Malawi's health sector in never-ending woes

Things seem to be going from bad to worse in the health sector in Malawi, where problems seem to be in a race against each other; one problem trying to ride on top of the other.

A case in point is Kamuzu Central Hospital (KCH), where nurses have stopped working extra hours after the Ministry of Health and Population turned down their proposal for an adjustment to overtime allowances. They have a right to withdraw their labour, anyway; for they have the backing of labour laws.

If the truth be told, the nurses have not withdrawn their labour. What they have done is to stop working extra hours; work they do at their will, despite getting less than what they deserve.

In fact, it is not the first time nurses have decided to boycott work, after their normal working hours, on the ground that Ministry of Health Services and Population officials do not want to bow down to their [nurses’] demands for allowances they call ‘locum’.

In May 2012, they did the same, demanding an increment to locum after the administration of the then president Joyce Banda devalued the kwacha by close to 50 percent.

And, like this year, the ‘epicentre’ that year was KCH, where nurses refused to work in the paying ward and Ethel Mutharika special ward. Management had no choice but to close the affected facilities.

What the nurses are saying is that, after working the normal hours, they are not interested in stretching themselves-- rather, their bodies-- for an allowance-package that counts for nothing less than an insult.

The other thing they are saying is that they are willing to put themselves up for service, but at a cost; cost higher than their current entitlement.  

It seems that the government is being battered left, right and centre for, in January this year, nurses who offer their services to the government despite not being full-time employees threated to go on strike.

Led by Donald Kanjere Zgambo, the concerned people said they wanted nurses and midwives who are currently not employed, but are working and form a strong force in public hospitals, to be employed.

Some of the nurses and midwives just get locum, internship allocation and upkeep allowances.

They get K2,500 for working during the whole day and K3,000 for working the whole night as locum, yet Malawi is in need of an additional 5,000 nurses for the health sector to tick.

The victims, as usual, are the poor. The situation is, therefore, nothing short of disheartening.

It is disheartening because access to health is listed as a human right, including in the Bill of Rights of the Constitution of the Republic of Malawi; meaning that the State is obliged to ensure that services are ticking and that citizens are getting medical services. Any failure to do so smacks of irresponsibility.

It is such irresponsibility that has led to the suffering of innocent patients. We are talking of patients referred to the facility from district hospitals, most of such patients are too poor to afford services in private health facilities.

As at now, some of the patients referred from feeder hospitals have complained of not being attended to, or medical personnel taking ages to attend to them. Hospital management has also referred other patients back to facilities they came from, meaning that something is wrong because the facilities that refereed the patients to KCH knew that there were things they could do.

It is only natural to feel for less privileged people who are being tossed to and fro like coins. This is inhumane.

That said, it is important that nurses concerned should, for a while, bear with the authorities and hold them accountable if they do not live by their word when Parliament meets for the budget session later in the year.

After all, it is less than three months before legislators who will be elected on May 21 take office and meet for the budget session of Parliament. We know, as at now, that it will take Malawi Electoral Commission eight days to announce results for the presidential election, 23 days for members of Parliament and 30 days for Local Government elections.

After that, the problem will be addressed.

As at now, the money being asked for, which is K10,000 on average per eight or 12 hours after normal working hours, was not budgeted for and, as such, funds cannot fall from the sky. Ministry of Health officials, through their spokesperson Joshua Malango, have accepted that something is wrong and have committed to making things right in the next financial year, which starts on July 1.

Sometimes, it is important to realise that passion, and not necessarily monetary gain, is the price we say for working so hard without being appreciated.

Let all those concerned put themselves in the position of the poor citizen on the ground, be a little patient, like patients themselves, and reap the deserved financial rewards in the new financial year.

There is no other Malawi than the one we know and, together, we must stand for each other, understand each other and develop together.

As for the government, it should learn that, sometimes, it pays, and saves us time, to do the needful at the right time. Its officials should not be forced to act all the time. The fact that top public officials seek medical attention in up-market health facilities, often outside the country, should make them blind to the reality back home.

Let must always put ourselves in the shoes of others.