Lucy Mthenga (not her real name) has been accessing free medical and health services from her local health centre without any hurdles.
Mthenga, 34, comes from Ndamera Village in the area of Traditional Authority (T/A) Ndamera in Nsanje District.
She never expected that things could change until a few months ago when some health workers demanded an advance payment of K2 000 (about $3) before she could access the services.
“I had symptoms of malaria and went to access treatment at this facility. But the health workers could not treat me because I could not pay the K2 000 they demanded,” she says.
Since she did not have the money, Mthenga says she was turned away without assistance. Annoyed and disappointed, Mthenga reported her ordeal to Ndamera Accountability Club.
The club mobilised communities surrounding the facility, area development committee (ADC) and health advisory committee (HAC) who then wrote the district health office (DHO) demanding immediate transfer of all the medics at the facility.
The club was established in November 2015 by Tiphedzane Community Support Organisation (Ticoso) with financial assistance from the National Development Institute for Foreign Affairs (NDI).
Ticoso executive director Mike Dansa says the club is mandated to provide answers to the challenges communities face, particularly by ensuring that duty-bearers do not abuse their powers at the expense of poor citizens.
Thus, the club was intended to be used as a vehicle for entrenching principles of democracy and good governance such as transparency and accountability at the local level.
“Where things go wrong, it is the duty and responsibility of club members to track down the culprits and ensure that they are reported to their relevant authorities,” he explains.
And in pursuit of social justice, transparency and accountability from duty-bearers, the club, ADC and HAC wrote the district health officer Alexander Chijuwa, demanding him to discipline health workers who were alleged to demanding bribes from patients.
The petition, which was signed by HAC members and the ADC chairperson Samuel Kasakatira, stated that patients from the surrounding communities were failing to access services at Ndamera Health Centre because they could not raise money to allegedly palm-oil the medics.
“We thought of writing their authorities so that they can address the challenges we were encountering. We could not accept the public health facility being turned into a private one. Lives of poor people were at risk as they had nowhere to access treatment for free,” says Kasakatira.
Reads the petition in part: “…medics are demanding bribes in the range of K5 000 and above, which is disadvantaging the poor who cannot raise such an amount. The unfortunate thing is that this fraud is reported to be spreading to other rural health centres in the district.”
Kasakatira states in a separate interview that efforts aimed at promoting safe motherhood were equally affected as most expectant women going to the health facility for ultra sound scanning (USS) to determine the gestation of the fetus were being asked to pay for the service.
“Thus, we demanded an immediate transfer of the health workers because they were putting lives of the poor at risk as they have nowhere else to access the treatment for free,” he explains.
Their petition drew the attention of the Minister of Health Peter Kumpalume, who visited the health centre.
Kumpalume says the discussions he held with the club, ADC and HAC were aimed at finding a lasting solution to the problem which, he said, was common in most public health facilities across the country.
“I hope that things will improve. Otherwise, the ministry is ready to dismiss any health worker engaging in unprofessional conduct,” he warns.
And after fighting a winning battle, GHV Ndamera and Kasakatira confirm that operations at the health facility have since normalised and that the health workers are no longer demanding payment for services.
“Democracy and good governance won in all this. And I feel very happy that my subjects were trained and are able to apply what we learnt for the benefit of our communities,” says Ndamera.
Group village head (GVH) Ndamera says the introduction and establishment of the accountability club has brought many positive changes in his area.
Ndamera says the club, which comprises 20 members that include women and other minority groups, has made significant strides in entrenching the spirit of accountability among citizens.
Says Ndamera: “My subjects used to suffer in silence before the club was established. A good example is that of Ndamera Health Centre where my subjects could not access health services without paying, yet they could not bring the issue to the attention of relevant authorities for fear of being blacklisted.”
The chief adds that medical workers used to open the centre very late and close it before 5pm.
“ Of course, people were aware that this was abuse of office, but they remained silent due to lack of knowledge,” narrates Ndamera.
Chijuwa confirms that his charges were engaging in unprofessional acts, but says things have since improved.
The DHO advises patients and members of the public never to relent when their rights are being violated.
“I wish to advise members of the public to take up such matters with my office or the Office of the Ombudsman for intervention,” he urges. n