An hour’s drive from Songwe Border Post to Karonga District Hospital at 2am could have been the longest drive Daniel Phiri, 35, has ever taken.
He was the only hope for survival of his day-old son who faced death due to lack of antibiotic drugs at the hospital.
“It was a very painful trip to learn that the hospital had no antibiotics, but necessary at the same to realise that the life of my only son rested in my hands,” explains Phiri.
Apparently, Phiri’s wife gave birth through induced labour the previous day after the baby was overdue for delivery. However, the baby was exposed to complications after it gulped amniotic fluid—a clear, slightly yellowish liquid that surrounds the unborn baby during pregnancy.
The baby’s condition deteriorated with each passing hour as its body temperature kept rising to undesirable levels.
“I received a call to search for Panado syrup which the hospital did not have.
“I drove a distance of 45 kilometres from Songwe and bought the drug at a private pharmacy at the Boma. But when I reached the hospital, the baby was already at his worst,” explains Phiri.
He alleges that the situation was worsened because health personnel administered the drug an hour later.
“And we lost the baby just a few minutes after giving it the drug,” says Phiri. “It’s a painful moment for me to lose the only male of the three children I had.”
Following the incident, Phiri has no kind words for government which he says has a duty to provide drugs to its citizens who bear the burden of paying huge taxes and yet are denied quality health services.
“It’s our money. They need to prioritise drugs rather than spending it on petty projects. Look now, I have lost a child who could have survived if he received enough care and medication,” he says.
Phiri is just one of the hundreds who have lost relatives and loved ones at the facility due to drug shortage.
According to a memorandum dated January 9 2017 and signed by the acting district health officer Lewis Tukula, the shortage is due to depletion of the hospital’s drug budget for the 2016/17 financial year.
Reads the memo: “Be informed that the annual drug budget (2016/17) for Karonga has been depleted. This can be attributed to low budgetary allocation and increasing drug prices.
“The implication is that Central Medical Stores cannot supply drugs to any facility in Karonga unless it gets authority from central level.”
The memo, which is addressed to officials in the district’s health centres, adds: “The district health office has since written relevant authorities, seeking direction on the subject matter. Authorities have so far indicated that negotiations are in progress to map the way forward.
“You will be kept updated on subsequent developments on this subject matter. Let us make sure communities are aware of this through our respective health advisory committees.”
In an interview, Tukula remained mum on the issue. However, a nurse, speaking on condition of anonymity, said the situation is so dire that patients are referred to private clinics or pharmacies for medication.
“At a certain point, we had a shortage of syringes such that we were referring patients to Banja la Mtsogolo.
“As of now, the acting DHO tried to get some supplies of syringes, but there are no drugs. Like today, we had a lot of children who were convulsing due to severe malaria and yet the pharmacy is empty,” said the nurse.
She said some of the drugs that are needed most are antibiotics, asthmatic drugs and anticonvulsant drugs like diazepam.
Rumphi district health officer Dr Stephen Macheso says the issue borders around the inadequate budgetary allocation to hospitals.
He says previously his hospital used to receive a drug budget of K223 million, but this time it was reduced to K207 million.
He says the reduction is happening at a time the currency is depreciating in value and the drug prices are going up. He says this is made worse with government’s stance to advocate health seeking behaviours.
“So, the OPD [outpatient department] utilisation is still going up because more people are going to the facilities yet the budget is going down. You wouldn’t expect the drug budget to last that much,” he says.
The district’s drug depletion rate is at 64 percent as of December, states Macheso. This means over half of the budget has been used in the first six months with the remaining 36 percent drug budget to be used for the other six months.
Macheso is, however, optimistic that with the inquiry, the ministry will intervene and provide solutions to the problem. He also understands that the problem emanates from lack of funding from donors.
Health activist Dorothy Ngoma faults government for failing to meet international treaties such as the Abuja Declaration of 2000 for African Union countries to increase funding towards the health sector.
The declaration demands member countries to allocate at least 15 percent of their annual budget to improve the health sector.
“With the crisis of HIV and Aids, tuberculosis and population growth, the healthcare package in Malawi has never gone beyond the 15 percent. Only once, we managed to get to 12 percent. Currently, we were told its nine percent.
“So, are we surprised that some hospitals have depleted their drug budget when they were given a mere nine percent?” wondered Ngoma.
While admitting that some of the drugs are lost through theft, she suggests that funding to healthcare be increased to 20 percent, if the country is “to meet the minimum 15 percent”.
MoH spokesperson Adrian Chikumbe admits that this is a nationwide crisis as some district hospitals have depleted 70 percent of their drug budgets, others 90 percent and yet others are at 100 percent.
“Most of the districts across the country are affected. So, we are equally surprised why this is the case,” says Chikumbe.
He says the ministry has instituted an inquiry to find out why the hospitals have depleted their drug budgets before the end of the financial year. He says the inquiry will come up with recommendations to the problem.
“We have gone to the districts with auditors and directors to find out why they are depleting their budgets so soon,” says Chikumbe.