Trustees Journal part 2
After breakfast we left Nkhamenya for Lilongwe to visit the Marist Brothers in Mtendere. We were greeted with a nice cold Fanta by Brother Felix , Brother John Katumbi and Brother Everestus. B. Felix runs the farm and is full of interesting ideas for it. B.Everestus seemed to be more to do with Pastoral care in the Community. B. John Katumbi is based at the same house as J H's friend B. Patrick and he is keen on starting a women's programme there. We were then taken to the school.
We drove past many mud huts and waving children and suddenly emerging from the bush a very large school, right in the middle of nowhere. This senior boys boarding school had been here since the '50's . JH had been here then teaching and was warmly welcomed. We went in to the Marist house and were introduced to the brothers, one of which, Brother Chunga was the Head.(pic 25)
He offered to show us round. The school has around 250 boys. I learnt later that B Chunga has his own project going in his home village, helping the villagers re roof their houses. Most of the Mission people seem to have some kind of personal project going.
We thanked B Chunga and went in the car again for another 10 minutes to Champagna House where we would be staying. We were made most comfortable. During supper the electricity went. No one bats an eye.
Slept very well. We visit the hospital tomorrow.
Breakfast at 7am and then JH and all the brothers went to mass at the school. There was to be a special ceremony to bless the new school bus after mass, so I said I would walk down and join them for that.
Mass from 8-9.30 so I had a bit of time. Thought I'd take myself off for a walk armed with my binoculars and camera. I got about 20 yards from the house and was hailed by a young man running after me down the track. He was one of the brothers' cooks called Quentin. He looked about 18 but I later found out he was 30 and had 3 children. They seem to drink the water of Eternal Youth in Malawi!
Quentin said he would take me on a tour of the farm. (pic 26) He took me down to where the water is pumped out of the river. They have created two small ponds full of fish that they keep topped up with a large hose direct from the pump. The crops all looked in good order and I saw the cattle being herded in the woodland in the distance. There are lots of trees here unlike Nkhamenya where there weren't many trees at all.
Talking to B Felix later, he said what a big problem it is as everyone uses so much firewood. In some parts of Malawi they are so short of wood they have started cutting the mango (pic 27) and avocado trees as well which is a shame as they are a good food source. Felix said that there were tree planting schemes that were encouraged by the government
I walked up to the school in time to hear the most amazing African music with drums coming out of the chapel. Such energy.
Watched the priest blessing the bus and listened to more wonderful singing from the boys and I was then introduced to Sister Florence who on her one day off a week was having to show me round the hospital. A very friendly and cheerful lady.
We got in to her new 4x4 'ambulance' to drive to Mtendere Health Centre .She was was very pleased with this 4 wheel drive only having had it since July. It was donated through a Spanish catholic charity called 'Africadirect '.
The hospital is smaller than Nkhamenya.(Pic 28) There are 32 staff, 4 nurses all of whom are trained Midwives. There is one medical assistant and they are hoping for a clinical officer.
Her latest project with the Spanish is the VCT centre.(Voluntary counselling and testing for HIV/AIDS) The VCT building has gone up from the original price as cement prices have rocketed. Nearly all the cement comes from Zimbabwe.
SF said that she is aware of over 100 HIV patients locally and at the moment they can give them very little help. The Govt. too are aware but don't give them any money for the VCT or for personnel to run it. The local diocese health board have now recruited a nurse and counsellors but there is no money to pay them and they will not come to Mtendere until there is. ( Pic 29)
I asked her what her biggest problems were (apart from this) and she said that the water tank for the hospital and the pump are tiny and cannot keep up with the demand .
The hospital laundry consists of one tap and a concrete slab for scrubbing clothes and sheets on. This is shared by all the patients ,their relatives and a local cat who was asleep on the edge of it when I was there.
She also needs IV fluids, gloves, disinfectant antibiotics for under 5 year olds and generally the same as Nkhamenya. She told me the prices of some of the items; IV fluids cost 250kwa per litre (less than £1) and Quinine costs 9000kwa for 1000 tablets (£30)
They do not have a Lab so all samples are taken to Dedza which is 30km away.
She said that they do collect fees from the patients but very little, usually averaging out at 250kwa per month (less than £1) The hospital salaries are paid by CHAM as this hospital is not part of the Govt scheme for mothers and babies. They receive no money for medicines. (Pic 30)
There is a Clinical Officer at the moment but there is no money to top up his salary so they are afraid he will leave to get a job in the city.
We were then taken round the wards . SF said that the Medical council came and were very critical of the beds as the paint is flaking off so they were a source of infection They need bed linen.
Another big problem is in the Paediatric ward.
The mothers have no nappies for the children. Many of the mattresses were not plastic covered, just pieces of foam.
I asked SF if they had any cots for the Paediatric ward as there were lots of babies asleep on these very high beds with no mother in the room. She said no because the mothers shared the bed with the child at night and often other family members slept under the beds. (Pic 31)
They have some private rooms used by trading centre people . These cost 150kwa per night 50p.
I asked what happened if people can't pay. She said that obviously they treat them regardless but that they can pay in instalments if they wish . She works with the village chiefs who gently remind their people that they need to keep up with their instalments.
The maternity ward was split into two with post and ante natal kept separately.
The labour room was very small and windowless .
SF said that the last big wedding blessing happened in July so she knew she only had to count on 9 months to know when her Labour ward would be full again!
At the back of the hospital are several buildings, including a large hall where maternity classes and outpatient appointments are held. She says that every night all the chairs and table are moved and the Guardians of all the pregnant ladies and their children all sleep in the hall. (Pic 32) Then every morning they all move out , the cleaners move in, clean the hall put the furniture back and the sessions can be held there again. At the end of the day, all change!
In addition to the hospital, they go to outreach clinics, 4 are just ante natal the rest are both ante natal and under 5's
They have only one ambulance.
There are 38 villages in their catchment area. They are trying to create good relations with all the chiefs as they know they need the chiefs' backing to help persuade the people to come for treatment and testing. Traditional healers are still very important here and they also have to be taken into consideration.
SF has to start the Govt. new PMTCT (HIV Mother to baby prevention programme) on Nov 1st this year but they have given them no extra money for staff or training up existing staff, just the vaccines. She is very worried about this.
She doesn't have a NRU (nutrition unit) and at the moment this is alright as there is no famine but SF said that if this changes, they just have to refer mothers to Dedza 30 odd km away. She said that in the past, they don't go and come back to the hospital weeks later to say that their baby has died.
We saw a building that housed a Public health officer who can give out TB treatment. (Pic 34) If the hospital hears of a problem in any of the villages such as an outbreak of cholera or unclean water ,they go and investigate it. There were also several buildings which were very run down that had been the old wards years ago that SF would like to renovate to use for the NRU etc. but they do not have the money to do this.
Finally I asked her for her priorities. She said:
- The water tank
- Training for the new PMTCT which she has to start Nov. 1st
- Transport. Only one ambulance out there is not enough
- All drugs for under 5 yr olds
- Anaemia drugs
A very similar story to Sister Margaret's hospital in Nkhamenya and I think fairly widespread.
I asked her for the estimated cost of various training programmes and she got the details from the diocese and let me have them before I went.