Drugless theatres risking lives

Most district hospitals across the country have run out of Suxamethonium, a critical drug for surgical operations in theatres, Nation on Sunday has established.

In an interview this week, Anaesthesia Association of Malawi (AAM) president Joel Moyo confirmed the development, saying the muscle relaxant is among several other drugs that have been in short supply in most hospitals’ operating theatres.

He said some of the essential anaesthetic drugs that have been in short supply include Ephedrine, Diazepam, Vecuronium, Neostigimine, Thiopental, Propofol and Halothane, while some sedatives such as Thiopentone has been out of stock for over a year now.

Moyo said the situation puts at high risk patients in critical conditions such as pregnant women because it is hard to refer them to other hospitals.

Said the AAM president: “Anaesthetists are also at risk of losing licences if it happens that the patients get complications in the process of using wrong drugs.”

According to AAM, hospitals such as Balaka, Mulanje, Chikwawa, Thyolo, Chiradzulu, Ntchisi and Chitipa run out of stock of some of the anaesthesia drugs and refer their cases to other facilities that had stocks in their theatres.

This development forced the association to ask some hospitals that did not have the drugs to stop conducting operations for patients’ safety and to refer cases to hospitals with drugs.

Dedza District Hospital anaesthetist Bernard Jali said before carrying out any surgical operations, an anaesthetist ensures they have the required drugs to numb sensation in certain areas of the body or induce sleep in the patient to prevent pain and discomfort during  the medical procedures.

He explained: “We choose the drugs depending on the patient’s condition, or sometimes based on what is available.”

Jali said working in a hospital without the necessary anaesthetic drugs is challenging.

“For example, you have a pregnant woman whom you have given spinal anaesthesia and you are able to talk to her throughout the procedure because we only paralyse the abdomen and the legs.

“But sometimes, the anaesthesia goes high up the spine to the brain and this becomes an emergency. The patient then needs general anaesthesia and when you don’t have drugs like Suxamethonium, this patient will die,” he said.

Following the SOS by the AAM, the Central Medical Stores Trust (CMST) issued a statement that it would start delivering Suxamethonium in hospitals this week.

Nsanje District Hospital was one of the facilities earmarked to receive its share of Suxamethionium.

In an interview, the hospital’s spokesperson George Mbotwa said they have been referring cases to Queen Elizabeth Central Hospital since they ran out of some essential drugs, including Suxamethonium.

Moyo confirmed that they were informed that the drug would be disbursed to hospitals this week, but that they had information that the consignment expires on November 30 2021.

In an interview on Wednesday, CMST spokesperson Herbert Chandilanga declined to comment on the expiry date of the drugs and referred the matter to Ministry of Health spokesperson Adrian Chikumbe.

However, he attributed the shortage of some essential drugs in some hospitals to a lack of funding to run huge procurements.

Chikumbe also declined to comment on the issue.

In a separate interview, KCH director Dr. Jonathan Ngoma said his facility does not have a shortage of Suxemethionine.

On his part, Mzuzu Central Hospital director Frank Sinyiza said the referral’s theatre is operational, but admitted that  Suxemethionine has at times been unavailable at CMST.

Nation On Sunday spot-checks found that Chitipa is one of the districts in the North that had a critical shortage of essential drugs in its theatre.

On Tuesday, Minister of Health Khumbize Chiponda told Parliament that K3 billion worth of drugs have expired in the custody of CMST. She blamed it on misprocurement.

The minister also told Parliament that CMST needs about K30 billion to procure enough drugs for the country.

Parliamentary Committee on Health chairperson Mathews Ngwale said his committee has since summoned CMST and the Association of Medical Doctors to a meeting on Monday over the expired drugs.