Se went the Penguin-stomached man,
Him and his noisy sister,
To the ants-filled land.
No, not only the so-filled land,
They, too, went to the Ngaliba land,
Before the badling Mountains.
There, the Penguin-man's sister sleeps,
When Mother ballot cries.
Four times she has cried
As the darkness kisses bye,
To the coming light.
So did the light
Bye the in coming dark.
Up came the foet,
It was a double might.
Neding another flight.
Hence went the Penguin man,
And his wife.
Sorry, its vice,
As together
They seek against their ants no mighty vice.
They have booted bye to kick backs,
So did they to vendor stalls
Lidding town of human vices
He and his vice.
In the ants land they made more noise,
Thinking it was all fine,
So did they
In Ngalibaland
Before the people said 'we want the lonely men,
A man and a woman
The party mount now so quiet
All the noise no prize
For the Penguin man and his wife.
So the ant-landers spiked,
The big man's quacking,
Their Penguin sister they spiked.
That, is that what you call our new life?
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Monday, August 17, 2009
Sole witness as Mulanje and Kilimanjalo mate
So innocent his mission,
Innocent Bushman set for the great Mulanje Mountain peak,
Sapitwa, that is the fame,
And the name.
Brother Kilimanjalo up river,
Of Sapitwa tolerates no riddle.
After all,
They hag up yonder
When shake the mighty winds,
When El Nino walks home,
To spread dry spells on land,
In miseries in the granaries.
That July morning,
Fog so covered,
The mighty Mulanje and Kilimanjalo kisses,
As Bushman
So innocently up mountain snaked.
The porter,So local in his knowledge
To Bushman's lonely insistence obliged,
To his lonely death no companion.
Mulanje Mountain so angry infuriated,
On why Bushman stil,l treked,
As Kilimanjalo and Mount Mulanje mate,
And unto another life's waters poured.
So went Bushman,
With the sperms of Father Kilimanjalo,
Down the Mulanje tube,
Yet he turned into no foetus.
Innocent villagers,
Wearing Bushman's innocence of July,
Up, up treked,
In search of daily bread.
Bushman quetly lay,
Flies nearby,
His new porter frriends,
That his own porter down he left
As towards death he solely treked.
Like the mighty winds,
The insolent fog,
Twain sheets as the two mounts met,
The news all over spread
That Bushman no longer breathed.
Innocent Bushman set for the great Mulanje Mountain peak,
Sapitwa, that is the fame,
And the name.
Brother Kilimanjalo up river,
Of Sapitwa tolerates no riddle.
After all,
They hag up yonder
When shake the mighty winds,
When El Nino walks home,
To spread dry spells on land,
In miseries in the granaries.
That July morning,
Fog so covered,
The mighty Mulanje and Kilimanjalo kisses,
As Bushman
So innocently up mountain snaked.
The porter,So local in his knowledge
To Bushman's lonely insistence obliged,
To his lonely death no companion.
Mulanje Mountain so angry infuriated,
On why Bushman stil,l treked,
As Kilimanjalo and Mount Mulanje mate,
And unto another life's waters poured.
So went Bushman,
With the sperms of Father Kilimanjalo,
Down the Mulanje tube,
Yet he turned into no foetus.
Innocent villagers,
Wearing Bushman's innocence of July,
Up, up treked,
In search of daily bread.
Bushman quetly lay,
Flies nearby,
His new porter frriends,
That his own porter down he left
As towards death he solely treked.
Like the mighty winds,
The insolent fog,
Twain sheets as the two mounts met,
The news all over spread
That Bushman no longer breathed.
Malawian soil plus German skills equals school blocks
By Richard Chirombo
Just about everyone around Nangungu Primary School in Makanjira, Mangochi, knew the German visitors were coming. Pupils, Senior Chief Makanjira, parents and teachers; they all tuned their reasoning towards October 2007.
But nobody, even his best friends, new what was up little Ali Mwamadi’s sleeve.
He had prepared a carefully woven reed hut, shaped like a plastic bag, and stood ready to receive his ‘gift’. Never once did he forget that little hut-cum-travel bag, lest he be caught unawares by the visitors.
When the Germans, for that was the nationality of the visitors, finally came in October, six year old Ali was there to welcome them. He stepped forward, a metre behind Wallace Christopher Chombo, project officer for the Malawi/Werkschule Scholen (Traveling Workschool Scholen) initiative.. Then, he stretched his bag-like hut, extending it towards the visitors..
For a moment, silence; nobody seemed to understand. There was a sense of confusion, too. But it was just for a moment because, before long, Mwamadi aired his views:
“Where is the soil they said you would bring? Throw it inside my hut!”
Laughter. Not for little Mwamadi: he was serious.
“I say, put a sample of the soil from Germany in here. What will you build the school block with, if not soil from Germany ?”
Everyone now got it. Mwamadi had heard right; that some Germans would come to Nangungu Primary School, the first of a series of visits planned by a German Non-Governmental Organization Reisende Werkschule Scholen, to help in the construction of school blocks in the district.
The only point he got wrong was the suggestion that the visitors- Eike, Evelyn, Eric, Joschus, Kim, Kolla, Marcel, Mario, Nadine, Niklas, Sean, Sebastian, Otis- would bring with them German soil, and the misconception that German soil must have been more durable than local Katondo, in the words of Ishmael Abna, a community members from the area.
That was 2007, when Mwamadi was only 6 years-old. He will be much older now, that the Germans are coming back for another construction project, to ask for German soil.. Some community members from Makanjira have already started preparing for the Germans’ 2009 coming. This year’s construction work will start on September 1, though some of the Germans will be in by August 10.
According to Michael Von Studnitz, chairperson and co-founder of Travelling Workschool Scholen, the organization chose Malawi out of 15 other choice countries because of high illiteracy rate, especially in Mangochi district, the friendliness of its citizens as well as prevailing peace and stability.
This feeds well into the fact that the country has been named the second most peaceful in Africa, after fellow Southern African Development Community member state of Botswana .
“Since 2001, we have been happy to help in the education and infrastructural development of Malawi . In fact, our research showed that there were only 13 countries in the world that needed more help than Malawi ,” said Studnitz.
Studnitz said the German organization, through financial assistance from Bingo Lotto and Stiftung Umvertellen, also wanted to boost cultural ties with Malawi , a development he hoped would help people from the two cultures appreciate their cultural heritage and learn from each other..
Through the development of learning infrastructure, the Germans also want to contribute towards the attainment of high education standards. Studnitz cited the general lack of up-to-scratch infrastructure in the country as one of the reasons for high illiteracy rates in many districts. His organization trains German children in various skills, some of which are exposed in Makanjira when those trained visit Malawi every two years since 2001 to do construction work.
This is done in collaboration with communities surrounding primary schools whose physical appearance seems to suggest doom, or announce news of imminent collapse. Trees have become the automatic substitute for such crumbling blocks, a temporally substitute that succumbs to the yielding pressure of heavy rains and the unyielding sun.
Influential community leaders like Senior Chief Makanjira have welcomed the gesture, hoping it would dig deep into the roots of illiteracy, and help enlighten hither to education-shy communities about the positives of education.
Various studies have shown that traditional Yao areas have been the heaven for illiteracy, a trend now changing with the establishment of many learning facilities in as many traditional Yao areas. This excites Makanjira so much, as manifested in his loud hopes that, very soon, the sons and daughters of Mangochi may begin to contribute positively towards their district’s development.
Those who attain the highest levels of education will now be able to flock to urban areas for work, look positively towards retiring so they may go back to the district for some good rest, and use that time (of rest) to share their experiences with the communities that nurtured and nourished them.
“In the end, Mangochi will be a developed lot,” said Makanjira.
Such is the hope of the chief; Reisende Travelling Workschool Scholen just nourishes it.
For people like Chombo, a son of Malawi who has joined hands with the Germans towards the development of Mangochi, the contributions they are making in raising up school infrastructure where in the past only hope rested is an incentive to foreign well-wishers eager to push us where our energies fail us
It always surprises people how the efforts always begin: a willing heart, community participation, eager and skillful German citizens, traditional, leaders’ support, the sight of little children bathing for education in the October sun, approaching rains, and readily available resources (water and soil).
Soon, a foundation is dug, one stone over another, iron sheets and…(boom) …students can now learn under protective shelter. It all happens within one month, and the Germans go home.
There are tears, also- always tears- in the end.
“ Malawi is almost like our own home; not a second home,’ says Studnitz.
Just about everyone around Nangungu Primary School in Makanjira, Mangochi, knew the German visitors were coming. Pupils, Senior Chief Makanjira, parents and teachers; they all tuned their reasoning towards October 2007.
But nobody, even his best friends, new what was up little Ali Mwamadi’s sleeve.
He had prepared a carefully woven reed hut, shaped like a plastic bag, and stood ready to receive his ‘gift’. Never once did he forget that little hut-cum-travel bag, lest he be caught unawares by the visitors.
When the Germans, for that was the nationality of the visitors, finally came in October, six year old Ali was there to welcome them. He stepped forward, a metre behind Wallace Christopher Chombo, project officer for the Malawi/Werkschule Scholen (Traveling Workschool Scholen) initiative.. Then, he stretched his bag-like hut, extending it towards the visitors..
For a moment, silence; nobody seemed to understand. There was a sense of confusion, too. But it was just for a moment because, before long, Mwamadi aired his views:
“Where is the soil they said you would bring? Throw it inside my hut!”
Laughter. Not for little Mwamadi: he was serious.
“I say, put a sample of the soil from Germany in here. What will you build the school block with, if not soil from Germany ?”
Everyone now got it. Mwamadi had heard right; that some Germans would come to Nangungu Primary School, the first of a series of visits planned by a German Non-Governmental Organization Reisende Werkschule Scholen, to help in the construction of school blocks in the district.
The only point he got wrong was the suggestion that the visitors- Eike, Evelyn, Eric, Joschus, Kim, Kolla, Marcel, Mario, Nadine, Niklas, Sean, Sebastian, Otis- would bring with them German soil, and the misconception that German soil must have been more durable than local Katondo, in the words of Ishmael Abna, a community members from the area.
That was 2007, when Mwamadi was only 6 years-old. He will be much older now, that the Germans are coming back for another construction project, to ask for German soil.. Some community members from Makanjira have already started preparing for the Germans’ 2009 coming. This year’s construction work will start on September 1, though some of the Germans will be in by August 10.
According to Michael Von Studnitz, chairperson and co-founder of Travelling Workschool Scholen, the organization chose Malawi out of 15 other choice countries because of high illiteracy rate, especially in Mangochi district, the friendliness of its citizens as well as prevailing peace and stability.
This feeds well into the fact that the country has been named the second most peaceful in Africa, after fellow Southern African Development Community member state of Botswana .
“Since 2001, we have been happy to help in the education and infrastructural development of Malawi . In fact, our research showed that there were only 13 countries in the world that needed more help than Malawi ,” said Studnitz.
Studnitz said the German organization, through financial assistance from Bingo Lotto and Stiftung Umvertellen, also wanted to boost cultural ties with Malawi , a development he hoped would help people from the two cultures appreciate their cultural heritage and learn from each other..
Through the development of learning infrastructure, the Germans also want to contribute towards the attainment of high education standards. Studnitz cited the general lack of up-to-scratch infrastructure in the country as one of the reasons for high illiteracy rates in many districts. His organization trains German children in various skills, some of which are exposed in Makanjira when those trained visit Malawi every two years since 2001 to do construction work.
This is done in collaboration with communities surrounding primary schools whose physical appearance seems to suggest doom, or announce news of imminent collapse. Trees have become the automatic substitute for such crumbling blocks, a temporally substitute that succumbs to the yielding pressure of heavy rains and the unyielding sun.
Influential community leaders like Senior Chief Makanjira have welcomed the gesture, hoping it would dig deep into the roots of illiteracy, and help enlighten hither to education-shy communities about the positives of education.
Various studies have shown that traditional Yao areas have been the heaven for illiteracy, a trend now changing with the establishment of many learning facilities in as many traditional Yao areas. This excites Makanjira so much, as manifested in his loud hopes that, very soon, the sons and daughters of Mangochi may begin to contribute positively towards their district’s development.
Those who attain the highest levels of education will now be able to flock to urban areas for work, look positively towards retiring so they may go back to the district for some good rest, and use that time (of rest) to share their experiences with the communities that nurtured and nourished them.
“In the end, Mangochi will be a developed lot,” said Makanjira.
Such is the hope of the chief; Reisende Travelling Workschool Scholen just nourishes it.
For people like Chombo, a son of Malawi who has joined hands with the Germans towards the development of Mangochi, the contributions they are making in raising up school infrastructure where in the past only hope rested is an incentive to foreign well-wishers eager to push us where our energies fail us
It always surprises people how the efforts always begin: a willing heart, community participation, eager and skillful German citizens, traditional, leaders’ support, the sight of little children bathing for education in the October sun, approaching rains, and readily available resources (water and soil).
Soon, a foundation is dug, one stone over another, iron sheets and…(boom) …students can now learn under protective shelter. It all happens within one month, and the Germans go home.
There are tears, also- always tears- in the end.
“ Malawi is almost like our own home; not a second home,’ says Studnitz.
PPM,DPP: Together, yet so far apart
By Richard Chirombo
People’s Progressive Movement (PPM), an alliance partner to President Bingu wa Mutharika’s Democratic Progressive Party (DPP), seems set to follow the state president’s footsteps, albeit on different missions.
This came to the fore again this week, when PPM president Mark Katsonga Phiri addressed a campaign meeting at Ndirande’s Chirunga Ground on Monday, a day after Mutharika addressed a similar meeting at Ndirande Community Centre Ground. The two venues are just a kilometer apart.
Katsonga was in the populous township to win votes for PPM’s parliamentary candidate in the by-elections slated for this week, Margaret Saenda, while Mutharika was in town for the sake of Themba Mkandawire.
Mutharika has this year attracted a lot public attention, and uproar in equal measure, largely generated through the purchase of Hummers, which now form an integral part of his presidential convoy. Katsonga has not let the Hummers’ phenomenon gather around Mutharika’s personality only, but has purchased his own- an automobile he is employing to good use during campaign, including the one for Blantyre’s City Central constituency now on the table for claim.
PPM surprised Malawians in the run up to the country’s May 19 Presidential and Parliamentary elections when it announced, during the handover ceremony of papers for its presidential candidates to Malawi Electoral Commission officials, it would no longer feature candidates. The party announced, instead, it would support Mutharika’s candidature.
Observers, including Mzuzu University political analysts Noel Mbowela, described it as a marriage of convenience at the time, one that lacked clear terms of reference and guidelines on mutual benefits.
Mutharika then, during a meeting addressed in Katsonga’s Neno constituency, denounced Katsonga, accusing him, among other things, of cheating constituents that the DPP had endorsed him as its parliamentary candidate when the party already had a female candidate in the name of Reen Kachere.
The outburst put Katsonga in a catch-22 situation, as he still maintained the two parties’ relationship remained intact, and that Mutharika’s outbursts were merely part of the heat that was campaign.
Now, some three months after the May 19 elections, the relationship between the two parties remains hazy. Mutharika has done little to clear the air by his apparent disregard of PPM officials at his official meetings and public rallies.
PPM, which previously had over five Members of Parliament in the previous House, now has none, reducing the party to a side show and preparatory ground for the 2014 Presidential and Parliamentary elections.
Observers see the difference in metres between Ndirande Community Centre Ground (where Mutharika addressed a campaign rally on Sunday) and Chirunga Ground (the abode of Katsonga on Monday) as being representative of the ‘inside’ distance between the two political bedfellows.
Kenwilliams Mhango, one of the observers, said the two parties were now drifting apart, and attributed the development to the lack of clear terms of reference for the parties since their relationship was forged by way of an ad hoc strategy.
This could be seen from Mutharika and Katsonga’s sentiments during their Sunday and Monday meetings, respectively. Mutharika told a mammoth gathering at the Community Centre Ground that they should vote for nobody else but DPP’s Mkandawire. He described the other aspirants as mere opportunists who had nothing to offer. This includes PPM’s Saenda.
Katsonga, on his part, implored constituents to vote for Saenda only, saying the other political parties had failed to meet the aspirations of the people. He especially took at a swipe at the most immediate past Member of Parliament for the constituency, Gift Mwamondwe, and his party, saying they had failed people.
Mwamondwe was a DPP parliamentarian who will now stand as an independent. He accuses the DPP, where he still claims to belong, of ‘doctoring’ results of constituency primaries last year in favour of Mkandawire.
The PPM President also took time to visit Ndirande Market vendors. Katsonga was one of the first politicians to respond to the vendors’ dire call of distress when fire gutted down the market late last year, and donated K3 million.
Addressing the vendors, who gathered in the market premises on Monday, Katsonga asked them to vote for his candidate Saenda, saying the other political parties had little regard for their plight as evidenced by their slow response to the calamity that befell them last year.
Vendors especially accused government of employing ‘abandonment’ tactics after the fire, citing the slow response to their troubles, a development that led to an attempted gutting down of a DPP office in the area.
Katsonga seemed to play this ‘anger’ card very well this week, imploring the vendors not to put the incident fast behind the wheels of the past but show that they, too, could make responsive decision at the ballot box, decisions that reflected the realities of everyday life.
"I would accept no other form of gratitude (to the donation I gave you) other than the gift of Saenda from this constituency. That is the best way to thank me. PPM is the only party that can do wonders for you, and that you can enjoy by voting for Saenda. I leave you with these words, my beloved vendors," said Katsonga.
When asked about the present status of his party’s relationship with DPP, Katsonga maintained it was intact. He said PPM had won the May 19 presidential elections by virtue of Mutharika, their supported candidate, winning the polls.
It was the voice of an ambitious party president looking forward to 2014.
At last, the coffin finally came. In went the PPM and DPP, together. Once again, the independents had ruled again in Zomba Malosa and Blantyre Central constituencies.
People’s Progressive Movement (PPM), an alliance partner to President Bingu wa Mutharika’s Democratic Progressive Party (DPP), seems set to follow the state president’s footsteps, albeit on different missions.
This came to the fore again this week, when PPM president Mark Katsonga Phiri addressed a campaign meeting at Ndirande’s Chirunga Ground on Monday, a day after Mutharika addressed a similar meeting at Ndirande Community Centre Ground. The two venues are just a kilometer apart.
Katsonga was in the populous township to win votes for PPM’s parliamentary candidate in the by-elections slated for this week, Margaret Saenda, while Mutharika was in town for the sake of Themba Mkandawire.
Mutharika has this year attracted a lot public attention, and uproar in equal measure, largely generated through the purchase of Hummers, which now form an integral part of his presidential convoy. Katsonga has not let the Hummers’ phenomenon gather around Mutharika’s personality only, but has purchased his own- an automobile he is employing to good use during campaign, including the one for Blantyre’s City Central constituency now on the table for claim.
PPM surprised Malawians in the run up to the country’s May 19 Presidential and Parliamentary elections when it announced, during the handover ceremony of papers for its presidential candidates to Malawi Electoral Commission officials, it would no longer feature candidates. The party announced, instead, it would support Mutharika’s candidature.
Observers, including Mzuzu University political analysts Noel Mbowela, described it as a marriage of convenience at the time, one that lacked clear terms of reference and guidelines on mutual benefits.
Mutharika then, during a meeting addressed in Katsonga’s Neno constituency, denounced Katsonga, accusing him, among other things, of cheating constituents that the DPP had endorsed him as its parliamentary candidate when the party already had a female candidate in the name of Reen Kachere.
The outburst put Katsonga in a catch-22 situation, as he still maintained the two parties’ relationship remained intact, and that Mutharika’s outbursts were merely part of the heat that was campaign.
Now, some three months after the May 19 elections, the relationship between the two parties remains hazy. Mutharika has done little to clear the air by his apparent disregard of PPM officials at his official meetings and public rallies.
PPM, which previously had over five Members of Parliament in the previous House, now has none, reducing the party to a side show and preparatory ground for the 2014 Presidential and Parliamentary elections.
Observers see the difference in metres between Ndirande Community Centre Ground (where Mutharika addressed a campaign rally on Sunday) and Chirunga Ground (the abode of Katsonga on Monday) as being representative of the ‘inside’ distance between the two political bedfellows.
Kenwilliams Mhango, one of the observers, said the two parties were now drifting apart, and attributed the development to the lack of clear terms of reference for the parties since their relationship was forged by way of an ad hoc strategy.
This could be seen from Mutharika and Katsonga’s sentiments during their Sunday and Monday meetings, respectively. Mutharika told a mammoth gathering at the Community Centre Ground that they should vote for nobody else but DPP’s Mkandawire. He described the other aspirants as mere opportunists who had nothing to offer. This includes PPM’s Saenda.
Katsonga, on his part, implored constituents to vote for Saenda only, saying the other political parties had failed to meet the aspirations of the people. He especially took at a swipe at the most immediate past Member of Parliament for the constituency, Gift Mwamondwe, and his party, saying they had failed people.
Mwamondwe was a DPP parliamentarian who will now stand as an independent. He accuses the DPP, where he still claims to belong, of ‘doctoring’ results of constituency primaries last year in favour of Mkandawire.
The PPM President also took time to visit Ndirande Market vendors. Katsonga was one of the first politicians to respond to the vendors’ dire call of distress when fire gutted down the market late last year, and donated K3 million.
Addressing the vendors, who gathered in the market premises on Monday, Katsonga asked them to vote for his candidate Saenda, saying the other political parties had little regard for their plight as evidenced by their slow response to the calamity that befell them last year.
Vendors especially accused government of employing ‘abandonment’ tactics after the fire, citing the slow response to their troubles, a development that led to an attempted gutting down of a DPP office in the area.
Katsonga seemed to play this ‘anger’ card very well this week, imploring the vendors not to put the incident fast behind the wheels of the past but show that they, too, could make responsive decision at the ballot box, decisions that reflected the realities of everyday life.
"I would accept no other form of gratitude (to the donation I gave you) other than the gift of Saenda from this constituency. That is the best way to thank me. PPM is the only party that can do wonders for you, and that you can enjoy by voting for Saenda. I leave you with these words, my beloved vendors," said Katsonga.
When asked about the present status of his party’s relationship with DPP, Katsonga maintained it was intact. He said PPM had won the May 19 presidential elections by virtue of Mutharika, their supported candidate, winning the polls.
It was the voice of an ambitious party president looking forward to 2014.
At last, the coffin finally came. In went the PPM and DPP, together. Once again, the independents had ruled again in Zomba Malosa and Blantyre Central constituencies.
Towards improved governance in public health care delivery system
BY RICHARD CHIROMBO
It begins with pain in one Molar or pre-Molar tooth.
Twenty-four year old Jonathan Banda invested hugely in dental care
over the years but finally, on Wednesday July 22, 2009, succumbs to
the beck and call of toothache and decides it was time he lived
without the tooth, anyway.
He underrates the medical services offered at Zingwangwa, Ndirande or
Chilomoni Health Centres in Blantyre and goes direct to the referral
Queen Elizabeth Central Hospital (QECH) where he is made to pay K200
for his pains in the public section.
He paid, yes, and wanted two things in return: no more pain as well as
taking the removed tooth (a Molar) home because 24 years are too long
a time to just pat like that. In addition, he hates the way people pat
with their teeth at the hospital- the patient goes home with some
cotton where once resided a tooth, and the troublesome tooth remains
in the bin at the hospital. Just like that.
“After removing the tooth, they gave me painkillers. I, then, asked if
I was free to go home, and they said ‘yes’. When I asked for my tooth,
they said no. Is that fair?” queries Banda.
Banda says some people love whatever they share a life-time with and
are not willing to easily pat ways with some of their body parts at
the hospital. He is talking about ‘unperishable’ organs such as teeth.
“We really need answers on what these people do with some of our body
parts. Some say they use them for study purposes at medical and health
science schools. Some say they throw them away. Only few people know
exactly what happens with their parts,” says Banda.
But, that is just the beginning: it ends with the pocket. Where does
the money (K200) that Banda paid go and, except for Ministry of Health
officials, how can the ordinary villager get hold of this revenue
information?
The Malawi Health Equity Network (MHEN) has been fighting for this,
and many more, patient rights. According to MHEN National Coordinator,
Martha Kwataine, it is in the interest of transparency and
accountability in the public health care delivery system that people
ought to now about what happens with their what.
“This will instill a sense of confidence in our health care system and
improve the relationship between patients and the system,” says
Kwataine.
The question of good governance in the health care service delivery
system has been a recurring theme, a theme that has resonated across
regional health forums and meetings.
Governance, according to one of the MHEN members- People’s Federation
for National Peace and Development Executive Director, Edward Chaka-
revolves around six key parameters.
“Broad participation, transparency, open responsiveness, consensus
based performance, equity and inclusion, and accountability, among
other notable factors,” says Chaka.
Not all members of the general public can have a say in this, he
acknowledges, hence the need for a more organized mechanism through
civil society groups such as MHEN.
Chaka indicates, in one of the papers presented at a MHEN (Southern
region) Regional Health Forum, that this can be achieved by
understanding the historical, social and cultural context of a given
society or community.
“This is especially true for hospitals. The essence of governance is
that an organization becomes accountable to those who will be affected
by its decisions or actions, and our hospitals, though trying, have
largely failed to make the mark. In deed, where do our teeth go? Don’t
we have the right to take them home? How are the finances run? Is
there no way of making them public, and timely?” he says.
Chaka acknowledges that, while good governance was ideal, it has
always been a challenge to achieve it in its totality. Very few
countries, including in the Western world, have mastered it. It is an
on going, continuous struggle.
To Kwataine, this struggle includes the need for a comprehensive
review of the health allocation formula. Her analysis of inequities in
health, service delivery and financing points to the gloomy conclusion
that our formula is not based on health needs.
This could be achieved by reshaping the formula to reflect an ‘Equal
access for equal need’ model, developing a needs based formula,
accommodating district specific cost and donor funding differences as
well as soliciting communitarian views on weightings in formula.
“(This will mean that) Population weightings include (s) age, gender,
residence, income, HIV status and performance criteria like in-patient
services,” says Kwataine.
The Malawi National Health Accounts (NHA)’s sub-accounts for HIV and
AIDS, Reproductive Health and Child Health, indicate that the Southern
region dominates in both health expenditures and facilities.
Between 2002 and 2004, for example, the South got 47 per cent of
health expenditures while the North and Centre got 17 per cent and 36
per cent, respectively. The South had a 47 per cent share of health
facilities, with the Centre and North sharing 35 per cent and 20 per
cent respectively.
Recent developments point to improved trends, however. It is also
intimated that K23 billion allocated to the Ministry of Health during
the 2009/10 fiscal year will go a long way in bringing equity in
health resources home.
Another factor includes the need to develop human resources and
capacity within the health sector. A Human Resources/Capacity
Development within the Health Sector Needs Assessment Study (Final
Report) released in April 2007 shows the need for more staff
recruitment and replacement.
The rate of attrition due to resignation, dismissal, redundancy and
death from 1990 to 2005 has been high, though it started to go down
between 1994 and 1995.
It started with a below-30 people figure in 1990, reached 320 in 1993
before going level at 200 workers between 1994 and 1995. Since then,
the number has been increasing, reaching 500 in 2005, up from 400 in
1999.
Ministry of Health officials blame it on the brain drain that
continues to hit many African countries including Malawi. Bilateral
donors, including Britain through its Department for International
Development, have tried to intervene with incentive-filled packages
and the trend seems to be slipping down into the record books.
Local Nurses and Midwives advocate, Dorothy Ngoma, says while the
biggest tide seemed far off the coast for now, conditions for health
workers remained pathetic in the country.
A paper by Prof. Cam Bowie (of the College of Medicine) indicates that
there have been staff inadequacies in both Ministry of Health and
Christian Hospitals Association of Malawi facilities between 2003 and
2007.
Except for Health Surveillance Assistants, positions for doctors,
nurses and+ technical personnel hardly filled the half-way mark. Many
more health experts continue to be lost to retirement, too.
The number of those lost to retirement now hovers above 50 annually,
raising the black flag even higher.
There is hope, however. Recent studies, including assessments
conducted by MHEN, seem to suggest that Public Private Partnerships in
health could be the answer. This will see private players deliver
health services on behalf of the public sector/government.
This recognizes the fact that, while the core business of the Ministry
of Health is to deliver the Essential Health Package (EHP), this is
hampered by poor coverage and access to the EHP services.
More hope lies in the fact, also, that health facilities such as QECH
have begun to open up to public scrutiny.
QECH, according to Felicia Chilipaine- Principal Nursing Officer,
Medical Unit, and a member of the hospital’s Suggestion Box Committee-
was now waking up to the notion of public responsiveness through such
strategies as suggestion boxes.
Chilipaine, who was speaking with the permission of Acting QECH
Administrator, said suggestions from the public were helping in
shaping the face of services delivery.
“It is also one way of achieving good governance and promoting
transparency and accountability,” said Chilipaine.
The public, through the ambitious initiative, now have the right to
demand quality services. Not only quality services but a timely
service, too, says Chilipaine.
--------------------------------------------------------------------------------
It begins with pain in one Molar or pre-Molar tooth.
Twenty-four year old Jonathan Banda invested hugely in dental care
over the years but finally, on Wednesday July 22, 2009, succumbs to
the beck and call of toothache and decides it was time he lived
without the tooth, anyway.
He underrates the medical services offered at Zingwangwa, Ndirande or
Chilomoni Health Centres in Blantyre and goes direct to the referral
Queen Elizabeth Central Hospital (QECH) where he is made to pay K200
for his pains in the public section.
He paid, yes, and wanted two things in return: no more pain as well as
taking the removed tooth (a Molar) home because 24 years are too long
a time to just pat like that. In addition, he hates the way people pat
with their teeth at the hospital- the patient goes home with some
cotton where once resided a tooth, and the troublesome tooth remains
in the bin at the hospital. Just like that.
“After removing the tooth, they gave me painkillers. I, then, asked if
I was free to go home, and they said ‘yes’. When I asked for my tooth,
they said no. Is that fair?” queries Banda.
Banda says some people love whatever they share a life-time with and
are not willing to easily pat ways with some of their body parts at
the hospital. He is talking about ‘unperishable’ organs such as teeth.
“We really need answers on what these people do with some of our body
parts. Some say they use them for study purposes at medical and health
science schools. Some say they throw them away. Only few people know
exactly what happens with their parts,” says Banda.
But, that is just the beginning: it ends with the pocket. Where does
the money (K200) that Banda paid go and, except for Ministry of Health
officials, how can the ordinary villager get hold of this revenue
information?
The Malawi Health Equity Network (MHEN) has been fighting for this,
and many more, patient rights. According to MHEN National Coordinator,
Martha Kwataine, it is in the interest of transparency and
accountability in the public health care delivery system that people
ought to now about what happens with their what.
“This will instill a sense of confidence in our health care system and
improve the relationship between patients and the system,” says
Kwataine.
The question of good governance in the health care service delivery
system has been a recurring theme, a theme that has resonated across
regional health forums and meetings.
Governance, according to one of the MHEN members- People’s Federation
for National Peace and Development Executive Director, Edward Chaka-
revolves around six key parameters.
“Broad participation, transparency, open responsiveness, consensus
based performance, equity and inclusion, and accountability, among
other notable factors,” says Chaka.
Not all members of the general public can have a say in this, he
acknowledges, hence the need for a more organized mechanism through
civil society groups such as MHEN.
Chaka indicates, in one of the papers presented at a MHEN (Southern
region) Regional Health Forum, that this can be achieved by
understanding the historical, social and cultural context of a given
society or community.
“This is especially true for hospitals. The essence of governance is
that an organization becomes accountable to those who will be affected
by its decisions or actions, and our hospitals, though trying, have
largely failed to make the mark. In deed, where do our teeth go? Don’t
we have the right to take them home? How are the finances run? Is
there no way of making them public, and timely?” he says.
Chaka acknowledges that, while good governance was ideal, it has
always been a challenge to achieve it in its totality. Very few
countries, including in the Western world, have mastered it. It is an
on going, continuous struggle.
To Kwataine, this struggle includes the need for a comprehensive
review of the health allocation formula. Her analysis of inequities in
health, service delivery and financing points to the gloomy conclusion
that our formula is not based on health needs.
This could be achieved by reshaping the formula to reflect an ‘Equal
access for equal need’ model, developing a needs based formula,
accommodating district specific cost and donor funding differences as
well as soliciting communitarian views on weightings in formula.
“(This will mean that) Population weightings include (s) age, gender,
residence, income, HIV status and performance criteria like in-patient
services,” says Kwataine.
The Malawi National Health Accounts (NHA)’s sub-accounts for HIV and
AIDS, Reproductive Health and Child Health, indicate that the Southern
region dominates in both health expenditures and facilities.
Between 2002 and 2004, for example, the South got 47 per cent of
health expenditures while the North and Centre got 17 per cent and 36
per cent, respectively. The South had a 47 per cent share of health
facilities, with the Centre and North sharing 35 per cent and 20 per
cent respectively.
Recent developments point to improved trends, however. It is also
intimated that K23 billion allocated to the Ministry of Health during
the 2009/10 fiscal year will go a long way in bringing equity in
health resources home.
Another factor includes the need to develop human resources and
capacity within the health sector. A Human Resources/Capacity
Development within the Health Sector Needs Assessment Study (Final
Report) released in April 2007 shows the need for more staff
recruitment and replacement.
The rate of attrition due to resignation, dismissal, redundancy and
death from 1990 to 2005 has been high, though it started to go down
between 1994 and 1995.
It started with a below-30 people figure in 1990, reached 320 in 1993
before going level at 200 workers between 1994 and 1995. Since then,
the number has been increasing, reaching 500 in 2005, up from 400 in
1999.
Ministry of Health officials blame it on the brain drain that
continues to hit many African countries including Malawi. Bilateral
donors, including Britain through its Department for International
Development, have tried to intervene with incentive-filled packages
and the trend seems to be slipping down into the record books.
Local Nurses and Midwives advocate, Dorothy Ngoma, says while the
biggest tide seemed far off the coast for now, conditions for health
workers remained pathetic in the country.
A paper by Prof. Cam Bowie (of the College of Medicine) indicates that
there have been staff inadequacies in both Ministry of Health and
Christian Hospitals Association of Malawi facilities between 2003 and
2007.
Except for Health Surveillance Assistants, positions for doctors,
nurses and+ technical personnel hardly filled the half-way mark. Many
more health experts continue to be lost to retirement, too.
The number of those lost to retirement now hovers above 50 annually,
raising the black flag even higher.
There is hope, however. Recent studies, including assessments
conducted by MHEN, seem to suggest that Public Private Partnerships in
health could be the answer. This will see private players deliver
health services on behalf of the public sector/government.
This recognizes the fact that, while the core business of the Ministry
of Health is to deliver the Essential Health Package (EHP), this is
hampered by poor coverage and access to the EHP services.
More hope lies in the fact, also, that health facilities such as QECH
have begun to open up to public scrutiny.
QECH, according to Felicia Chilipaine- Principal Nursing Officer,
Medical Unit, and a member of the hospital’s Suggestion Box Committee-
was now waking up to the notion of public responsiveness through such
strategies as suggestion boxes.
Chilipaine, who was speaking with the permission of Acting QECH
Administrator, said suggestions from the public were helping in
shaping the face of services delivery.
“It is also one way of achieving good governance and promoting
transparency and accountability,” said Chilipaine.
The public, through the ambitious initiative, now have the right to
demand quality services. Not only quality services but a timely
service, too, says Chilipaine.
--------------------------------------------------------------------------------
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