Surgery crisis in district hospitals
It has emerged that most district hospitals in the country are facing acute shortage of anaesthetic drugs, and this has in some cases resulted in deaths of some patients in the theatre.
According to the list we have seen from anaesthetic authorities, only Mwanza, Dowa and Rumphi have the important anaesthetic drugs such as Ketamine, Adrenaline, Atropine, Halothane Suximethonium and Propofol.
Other district hospitals such as Chitipa, Nkhata Bay, Mulanje, Chikwawa, Thyolo and Balaka do not have such stocks, including Ephedrine, Diazepam, Thiopenton, Vecuronium, Neostigimine, Atropine and Local Lognocaine.
Alarmed with the situation, the Anaesthetics Association of Malawi president Joel Moyo led a team on Wednesday to Ministry of Health at Capital Hill in Lilongwe as well as the Central Medical Stores Trust (CMST) to plead with authorities on the matter.
In an interview, he said they have for the past two weeks been receiving reports from their members in district hospitals on the matter, and later created a database of the required drugs which they presented to authorities.
Moyo said: “We made summation of the drugs and it transpired that most of the drugs that we need are not available.
“This is an emergency and we wrote the Ministry of Health, and met them on Wednesday, and also CMST. We verified that, indeed, the drugs are out of stock. The issue with CMST is that they told us they are unable to procure the drugs because they owe private suppliers billions of kwacha.
He said even when the CMST pays the suppliers, the money is deducted for old bills, which is not helping the situation while the Ministry of Health, asked to respond after some days.
“We said there is no need to wait for days because patients are coming to theatres now and again, and we have instances where patients were referred to central hospitals but died on the way.”
Moyo said they have given government 72 hours to deal with the matter.
Yesterday the association issued a statement, saying drugs such as Suxamethonium and other muscle relaxants are supposed to be always available in the theatres for surgery.
“After consultative meetings with the Clinical Directorate and CMST, the executive made a decision that all hospitals which have no essential anaesthesia drugs should not take patients to theatre for the safety of patients and anaesthetists.
CMST public relations officer Herbert Chandilanga admitted in an interview that a routine, large quantity procurement of the anaesthesia items has delayed and the institution has consequently had a stock-out of certain anaesthesia supplies.
“CMST is emphasising airlifting as a mode of delivery for the items in the fast-tracked procurement,” he said.
Clinical Services director Chithope Mwale, to whom the concerns were addressed, said he had not met the team from the association and could not comment on the matter.
But director of Health Technical Support Services Godfrey Kadewere said supply chain was a major issue, as drugs that were supposed to take three months now take over six months to come.
“A trip which used to take three months from India to here, now takes six months; so logistics have become a total challenge.”
Kadewere further said government has since provided K1.5 billion which CMST will use to procure emergency drugs.
Health rights activist and community health ambassador Maziko Matemba said this is a matter of life and death, so “let the Ministry of Health source the drugs from wherever they can. Let us not expose patients to more misery because they are in pain and the drugs are very expensive.”
Central hospitals are able to procure drugs privately, but that cannot happen for district hospitals as they are under district councils and do not have such a waiver.
