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Depth of the health crisis

The country’s health care system is in shambles as public hospitals are feeling the pinch of poor funding, a development that has forced some hospitals to send patients home due to lack of essential drugs.

A Nation on Sunday visit to Queen Elizabeth Central Hospital (QECH) and Ntchisi District Hospital, and random interviews with officials from Mwanza, Nsanje, Chiradzulu, Salima, Chitipa and Nkhotakota district hospitals have revealed that most health facilities are operating without critical drugs.

Patients waiting to meet a doctor

At Malomo Health Centre under Ntchisi District Health Office (DHO), for example, patients are either being sent away or referred to other facilities as the centre has run out of essential drugs.

An official at Ntchisi DHO, who opted for anonymity, said the health centre with a catchment area of over 55 000 people, had for the past three weeks Thanzi Oral Rehydration Therapy (ORS) for treating diarrhoea, Acetylsalicylic acid (Aspirin) which is a pain killer, and Lumefantrine-Artemethei (LA) which is used to cure malaria.

“We don’t have a vehicle and we always use motorcycles to procure some drugs from the DHO office at the Boma which is about 30 kilometres away,” said the official.

Last Wednesday, patients at the health centre were seen on long queues, with others sleeping in exhaustion, after receiving news that the facility was about to receive a new stock of essential drugs from the district hospital.

But Ntchisi District Hospital spokesperson Samson Mfuyeni said while the district’s satellite health facilities may have run out of some essential medicines, the situation is not as critical as having only three types of drugs.

The drug challenges have not spared the country’s largest referral, QECH.

In an interview last week, a senior hospital official, speaking on condition of anonymity, said for the past three years, the hospital was barely managing its operations on a K250 million monthly funding, but were surprised to see the funding reduced to K150 million in September.

Said the official: “The K250 million was already on the lower side for a facility of this magnitude. In fact, we have been asking government to increase our funding. Hence, we were surprised to see the cut.

“We normally buy drugs from Central Medical Stores Trust [CMST] but of late, the trust has been experiencing stock outs, a situation that has forced us to buy drugs from private suppliers whose prices can be as much as five times higher.”

The source added that the hospital has run out of some essential drugs like Intravenous (IV) fluids, especially normal saline drips and ringers lactate which is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure.

Furthermore, the hospital does not have electrocardiograph paper (ECG), which is used for checking heart problems.

Said the official: “Currently, we are not doing biochemistries, which include liver function tests, urea tests, and creatinine tests. We are low in stock of propofol, diclofenac and we have run out of thiopentone drugs. We had stayed long without plasters but we just received them mid November.”

Efforts to speak to QECH director Samson Mndolo proved futile as he did not answer our calls for two weeks.

When we visited his office on Thursday 26th November, his deputy gave us his email address to send him questions to which he has not responded by press time.

In a separate interview, Nsanje District Hospital spokesperson George Mbotwa said the hospital has run out of some essential drugs such as dental lignocaine for dental services.

He cited an incident on Tuesday last week where a 24-year-old man from Traditional Authority Tengani in the district was referred to Zomba Mental Hospital after Nsanje DHO ran out of schizophrenia drugs for suppressing mental disorders in psychiatric patients.

Mbotwa said the hospital is also failing to conduct routine maintenance works due to inadequate funding.

Mwanza District Hospital is also struggling to settle a K71 million electricity bill dating back to last year.

The hospital’s spokesperson David Chadza said: “In fact, we also had high water bills which we just recently settled. The hospital commits part of its Other Recurrent Transaction [ORT] funds to settling the bills, but the ORT is also meant to cater for other critical needs of the sector.

“So, each year part of our budget is being used to pay the bills but the ORT funds are not enough to offset bills without paralysing health delivery.”

He said the hospital does not have all essential drugs because CMST supply rate has been around 45 percent of the items ordered.

On his part, Zomba Central Hospital spokesperson Arnold Mndalira also said the hospital has run out of some drugs.

“Our monthly funding, which is around K40 million, is still intact. It is just that we cannot buy drugs as we used to from CMST,” he said.

At Nkhotakota District Hospital, almost 10 drugs are not in stock. The drugs include diazepam injection, CPZ injection, bisacodyl, cotrim 480 and tranexamic acid as well as other essentials like cotton, gauze roll and sutures.

It is the same with Chitipa District Hospital, which has a shortage of about 20 different types of drugs. Salima District Hospital has also run out of about 15 different essential drugs, as have Chiradzulu and Neno district hospitals.

On his part, Mzuzu Central Hospital (MCH) director Frank Sinyiza said the hospital operates on a nine-month budget of K1.35 billion which caters for drugs, blood supply and medical gas.

He said MCH is able to source the items from private suppliers through set procedure when the CMST does not meet their order.

Similarly, Kamuzu Central Hospital director Jonathan Ngoma said their financial support has not been affected.

Last month, the Anaesthesia Association issued a letter to all serving anaesthetists to practice safe and standard procedures as anaesthetic drugs were out of stock.

The association’s president Joel Moyo said they had received messages of drugs shortages from various district hospitals, and they followed up the issue with suppliers.

Said Moyo: “So, we discovered that we have procurement hitches that they are not able to pay the suppliers money. For example, CMST procured drugs in May [this year] but up to now the drugs have not been delivered.”

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