The waiting area of the out-patient department at Phalombe Health Centre has been forbiddingly cold since the onset of the winter season.
Yet, Rose Namangale, 46, of Kazomba Village, Traditional Authority (T/A) Mkhumba, has dared and endured this ice-cold floor for the past two nights.
By Tuesday morning, Namangale had clocked three days sleeping on this floor as she waited for her turn to receive treatment for her yet-to-be diagnosed illness.
When she went to the clinic on Sunday morning, she found more than 300 other patients on the queue awaiting medical attention.
Sadly for them, only a few were attended to by the doctor while the rest waited in vain.
Namangale wished she could go home and return the following day, but the distance and the excruciating pain she was going through forced her to stay.
Thus, she joined many others who have been sleeping in the two-metre corridor of the health centre without any sheets or blankets.
“Imagine we are losing friends and relatives right here in this corridor before they are attended to by doctors. Well, you may call it a health centre, but we are convinced it is not.
“It is a death-waiting centre because people are dying before they are assisted. Do you call that place a health centre or death centre?” wondered Namangale.
Such is life for Namangale and others in Phalombe where 346 000 people scramble for services at the government’s 10 health centres and two health posts.
It has been a long wait for her, not only for the doctor to attend to her, but also for government to use the money it has been setting aside since 2010 to build a district hospital.
Budget records show that government has been providing millions of kwacha for constructing the hospital, but about three years on and with over K300 million spent on the project, there is nothing concrete to show for it.
Budget documents show that the project was allocated K50 million (about $120 000) in the 2010/2011 financial year, K150 million (about $358 000) in the 2011/2012 budget while for 2012/2013 financial year, K100 million (about $238 000) was allocated for the project.
Our visit to the district this week found that all that happened on the proposed site of the project was some clearing.
Noticing that nothing is happening on the project, some locals turned the site into maize and sunflower gardens.
Spokesperson for the Ministry of Health, Henry Chimbali, conceded in an interview yesterday that the delays in building the hospital are causing serious problems to the people of Phalombe in accessing health care.
Chimbali also admitted that government has been making budgetary allocations for the project since 2010, but said the money has been used on “planning purposes as per the conditions with the institutions assisting us in the construction of the hospital.”
“We know the district should have had the hospital long time ago and we know how much costly this has been to us also. We, however, need to do things right so that we make meaningful and long-term investments to the people of Phalombe,” he said.
According to Chimbali, government is expected to contribute 25 percent of the $22 million (K8.8 billion) project, while Badea and the Saudi Bank will provide $7.5 million (K3 billion) each.
But Chimbali said there are strong indications that the Saudi Bank would increase its support for the project to $12 million [K4.8 billion].
“Since 2010, we have been negotiating with Badea and the Saudi Bank over the funding on many terms and as such, we have an obligation to contribute about 25 percent of the total cost as government.
“We, therefore, allocate this money in anticipation that the project may commence in that particular year and when this has been failing, the money is reallocated within the course of the year to support other development projects such as Umoyo Housing, rehabilitation of hospitals and indeed other emergencies within the infrastructure projects. We do this reallocation in consultations with relevant government institutions that manage government budgets,” he said.
Asked what the ministry is doing to ease the pressure on health centres in the district, Chimbali said the ministry has developed short-term responses to manage the situation through service level agreements with institutions under the Christian Hospitals Association of Malawi (Cham).
He said the ministry has ‘almost’ finalised all negotiations and is currently listing consultants who are expected to be on site by July this year.
But Chimbali could not indicate when construction work would begin, saying this will depend on how soon donors provide their funding.
Phalombe district health officer Dr Alexander Chijuwa said his office has been flooded by complaints from people across the district decrying poor service delivery in the government clinics.
Chijuwa said he understands the feelings of the people as health workers “are really failing to provide timely and professional services due to lack of space where, for instance, serious cases such as palliative care, sexually transmitted infections (STI) and anti-retroviral therapy (ART) can be handled.”
He attributed the poor health service delivery to inadequate human resources, lack of space in health centres and poor road networks to referral hospitals such as Zomba Central Hospital.
“The population of this district deserves a hospital of its own. It is not necessarily that we don’t care when people are dying before seeing the doctor.
“For instance, we don’t even have rooms to store medicines. This has forced us to keep medicines in the open air spaces outside offices. What do you think would happen if security guards had ill-motives? We thank God they are not evil-minded, otherwise you couldn’t see the drug cartons packed outside this office,” said Chijuwa.
Martha Kwataine, executive director of health rights advocacy organisation Malawi Health Equity Network (Mhen), expressed shock over the situation in Phalombe, describing it as inhuman.
She said the lack of a hospital in the district is stretching the capacity of health centres, a situation she said results in substandard services that people are complaining about.
“What government must know is that it is not only violating people’s right to health, but denying them their constitutionally-enshrined right to development. How can Phalombe, which was declared a district in the UDF era, remain without a hospital even when funding is being approved? I suspect corruption in this whole project and someone must explain. Or, should we wait for people to protest?” Kwataine said.
She also blamed Members of Parliament (MPs) from the district, saying they are giving their people ‘a raw deal’ for failing to stand up for the rights of those they represent.
The activist said K300 million [about $715 000] is “too much for the little work done such as planning.” She also wondered why government was keeping people in the dark on the progress of the project, saying citizens need to have information on reallocation of the resources.
“Our stand is that this figure is too much for planning purposes. If there’s reallocation, were they not supposed to inform the public, which has an interest in the hospital project? No, the ministry must explain what they have been doing with all this money, otherwise we don’t believe what they are saying,” said Kwataine.
Holy Family Hospital is the most reliable hospital in the district, but as a faith-based health facility under Cham, patients are required to pay before accessing the services.
Matthias Solomon, 35, of Namtapo Village, T/A Mkhumba, another patient who had spent days waiting for treatment when Nation on Sunday visited Phalombe Health Centre, said it is a big insult and risky experiment for government to service a population of 346 000 with inadequate, under-staffed and ill-equipped facilities.
“How can government allow such substandard services at a facility that deals with human life? Do leaders really care about the people of this district?” said Solomon.
T/A Kaduya, who allocated land for the hospital project at Migowi Trading Centre, said he had no idea when the project will start.
“The momentum and excitement that we had on the prospective hospital has died down. What is worse is that we don’t receive any updates from the ministry,” said Kaduya.