By Isaac Salima:
As demand for oral and facial reconstruction keeps rising, patients in dire need of the services continue to be pushed onto the waiting list for the surgeries in a country that is overwhelmed with cases.
The problem is being compounded by lack of trained specialists as, currently, Malawi has one surgeon, Dr James Mchenga, who is an expert in jaw and face operations.
Mchenga said in an interview that the country has over 250 patients with facial conditions on the waiting list.
One of them is David Bagile from Chigumula Township, Blantyre. He has ameloblastoma, a condition where a tumour develops in the jaw.
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Bagile said a problem that started as a mere toothache has grown into the swelling whose surgical procedure he has been waiting for since 2021.
Just by looking at the protuberance, one can tell that the patient is in great pain.
However, he is on position 153 on the queue before he can be assisted.
Mchenga, who is employed by Kamuzu University of Health Sciences but also works at Queen Elizabeth Central Hospital, conducts one surgery in a week due to space challenges in the operating theatre.
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This means that at most, the hospital can conduct 52 surgeries in a year.
Bagile would, hence, need to wait for some three years before his turn into the theatre would arrive.
“I have one theatre day per week, which is Monday. On the Monday, I share the theatre with other emergencies, meaning that if there are other emergencies, I am put out because my cases are not emergencies,” Mchenga said.
He has since called on the authorities to train more specialists in his field.
“If we are talking about Malawi 2063, we must build capacity. We must train some people. We must also have a theatre facility dedicated to oral and facial surgery. That way, we will increase the number of patients that can be operated per week,” he said.
Bagile is, meanwhile, looking for K6 million so that he can access the surgery at Blantyre Adventist Hospital, which offers the services.
“The pain is just too much,” the 39-year-old said recently as he struggled to utter a word since the tumour has affected part of his mouth.

Health rights activist George Jobe has urged authorities to come in and address the challenge.
“We need a short-term solution where the government must take stock of different health conditions. They need to hire specialists or must be in agreement with experts to conduct the surgeries,” Jobe suggested.
Secretary for Health Samson Mndolo Sunday said he was travelling and asked to be called in the evening.
We had not managed to get his comment by press time while Ministry of Health spokesperson Adrian Chikumbe was not available on his mobile phone.
Meanwhile, a team of United States (US)-based surgeons on Saturday arrived in the country to conduct maxillofacial surgeries.
The development is expected to bring smiles to patients in dire need of the treatment.
However, not all of them will be attended to as the 10-member team is expected to handle 40 cases, meaning over 200 will remain on the waiting list.
“Our desire is to take care of everyone but, due to time limitations and facility space, we hope that, in the next fortnight, we will treat about 40 patients.
“These are major surgeries. These conditions are bad because they affect patients in all sectors of life and, sadly, it is only one specialist who has to attend to these cases here in Malawi,” team leader Tania Nkungula said.

Malawi’s Ambassador to the United States Esmie Chombo said the coming of the experts is good news to patients who have been longing for relief.
“These specialists are coming to conduct operations which would not be done in the country without their help.
“There is another team that will also come in August and we, as government, are pleased because if these patients were to be sent outside the country, we needed a minimum of $40,000 [K69 million] per patient,” Chombo said.
This is the second time the doctors have come to Malawi. During their first visit last year, they conducted 25 surgeries.
