Monthly Updates

May, 2008 -
Rural Health Centers

Rural health centers are the front line of Malawi’s health system, and I thought you might be interested in what a representative sample of these is like.  (The photo is not of the center described below.)

Our Malawi staff provide directions to the facility:  Drive out the X Road toward Y Town and just before the river turn left for 6 km on a dirt road until the first trading center.  There you will see the health facility.

It is one building with one room for out-patient care and another for consultation.  There is no laboratory or land line for telephone service.  One staffer has a cell phone and sends text messages to a larger hospital requesting advice or an ambulance, when needed.  A separate building is being constructed to counsel and HIV test villagers by rapid test kits.

The services here include vaccinations, nutrition education, and under-5 check ups.  Ante-natal care is provided, with education on the prevention of mother-to-infant transmission of HIV. Male condoms and depo provera tablets are available for family planning.

The center treats schistosomiasis, caused by a nasty parasite in the nearby lake, and eye, ear, and skin problems, and they have de-worming medicines for the children.  Home- based care is extended to the dangerously ill.  Malaria is a big problem, due to mosquitoes from the nearby marshes, but anti-malarial bed-nets are scarce and can be given only to pregnant women.

The center’s service area contains 22,570 people.  Of this number 10,884 are children under the age of 15.  There are 5,191 women of child-bearing age.

In one month 897 out-patients visit this tiny facility.  Complicated cases might be transferred to distant hospitals if there is room in them and if transportation is available.  So many hospital beds are already taken by HIV patients, and in the rainy season by malaria and cholera patients as well.  If a bed is indeed available, patients usually reach the hospital by ox cart.

A medication census shows there are no medications to treat asthma, hypertension, sexually transmitted infections, or malaria.  Even basic pain killers are in short supply. 

In charge of the facility is a Medical Assistant (MA).  MAs have just two years of training but must carry a heavy load.  He is thoughtful and dedicated.  He says, “As you can see this is a small clinic and I am the only trained person apart from the Health Surveillance Assistants [they receive 10 weeks of training] but the problems that people bring here are enormous.  If we had better facilities we could help them much more.  If I leave the clinic for something else then the clinic has to be closed, so we would like to have another qualified person here.”

At GAIA we are taking a hard look at basic health services, since HIV is so greatly intertwined with other infectious diseases, with maternal and child health, and as usual with the myriad problems of poverty.  We are so deeply grateful for your help.

William Rankin
President & Founder of GAIA

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