Balaka’s smoky guardian zone

Thick smoke billowing from open fires at Balaka District Hospital’s guardian shelter tells a familiar story of neglect in Malawi’s hospitals overwhelmed by a high disease burden and shortage of nurses.

The hospital has no decent building to house people who escort critical patients receiving treatment, care and support in its interiors.

Instead, the guardians have to do with a run-down unsanitary structure with broken windows and rusty iron sheets.

The scarcity of skilled nurses makes these guardians an integral part of the country’s health care system. They do some small but important chores for the patient, including serving meals hospital kitchens never prepare.

However, the unsanitary environment where the guardians live puts them at risk of contracting diseases in a hospital environment.

Those at Balaka’s largest hospital endure a stench emanating from filled toilets that are falling apart. Flies from the stinking latrines, land on food which finds its way into the wards where patients wait for tasty bites.

Equally haunted are people in homesteads surrounding the neglected shelter.

“It is pathetic how the guardians here suffer, especially during the rainy season. I feel things could not have reached this far for a district, which has produced two first ladies,” says Amina Asima, from Khwisa in the district.

Asiyatu Jawadu, another guardian, said women fleeing the inhabitable shelter clog corridors of the hospital “where they sleep like inmates” in the country’s overcrowded prisons.

“We endure sleepless nights in the corridors because there are numerous disturbances. When there are emergencies, we lift our beddings and step aside to pave way for the stretchers ferrying the patients,” she says.

When it rains, it is nearly impossible for the guardians to cook for the patients.

“Patients are choosy when it comes to food. When a patient prefers a special meal, we cannot deliver when it rains. At times, women in labour deliver on an empty stomach.”

Esnart Frank, a guardian from Ntcheu, had a daughter in the maternity ward. She appeals to Balaka District Council and well-wishers to construct a better guardian shelter to restore the dignity of its occupants.

The facility lacks decent bathrooms and toilets.

“Now and again, naughty boys climb over the fence to gaze at women bathing in the shabby, makeshift structures,” she states 

Former first lady Patricia Shanil Dzimbiri sympathises with the guardians living degrading conditions.

She narrates: “Freedom Foundation was just receiving material donations like clothes and wheelchairs, so it was difficult for me to embark on such a big project.

“However, during my tenure as Balaka West member of Parliament [2014 to 2019], I teamed up with fellow legislators in the Parliament to lobby government to build a new hospital complete with a decent guardian shelter, but to no avail.”

However, Dzimbiri said instead of looking up to individuals of goodwill, it remains the duty of the council to implement such projects using the District Development Fund.

 Edgar Chihana, director of planning and development at Balaka District Council, hinted at long-standing plans to construct a befitting guardian shelter.

He said the shelter is one of the priorities in the council’s 2021/22 financial year.

“The plan to construct a new guardian shelter was partly affected by fire which destroyed part of the hospital’s kitchen last year,” he explains. 

Meanwhile, patients’ guardians keep sleeping rough in hospital corridors to escape from the dilapidated shelter where the breakdown in water, sanitation and hygiene put them at risk of catching preventable infections in a hospital setting.

“This is a ticking bomb,” Jawadu releases her innermost fear. “As duty-bearers are either looking away or just buying time, as guardians, we don’t know whether we will wake up healthy or hospitalised like the patients we come to assist.”