit last week, there were 146 referrals to St John of God in Lilongwe. We established that KCH spends K200, 000 for each referral for a minimum of 4-6 weeks.

We also established that the government spends K29 million per month for the referrals made to St John of God and about K350 million per year and about K 2 billion for the past six years.

The Ministry of Health admitted that the Service Level Agreement with St John of God for referrals is not sustainable.

Assistant Director of Curative and Medical Rehabilitation Services Michael Udedi told Malawi News that referrals and Service Level Agreement were put in place as interim measures.

“They are however not sustainable in the long term. As such, plans are in the pipeline to have an inpatient mental health/psychiatric unit at Kamuzu Central Hospital but I would not be able to give the timelines for that,” Udedi said.

Centre for Social Accountability and Transparency (CSAT) Executive Director Willy Kambwandira urged the government to construct a new clinic for mental health patients, arguing that the funds for the referrals can be used for a new clinic.

“Our greatest concern is that the figures you are mentioning are enough to construct a state-of-the-art mental health facility and sadly no one is paying attention.

“Again, taking patients to Zomba Mental Hospital is expensive too. As a country we must strive to save tax payers’ money,” Kambwandira said.

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