Malawi waiting rooms of death: What needs to be done

The chronology of our medical infrastructure’s decay has always been there, but like the proverbial man staring at a flying arrow, we have let our eyes be pierced by the grim and sober reality in the form of a desperate plea by medical doctors at Kamuzu Central Hospital.

In 2004, when my 18-month old son was admitted to the Kamuzu Central Hospital, doctors repeatedly needed to conduct a full blood-count. Unfortunately, there were no reagents in the lab of one of Malawi’s biggest hospitals. They had to give me the blood in some kind of test tube for me to dash to the City Centre Clinic across the city. In a couple of tragic instances, the blood dried up before my arrival at the said clinic, making me return to the Kamuzu Central Hospital for them to, once again, pierce the skin of my suffering son, who passed away after thirty-eight days in hospital.

When news broke earlier this week that doctors have written President Joyce Banda on the drug shortage crisis at KCH, the incident was refreshed in my memory, making me feel as though somebody has opened a wound that had healed.

The shambolic state of our medical infrastructure has been the biggest disaster we have always faced. It has always been there, at any time. With an estimated two doctors for every 100,000 people and a 60 percent vacancy rate for nurses in rural areas, the problem has probably not made headlines because most of those affected by it are the invisible poor who live in our villages and small towns. Those in the city, most of whom are on medical schemes sponsored by their employers, have always had alternatives, such as Mwayiwathu (for the very rich), Adventist Hospitals and other private clinics that cannot be afforded by the common man.

Malawi public hospital: Drug shortage
Malawi public hospital: Drug shortage

No one can argue, however, that no matter how much we choose to disregard the hemorrhaging of our public medical infrastructure, one day we will still need it. None of the private hospitals has critical care facilities or a pool of specialists that can be found at our biggest referral hospitals of Kamuzu and Queen’s. Malawi, after all, has less than 200 medical doctors, and none of the private hospitals has the means of keeping them fully maintained on the private hospital’s payroll, the capacity only the Ministry of Health has.It is not only reagents that have been repeatedly in short supply in our hospitals. It has always been not unusual for facilities to run out of supplies, including such simple things as surgeon’s rubber gloves, Tylenol, aspirin, and even band-aids and gauze. Larger items such as good beds and mattresses are non-existent in many hospitals; oxygen concentrators,  x-ray machines, and sterilization equipment is broken or long since discarded.

The problem has always been there.

On 16 November, 2011, an Inter Press Agency news report by Claire Ngozo, read: ‘Malawi is experiencing a drug shortage as the country’s international donors remain reluctant to release aid meant for the health sector. About 60 million dollars in funding has been withheld amid allegations of pilfering and corruption in the procurement of drugs at the government’s Central Medical Stores’.

The biggest mistake we have made as Malawians is to let the President, cabinet ministers and members of Parliament  be receiving treatment outside the country. For as long as they run to garden city for toothache and stomachache, they will never see the urgency of keeping our hospitals well stocked.

I suggest that top politicians should be banned from seeking medication outside Malawi. Budgets should be cut for non-essential travel by our presidency and cabinet ministers to save money for buying medicine. Each Ministry should be asked to identify areas it can cut budgets up to five percent, and the money should be channeled to the procurement of medicine. Salaries of cabinet ministers should be reduced by K100,000. Cabinet ministers should no longer fly business class. All of them should fly economy. Cabinet ministers should no longer have three official vehicles per person; only one will do. The rest should be sold.

More importantly, stringent measures need to be put in place to curb the corruption that stains the Central Medical Stores, and also to stem the theft of drugs and medical equipment. Only two days ago, Zodiak Broadcasting Station was lamenting the theft of a CD4 Count machine at the hospital of the lakeshore district of Nkhata Bay.

It is a vicious cycle, when looked at through another prism. Government buys drugs and equipment to be used by underpaid medical personnel who end up stealing some of the equipment and medicine to top up their low and often delayed pay (staff of Queen Elizabeth Central Hospital have not yet received their January salaries as we speak). Until all these problems are looked at more hollistically, it will be like a mad man filling a bottomless bucket with water.

That nothwithstanding, with austerity measures I have suggested, we could solve the problem for now, while looking for a longlasting solution. Otherwise we are doomed.

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