Left in health despair
“Pregnant women are forced to give birth in the bush because it is 15 kilometres away from Likuni Mission Hospital. It is a pathetic situation we are in.”
Malawi’s efforts to achieve universal health coverage remains a far-fetched dream because some people, especially in rural areas, are still struggling to access medical care due to either poor or absence of infrastructure. AUDREY KAPALAMULA exposes how one community in the outskirts of Lilongwe is being denied this human right.
For 13 years, some 500 households of Traditional Authority Malili in Lilongwe have lived without a functional health centre in their area.
People travel long distances to access health services, yet in the area there is Ngulube Mtolo Health Centre which was built with support from European Union in 2006; but somehow it is not operational.
As a result, says Senior Group Ngulube Mtolo, his subjects seek health services at Bwaila Hospital or Likuni Mission Hospital located several kilometres away from Malili.
“It really pierces my heart to see people groaning in pain while passing by the infrastructure which we thought would give us hope of accessing health services just like other areas. We are being denied our right to quality healthcare services.
“The next public hospital, which is Bwaila, is very far from us and people are forced to go to Likuni Mission Hospital where they are also asked to pay. We have tried to ask the government to consider us but to no avail,” he said.
Catherine Rodwell, vice-chairperson of the health committee at Ngulube Mtolo, says the building is now being used for under-five clinics and family planning services from Banja La Mtsogolo only.
She says in 2019, the committee built a guardian shelter after authorities promised to open the centre.
“We work to ensure that there is sanitation and hygiene at the hospital building. Last year, we built a shelter when we were told that the hospital will be opened. We are still working with others to mold bricks for a guardian shelter,” she said.
Through various services that are being offered, children get malaria treatment and painkillers while pregnant women go for antenatal treatment.
“Pregnant women are forced to give birth in the bush because it is 15 kilometres away from Likuni Mission Hospital. It is a pathetic situation we are in,” she says.
Councillor for Chiweka Ward, Henry Mwiyo, says what is needed is connection of a proper water system.
“We were once told that the water that surrounds the hospital is salty and we needed to tap water from another source. We had partners of Bwaila Hospital who promised to support us, and they came to test the waters at Ngulube Primary School. What we need at the moment is technical support for water pipes,” he said.
Minister of Health and Population, Jappie Mhango, admitted that the country still has a number of health facilities that were built a long time ago but are yet to start operating.
“We still have a situation where 80 facilities that were built decades ago have not been operational because of lack of healthcare workers and what is happening now is to recruit more health workers that will now be distributed across all facilities to make sure that some of them are operational,” he said.
Mhango then said the ministry is working hard to improve the situation in most health facilities by ensuring that they always have adequate drugs.
But Member of Parliament for Lilongwe South West, Jean Sendeza, where Ngulube Health Centre is, brushed off Mhango’s response, saying it will take ages before the ministry recruits and procure equipment for such hospitals.
Sendeza said the leadership in the development of the community has agreed to put on hold other small projects and utilise the Constituency Development Fund (CDF) to procure the much-needed equipment while engaging the District Health Office (DHO) to support them with some of the workers that are already in the system.
“From the quotations that we got from the DHO, we need to use K15 million. We will sacrifice the small projects so that we can have this equipment so that we also address emergency issues. We want to have this hospital opened. The challenge will be having healthcare workers,” she said.
The legislator said they have plans to have the facility opened in the next six months, but that considering that CDF is released in trenches, the timeframe may change.
All this is happening despite that the government, through the Ministry of Health and Population in its Health Sector Strategic Plan (HSSP) II launched in 2017, promised Malawians access to universal health coverage whose activities will be implemented up until 2022.
Among other activities, the ministry said it will focus on completing ongoing projects and maintaining, rehabilitating and upgrading the existing stock of infrastructure as part of infrastructure development.
With two years to complete HSSP II, people of Malili are still struggling for better medical care.
Malawi Health Equity Network Executive Director, George Jobe, said it is high time the country revisited its priorities as indicated in HSSP II which, among others, advocates that communities need to have a facility closer to their areas.
“We have infrastructure that was already constructed but has not been opened. When you look at the direction, we are just under-utilising resources. As we are forging ahead with constructing facilities, why don’t we start by operationalising the existing ones?” he queried.
Jobe said the government should give opportunities to graduates from health institutions and prepare them to run facilities that have stayed idle for decades.
“We have people who have graduated and are just sitting idle in their homes; why don’t we mentor and allow them to manage such facilities?” he said.
Ministry of Health (MoH) policy clearly indicates that every Malawian should reside within an eight kilometre (km) radius of a health facility.
According to MoH, in view of the statistics which show that 90 percent of the population lives within 8km radius of a health facility, there is still a proportion of the population that is underserved such as those in rural areas.
With a good proportion of communities left to walk long distances to access healthcare services, it is inevitable that improving the well-being and good health of people will be a challenge as demanded in Sustainable Development Goals.
Failure by the government to operationalise health centres will have an impact on the gains made in the health sector such as reduction in maternal and neonatal deaths.
This is the case as the country will still grapple with non-communicable diseases, hence failing to achieve the global targets by 2030.
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