Lack of information undermines rights


The hospital attendant always said demeaning words to patients in the ward and Hanna Mandasi of Kantsizi Village, Traditional Authority Mpama in Chiradzulu thought it was normal for staff to do so.

The ward had guardians and expectant women.

“That ’s another reason everyone remained quiet because it’s not good to quarrel with others when you or your daughter is expectant, or else she may give birth to a still born baby or an object,” says Mandasi.


She recalls that the ward attendant called them names and accused patients and guardians of being unhygienic villagers who are making her job difficult by throwing away food left overs anywhere.

“The attendant always reminded us that this was a free hospital and that because of that, guardians had to help in the cleaning of the ward.

“We couldn’t even report them to the nurses because we were afraid the nurses may be on their side because she is their colleague. After all, she was right. We were all villagers and we didn’t know what to say or do,” Mandasi laments.


Joyce Awadi of Tawakali Village, Sub TA Mpunga in the same district had a similar experience.

She went with her child who had an injury to a referral health facility but her child was not given even a pain killer as she waited for the doctor to examine her the next day.

The health worker she met told her that the doctor would be available the next day and that they had to come back then.

“We needed to find our own accommodation till then. We just slept on the veranda of the hospital,” says Awadi.

It is clear that Mandasi and Awadi did not have information about their rights and responsibilities at a health facility.

And there are many of such women who face hurdles at health facilities and other public places because they have no knowledge or access to information on various issues to help them make informed choices.

But it is not only urban women who face such experiences.

In September last year, The Daily Times reported a case where expectant women at Queen Elizabeth Central Hospital were asked to pay money for them to jump the queue to the theatre to have a caesarean section surgery done and have extra care.

The women were threatened that they had high risk pregnancies and that if they did not get surgery quickly, they or their babies would die.

Out of fear, the women paid for services that are free.

Malawi Health Equity Network (MHEN) Executive Director Martha Kwataine says there are sets of health rights and responsibilities which every health facility is supposed to post prominently on its facilities for patients and workers to know their obligations.

She said health workers are also supposed to talk about patient and health work rights to patients just as they do at antenatal or family planning clinics.

“You find that at the health clinics, they only talk about the various services offered. They don’t talk about rights and responsibilities,” she says.

Kwataine says even in the facilities that display health rights on their walls, people rarely read them because of literacy problems among many Malawians.

“The information on where to complain if one has a complaint with a health care worker or the entire system needs to be made available to patients and guardians,” says Kwataine.

She says lack of access to such information among patients is what is leading to consumers getting raw deals from health service providers.

“People can only begin to demand quality care if they know what the minimum requirement is. It’s time to start providing information to health service consumers as one of the rights for patients and guardians. Health care workers too have rights and responsibilities,” she says.

Kwataine also notes that people are good at demanding rights but they do not want to be responsible.

“Health care workers have an obligation to respect the rights of patients and guardians too but they too are so obsessed with their rights, leaving behind their obligations. There can be no optimal health service delivery if the two sides don’t play their roles well,” she says.

The Access to Information Bill whose introduction in Parliament has been stalling for a decade now is generally regarded as for journalists only.

But Media Institute of Southern Africa – Malawi Chapter (Misa- Malawi) chairperson, Thom Khanje, says on the contrary, passage of the bill would benefit other citizens more than it would benefit journalists.

“Research has shown that Access to Information law benefits ordinary citizens 75 percent more than journalists. Journalists already know how to get information which they want. It is my poor uncle and aunt in the village who can’t get information they want from public offices,” he explains.

He says an Access t o Information law would enable every person to access information from public offices with legal backing.

National Coordinator for NGO-Gender Coordination Network, Emma Kaliya says the law would benefit every section of the Malawian society including women.

“If the law was in place, it could have helped the women make informed decision. Women are usually marginalised and mostly at the far reaching end of many things,” she notes.

Kaliya stresses that law is essential in a democratic country because currently the situation is that institutions choose to release only information they have interest in while hiding that they do not want the public to acquire for reasons best known to themselves.

Despite the importance of the law to the development of the country, successive governments have dragged on for years now to enact the bill into law.

At this year’s World Press Freedom Day commemorations in Mzuzu, Media Institute of Southern Africa (Misa-Malawi) chapter governor Mandala Mambulasa expressed his frustration over the slow pace the bill has taken to be tabled in parliament.

“I’m disappointed that the bill will not be tabled in this parliament session. Misa Malawi has done all possible things to pave way for this bill to be tabled in parliament such as the establish Access to Information Policy,” said Mambulasa.

Meanwhile, poor and illiterate Malawians continue to be denied their rights and offered mediocre public services as there is no instrument in place to compel public officers to provide them with information on their rights.

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