Mwanjasi Levati is a 20-year-old expectant mother who comes from Njovu Village in Villa Mwaladzi in Mozambique. Although she stays within reach of Bai Clinic, Levati opts to go to Kapanga Health Centre across the border in Mchinji, Malawi. She does not mind walking the long distance because at the Malawi health facility she is assured of good and free service.
“Bai Health Centre is about one-year-old, but I prefer going to Kapanga where I have been going since I was a child. The service there is superb, unlike where I come from, where they cannot even do blood transfusion. Furthermore, in case of developing complications, I am assured of being referred to Mchinji District Hospital where the service is also free,” said Levati.
Prisca Godfrey is another pregnant woman who comes from Werengani Village within Villa Mwaladzi and does not mind travelling close to five hours on a bicycle to access health service at Kapanga Health Centre.
Godfrey stays close to Dindani (Pvt) Clinic, where services are not as expensive, in her view, but opts to cross the border to access similar service because it is better, free and easy.
Treating ‘foreign patients’ is not a strange occurrence at Kapanga Health Centre so much that the facility’s hospital-in-charge, Felix Ngalawa, believes the number of foreigners accessing health services there exceed 50 percent. This, he said, puts a strain on the health centre’s meagre resources because naturally, the ‘foreign patients’ are not part of the population for which the services are planned.
Unconfirmed reports have it that in neighbouring Zambia no foreigner can access health service at a public hospital because there is a computerised system where all locals are registered and are expected to produce an identify number to be assisted.
But why are services at the Malawi health facility not restricted to Malawians?
Although it is a known fact that more than half the patients at Kapanga are not Malawians, the health personnel say that they cannot stop anyone from accessing the service because the patients lie that they are Malawians and in the absence of national identities (IDs) there is no proof required other than word of mouth.
Director of health services in the Ministry of Health, Dr Charles Mwansambo, said his ministry is aware of the issue and that Kapanga is just one of the health centres in Malawi’s border districts where foreigners are accessing free service at the expense of deserving citizens.
According to Mwansambo, in other health facilities the population of patients from across the border hovers between 30 percent and 40 percent.
But Mwansambo said there is nothing his ministry can do to avert the problem unless Malawi embraces a national identification system.
Said Mwansambo: “Until we have all citizens registered, it will be difficult to distinguish Malawians from foreigners and may be charge them appropriately where need be. This is not just a Ministry of Health problem, Rather it is a national problem because it cuts across all sectors. We started registering death and birth, but that is not enough, we need to do more.”
National Registration Bureau (NRB) is in the process of rolling out a national registration and issuance of national identity cards. According to the bureau’s public relations officer, Norman Fulatira, national IDs registration is expected to start in the next few months.
He said UNDP has procured equipment which is expected to arrive in the country mid-October and has already hired an expert, Frik Oliver, to install the equipment. n