We have only one famous trolley left at this hospital. It is famous because those pushing it have to be muscular; you may be pushing in one direction but the trolley will go sideways, for example, and you have to be strong to control and properly redirect it. That’s how old the machine is. “The then Mzimba District Hospital’s District Health Officer (DHO), Dr. Alinafe Tambala, says this to point out that current funding woes in the government’s medical facilities have generally hit Mzimba District Hospital, whose farthest facility. Kabuwa, is more than 300 kilometres from the boma. “To get to the remote Kabuwa, hospital vehicles have to pass through Mzuzu and Nkhata Bay.”
She explains that the hospital’s budget last year was K195 million for the entire year. The hospital was also separately given over K90 million by a Norwegian Development Aid (Norad) fund that took care of many key operations, including purchasing fuel for ambulances, food for patients and allowances and overtime for medical personnel.
“Since then, Norad stopped funding us in that manner and this has put a lot of pressure on us and some services have been seriously paralysed. For example, this year, the government increased our budget to K254 million but we struggle seriously, as –among other things– we have to find our own fuel for ambulances and we have to feed our patients on cumulative funding that is K30 million less than last year’s,” Tambala says.
When the United Nations Children’s Fund (Unicef) and other donors intervened recently to try and reduce maternal deaths in district hospitals, Mzimba benefitted by receiving six ambulances to improve the facility’s referral system.
“This means we now have a large fleet of seven ambulances servicing the 31 health facilities and Mzimba Central Hospital itself. But the problem is fuel and this is why most of the ambulances are usually parked at the hospital,” the DHO states.
She explains that, normally, the ambulances are based at rural hospitals in clusters in Mzimba, where Mzimba North and South utilise three ambulances apiece, for as long as their shared fuel allocations allow.
“Each ambulance that depletes its fuel allocation is parked at this district hospital. That means there will be no more referrals from that concerned cluster and it becomes a sad situation for the sick people,” Tambala laments.
She admitts that the hospital administrators allow stranded patients, or their relatives, to buy their own fuel for use in the parked ambulances where they need to take patients to the hospital, or dead bodies to homes of the bereaved.
“Some politicians and other prominent community members have usually been very helpful in purchasing fuel for poor people who need to use the grounded ambulances. We don’t like such selective private arrangements on a public facility but what else can we do?” the DHO wonders.
She states that whenever the ambulances are grounded, expectant mothers in the far-flung health facilities are advised to avert problems and complications by travelling to the district hospitals many days, or even weeks, in good time before they are due for delivery. This causes serious congestions at the hospital because the hospital does not have a waiting home for expectant mothers. The women’s guardians have a shelter but this is very old and is in a very bad shape, with serious sanitation problems the order of the day.
On feeding patients, Tambala says she is happy that the hospital has prioritised this provision, albeit at the expense of some services. She stressed the need for patients to be fed, in order to increase their chances of healing.
“So, at Mzimba District Hospital so far, we are committed to giving our patients the normal three meals per day. Other well-wishers often come with maize donations, for example. Our challenge is, with prices of foodstuff increasing these days, the reality is that we are providing basic food whose quality we wish we could improve,” the DHO reflects.