Trustee Karen and son Sam arrived at St Joseph’s having been met in the new Land Cruiser ambulance by Sister Florence and driver Emmanuel. He is delighted with his new charge and drove with enormous skill over the extremely steep and rocky tracks to the Health Centre.
It is clear that this vehicle has greatly improved the working life of the hospital by enabling far more staff to travel to the remotest of villages. This is by far the remotest hospital we have been to in Malawi.
Sister Florence, our old friend from the earliest days of Angels’ involvement with Malawi (when she was in charge at Mtendere) greeted them both and was keen to show them the amazing new clinic. Karen and Sam were so thrilled! It was larger than either of them had imagined and not far from being finished.
The shell of our clinic is now almost complete therefore we need to supply funds to furnish the rooms so that the staff can move in and begin work in this purpose built environment without delay.
There was a spike in November 2015 with the amount of children being diagnosed as HIV positive rising sharply to over 200. This was explained by an increase in the screening process.
The supplying of ARVS (anti-retroviral) to treat HIV has changed. Each facility now receives its own supply, whereas before there seemed to be a central source.
Our new clinic will primarily provide areas for treating patients with HIV and all its related problems, including counseling, TB and pneumonia.
Two NGOs from Lilongwe are now running programmes at the hospital. Both are Malawian initiatives and have committed to help here for the next three years.
The Lighthouse Project provides counseling for individuals and families living with HIV.
Mother to Mother is a very small but effective initiative involving three women who are all HIV positive and who go and share their experiences of living with it with other women and their families, giving them hope and encouragement and above all information about how to manage their lives. Sister Florence says that the main battle with HIV remains, as ever, with fear, stigma and lack of education.
The population here is of mixed religions and beliefs. The majority are people from the Yao tribe, who are Muslim, the rest are Chichewa people, some of whom are Catholic. With this in mind, Angels has asked Sister Florence to put all written messages on our new clinic (traditionally there is writing on the front of all new hospital buildings) in three languages, Yao, Chichewa and English. We feel very strongly that the clinic should represent the cultures of its catchment population.
Sister Florence feels that this initiative (the feeding and care of the malnourished) needs more house to house monitoring as the main problem would appear to be ignorance on the part of the mothers as to what is nutritious for their children. This would improve the effectiveness of the NRU programme and save the hospital money by not having families staying for weeks at the facility, but enable them to remain at home with regular medical advice and involvement. We hope to be able to fund this outreach prototype in 2017.
There is no running water in the convent and the supply in the hospital is intermittent. The water pipes have not been changed since the hospital was built in the 1960s. Many of the pipes that were buried now lie on top of the ground and many of them leak. The whole system needs overhauling. Angels have pledged to help the hospital do this.
This has 10 members, 3 of whom are women and one of whom represents the Yao tribe and who speaks their language. She works as a translator on occasions when needed, especially in the maternity department. The committee has been set up as a bridge between the community and the hospital and works together on all aspects of the hospital and its services. As a body they are concerned because the Government has informed them that they will be signing a maternity service agreement in October, which means free treatment for all maternity cases coming to the hospital. This happens all over Malawi and in theory the Government then reimburses the hospital for each maternity patient it treats. In reality this seldom occurs, or if it does, it can take up to a year.
All that the hospital has at present is a fairly primitive little twin burner used outside. It is vital that it has a proper autoclave to prevent cross infection and we are going to try and raise the funds to purchase this.
Sister Florence told us that her main concern was the number of maternity patients that she will receive after signing the Government Service Agreement. She has asked us if we could raise funds for the building of an extension of the maternity unit. Today there are only 24 beds (10 antenatal, 10 postnatal, 2 in a spare room and 2 in the Labour Ward). This will not be enough to meet the demand. We are hoping to share the fundraising with Africa Directo, with whom we work alongside at Mtendere Community Hospital.
A new borehole is absolutely essential, as the villagers are using the water supply that currently services the hospital; they need to sink a new hole that will be exclusively for the use of the hospital
This is a major project that Sister Florence needs to address if St Joseph’s is to expand and continue to serve the community that it caters for. Its reputation is now growing and more medical staff are now applying to work there. However, the housing available for staff is totally inadequate. Thanks to our new clinic, the old colonial building that had been used is now redundant but needs total renovation. Electricity needs to be installed. With work the building could provide accommodation for staff.
Because of the new Service Agreement with the Government, there is huge pressure on hospitals such as St Joseph’s to supply as many antenatal outreach clinics as they can. At each selected site they need a small shelter where people can gather and have the necessary examinations under cover, especially during the rainy season. Sister Florence has been negotiating with local chiefs and has managed to acquire several buildings that she could use to run the clinics in.
What they all need is work on their interiors to accommodate medical staff and outpatients. We will endeavour to fund this, as it will have a very significant impact on the lives of the men, women and children living even in the remotest villages of the hospital’s catchment area.