SPEECH DELIVERED BY COMMISSIONER MRS ELVEY MTAFU
DURING THE OPENING OF BRIDGE COURSE FOR MEDIA PRACTITIONERS
13TH MAY, 2013
SHIRE HIGHLANDS HOTEL
BLANTYRE
My fellow Commissioners
The Chief Elections Officer, Mr Willie Kalonga
Ms Thandie Nkovole, Coordinator of the Course
Mr Wellington Katantha, The Lead Facilitator and other Facilitators
Distinguished Participants
Ladies and Gentlemen
I should start by saying that am delighted to be here and offer a few remarks before the start of this workshop. This is the first training that the Commission is organizing for the media as part of capacity building ahead of the Tripartite Elections in 2014.
The media are a crucial partner in elections and as Malawi Electoral Commission we are eager to see to it that our partners are discharging their roles in a professional and excellent manner and that any competency gaps should be addressed. That is why we have lined up a number of training workshops aiming at equipping our stakeholders with knowledge and skills. Two weeks ago, we had a two-week Train the Facilitator Training (TTF) workshop at this very same place where we invited participants from the civil society organizations to train them so that they can also train others competently using adult learning techniques.
Ladies and Gentlemen, there are several media training workshops which the Commission has lined up just targeting the media but the one we are having today is unique from the others. This training is following a Building Resources in Democracy, Governance and Elections (BRIDGE) curriculum. BRIDGE is an internationally reputed project and an authority in elections curriculum. What it means is that the material you will learn from this workshop is the same that is being learnt in all other countries where this module has been tackled. Our facilitators are going to explain to you the background of BRIDGE and you will agree with me it is a rich curriculum. The certificate that you will get at the end of the training is internationally recognized and that is why I urge you to attend all the sessions. Fulltime attendance is one of the conditions for one to be awarded a certificate.
Ladies and gentlemen, I wish to talk about the responsibility of the media in ensuring that we have free, fair and credible elections. Because the media reaches out to a multitude of audience within a short time, you have a critical role of bringing electoral information to the public. You need to do this in a manner that does not disadvantage any contestant. Otherwise, if the media do not offer a level playing field for all contestants, this approach can easily undermine all the efforts by the Malawi Electoral Commission and all stakeholders to have free, fair and credible elections. You would, therefore, be doing a disfavor to the Malawian populace. As the media you also have a responsibility of building a well informed electorate that is motivated and interested to participate in elections.
As we are in elections period, may I also appeal to you to exercise reason and rationale in your reporting. Elections are an emotive exercise because of what is at stake and no one goes into an election expecting to lose although the fact still stands out that there will always be only one winner in an election. You should be cautious that the material you broadcast or publish does not perpetrate hostility, violence, aggression, hatred, tribalism, unrest, conflict or anything that falls in this class. Examples abound world over where media, without exercising caution in their reportage have fueled electoral disputes resulting in civil unrests and loss of life. The Rwandan genocide always stands out as a classical example. One of the radio presenters in Rwanda, Georges Henri Yvon Joseph Ruggiu, was sentenced to 12 years by the International Criminal Tribunal for inciting violence. And recently, during the previous elections in Kenya, the media had a portion of their blame for the aftermath violence that erupted . We would not want such scenarios for Malawi and that is why we are conducting trainings like these ones that will enable you report effectively about elections.
I should also urge you to be cautious on reporting opinion polls. We usually have pollsters surfacing during elections some of whom their credentials are very questionable and always come up with questionable poll statistics. We would urge you to question such characters before publicizing their results. Some of the opinions that are published, have potential impact of discouraging the electorate from participating in electoral activities and perpetuating voter apathy. Always ask them to disclose how they carried out their opinion polls, their sample size, who commissioned the opinion poll and when it was done. Few critical questions can unearth information that can help you establish whether an opinion poll was bogus or genuine.
Ladies and Gentlemen, as Malawi Electoral Commission we will continue to remain a friend of the media. We will always give you information so that you write better and informed articles about elections. Apart from training, we are also planning for the review of the media code of conduct, which acts as a guide and reference book your practice as far as election reporting is concerned. This review will be done in a consultative process whereby all media houses will participate. We will hold a consultative workshop where all the media houses in the country will attend.
Ladies and Gentlemen, the Malawi Electoral Commission has taken a cycle approach to elections management, that is we are no longer treating elections as an event that takes place once every five years but as a cycle of five years. I also invite you to adopt the same cycle approach to your reporting about elections. It is common to see many journalists writing about elections, radios come up with special programes and newspapers coming up with special supplements. All these disappear after polling and results announcement. With the electoral cycle approach, there will be many activities that will be happening in between the ballot that we will need you to publicise for our and the benefit of the Malawian public.
People still need to be informed about electoral issues; those who attain voting age in between elections need to be educated about their right to vote and in all this we need the media. Your sustained reporting about elections even after elections can greatly help counter voter apathy and maintain the interest of the electorate in election issues. That aside, you also have a responsibility on checking on elected officers to ensure that they are delivering what they promised the electorate during the campaign period.
Ladies and Gentlemen, I will not resume my seat without talking about the new media. Facebook, twitter, blogs and other platforms have become effective and cost effective tools for communication. With the convergence of the media, we have already seen newspapers and radio stations setting up facebook pages. This just shows the influence that the social media platforms are gaining. I have also noted that some journalists have their own facebook and blogs where they post their material to share with the public. I should urge you to still apply your journalistic ethics and standards when using social media.
The media code of conduct is not suspended just because the material is being distributed through new media where we currently don’t have a legislation as a nation. Those with interactive platforms where readers can post comments ought to exercise care and responsibility that the comments being posted are palatable and that they could run in their papers or radio. If newspapers edit letters to the editor why should you not exercise the same with comments from readers for their online publications? Without curtailing freedom of expression, the media have a responsibility to ensure that there is sanity in the comments and feedback from readers that appears on the online publications.
Lastly distinguished Ladies and Gentlemen, I would like to thank the European Union through the Democratic Governance Programme (DGP) for proving the financial support towards this course. Let me express our gratitude to the EU DGP for the countless unconditional support it gives to the Commission. The preparatory phase of this election period has largely been successful due to the support from the EU DGP.
It is now my hounor and privilege to declare this workshop opened. I wish you fruitful time and stay at this place.
Thank you very much
May God bless you all
May God Bless Our Nation
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Tuesday, May 14, 2013
Saturday, May 11, 2013
Friday, May 10, 2013
Civil Society Agriculture Network Position Paper on Hunger in Malawi
Introduction
In December 2012, the Civil Society Agriculture Network (CISANET) released a press statement on the hunger situation in Malawi. Among many issues that were raised in the communiqué, CISANET pointed out some shortfalls being experienced in the response to the hunger situation in Malawi.
The communiqué also did advice against politicizing food in order to gain political mileage for the ruling elites. Three months down the line, the hunger situation has been exacerbated by floods and other natural disasters also coupled with lack of capacity for ADMARC to cope with the increasing demand for maize.
A lot of people are now spending hours on end on queues lining up and having travelled a long distance and sometimes spending more money for transport than the food they are buying only to buy 10kgs of maize being rationed by ADMARC.
CISANET feels this to be a mockery to the hunger situation and urgent action needs to be taken.
The price of maize has soured from the government recommended price of K3, 500/50kgs to K10, 000/50kgs making it unaffordable by the average poor family in rural and urban areas of Malawi. CISANET is aware of the current efforts being implemented by the government to distribute free flour (25kgs); and maize both to the people in the South and other areas that were mapped out by the Malawi vulnerability Assessment Committee (MVAC) report in its September 2012 assessment.
On December 26, 2012, the State President imposed a ban on maize export to avoid continued loss of maize outside the country.
However despite the ban, reports are still showing that massive amounts of maize are being smuggled outside Malawi using the uncharted routes and illegal means. The Nation Online of Friday 8th March 2013, quoting FEWSNET report, confirmed this.
CISANET is also aware that an amount of 10000MT was approved for ADMARC to draw down from National Strategic Grain Reserves (SGR) in December. It is therefore worrisome that we should have such shortages in most ADMARC markets. Government needs to assure the nation that there is enough food available in the country to run through for the rest of the lean season.
A recent visit to the National Food Reserves at Kanengo by the donors indicated that the country has sufficient food to feed itself, and the nation was assured of having enough in the strategic reserves. Ironically, barely a few days afterwards, the nation is informed differently and the leadership is now asking for outside support.
Such inconsistencies are a major cause of concern. 2.0 Policies In the constitution of Malawi, every person has a right to life and food is believed to be equated to life so that by denying people food, it is inadvertently denying that individual the right to life.
The country's leadership swore an oath to protect the constitution of Malawi and thus has an obligation to ensure that its citizens have adequate and healthy food for productive life.
The Food Security Policy of 2006 has several sections that commits government to ensuring that it is obligated to its citizens to provide them with food and to see that no practice either by government, political or otherwise interferes to deny anybody the freedom to enjoy food security.
In this regard, reference is made to the following sections of the policy: Section 1.2.2.4 Human rights: it states that: Cognisant of the provisions for the protection of human rights and freedoms as enshrined in the Constitution of Malawi, the right to adequate food is fully accepted as a human right. The right for everyone to have access to safe and nutritious food shall be observed in accordance with the fundamental right of everyone to be free from hunger.
The International Covenant on Economic, Social and Cultural Rights says, “the right to adequate food is fully realised when every individual, alone or in a community with others, has physical and economic access to adequate food or the means of its procurement"
Section 1.2.7 - protecting the right to food: it states that:
Government will be committed to ensuring that no government actions or those of private traders would reduce any Malawians access to safe nutritious food and that there is no discrimination in the buying and selling of food.
Section 1.2.8 - Social Protection it states that: Every person has the right to food security and a standard of living adequate for health.
Recognizing that there will always be a part of the society that will require social protection in order to meet their food requirements, government will provide distinctly targeted safety nets cautious of the need to avoid creating dependency and negative impacts.
In line with the Government’s National Safety Nets Strategy, social protection programmes shall be designed, in such a way that they complement the broader pro-poor growth strategy and also help people prevent, manage and cope with risk to reduce vulnerability.
They shall be designed to enable the vulnerable to gradually build up their assets so as to escape the threat of poverty in a sustainable way and to increase their resilience to shocks.
Against such policy provisions, government is mandated to ensure that its citizens are well protected and adequately provided for and that their dignity as human beings is respected. It is thus in light of this policy provision that government is called upon to rise up to the situation and provide appropriate response to the hunger situation.
Our stand
CISANET supports the current efforts taken by government to mitigate the hunger situation in the country.
Among other things we have seen political will by calling Malawians to mobilize resources. A number of organizations and individuals have come forth to contribute food and financial resources. This is a commendable starting point. We wish to unreservedly condemn forthwith all unscrupulous and inhuman acts of smuggling maize outside the country that should otherwise be used by our brothers and sisters in the country. We commend the efforts by the Malawi Police Services for tracking down and making arrests on some of these heartless and unpatriotic individuals.
We wish to condemn all private traders that are hoarding the food for one reason or the other to have a human heart and release the stocks to the market forthwith. In that vein, we wish to remind all those that are doing so, that under the provisions of the Food Security Policy of 2006, Government is empowered to take any action to stop this malpractice.
We condemn all possible acts that are leading to unwarranted profiteering and politicizing of the ongoing food distribution in the country and call upon all Malawians to sympathize with the hunger situation in the country. We call upon all Malawians of good will to rise beyond petty divisions and come together with a unity of purpose to assist the situation.
CISANET feels that more should be done by all concerned stakeholders to take a role in mitigation and responding to the hunger situation. As such, CISANET has put across the following as recommendations for moving on.
Our Recommendations
Government should avoid sending wrong or unconfirmed and some contradictory messages to the public as this causes undue panic and can spur speculations and distort market prices. Most recent reports indicate that both the President and the Minister of Agriculture issued statements to effect that there is inadequate maize stocks in the country against earlier statements issued when the donors visited the Strategic grain reserves, which indicated that there are sufficient amounts at the SGR.
We would like therefore to request that a Ministerial statement be issued that will state the situation of the Grain Reserves and also outline the gravity of the hunger situation and what the Government is doing about it. Government to issue instructions to ADMARC to immediately stop rationing maize to only 10kgs.
Increasing the ration to at least 25kgs. It is a pity to see that people with meager resources are travelling long distances and even paying more on transport than the food they are buying. This practice is deplorable and should be discouraged. We request Government to embark on restocking ADMARC markets that have no maize especially those that are in the rural areas.
Ironically, it still remains a wonder why maize being produced and bought from the village should be taken all the way to cities and towns and be taken back to the village during a time of stress like this one.
We are of the view that government would save a lot of costs if it made much use of the decentralized granaries that have been constructed in Luchenza, Mangochi and also stock up the ADMARC warehouses in all the Regions in time before the rains management of the SGRs.
Government has the capacity through the MVAC assessments to know way upfront which areas are going to be the hotspots and yet there is little preparedness done to stock up those areas in good time. Government to have a critical analysis on the causes of spiking food prices on the open market and address the issue.
Simple economic models will appeal to the reasoning that if maize is being bought in bulk from ADMARC and being sold a few meters away from the ADMARC selling points, it is suggestive of a deficit that has been created by the demand and that what ADMARC is supplying is not adequate otherwise if a market equilibrium is reached, then the private trader would not find a market.
It calls for simple reasoning that ADMARC through government should increase stocks in all its markets. If government cannot operate these silos and warehouses, then in the spirit of a private public partnership (PPP) outsource these services to the private sector to manage the silos and the warehouses.
Government to strengthen surveillance system so that the so called unscrupulous traders are tracked down and are appropriately panelized. It is a shame for government to go in the open to admit that the country continues to lose its maize stocks to unscrupulous traders while the same government has the law at hand and the right machinery to contain the situation.
We, therefore, appeal for a more vigilant surveillance system and increase border patrols to stop the pilferage of the maize.
Government should step up the efforts to pioneer a change in mentality for the people. Malawi has for the foreseeable past promoted in its policy the mentality of regarding maize as the only existing food in Malawi. It is high time that government through the appropriate political and technical muscle that it has promoted dietary diversification.
Government should continue to protect its people from being exploited by private traders through price regulation practices like enforceable minimum farm gate prices and also through ADMARC, influence the selling price for maize.
It should be known that food is life and every citizen has the right to food. As such government has the mandate to ensure that its people have access to food by employing all necessary means to protect the consumer regardless of the liberalized economy. Certain items in every economy are enviously guarded to safeguard the interest of the economy.
In Malawi, maize is one such commodity that must be properly regulated. Government will be doing that under its mandate to protect the right to food for its people. Forward looking, the country should promote policies that will promote adequate food production in the country.
While maize production has been supported through smallholder subsistence farming systems, except for the FISP program which unfortunately it is also politicized, maize production under the smallholder farming systems is an expensive option and does not bring profitable returns. The ministry of agriculture should consider other more productive options such as contract farming especially targeting those groups that can afford to buy.
Let the smallholders still produce for subsistence but experience has shown that producing maize through the conventional smallholder way is unproductive and not viable option to excite the market. Government should consider investing into proper technologies and supportive infrastructure that can support the agriculture industry.
The country has a high potential for irrigation but it lacks the supportive energy infrastructure to power the irrigation machines. There is already a lot that can be done which is not being tone to support agriculture production. The country must address these if the issue of food security has to be taken seriously in Malawi.
Response to the hunger situation should be well coordinated and left to the experts to do it.
Recently there has been a lot of talk about the countrys leadership being heavily involved in the food distribution and while this demonstrates good will from our leaders, it has been seen to be politically motivated with a number of stakeholders calling for the President not to be directly involved in the exercise. CISANET, believe that there are appropriate institutions that should be entrusted to handle the food distribution.
The Department of Disaster Management Affairs (DoDMA), under the Office of the Vice President and its partners such as the WFP and the JEFAP consortium has the capacity to coordinate the response to the hunger situation in Malawi. Wanton distribution of food as is being seen currently does not respect the response strategy and can lead to being wasteful and partisan.
The Food Security Policy of 2006 under section 1.2.8.1 Food aid states that all programmes shall be designed for desperately vulnerable people whose needs cannot be addressed through any meaningfully viable programmes other than being supported by special programmes like food aid. Efforts shall be made to ensure that food aid is not used for political purposes or as a means of forcing other concessions and bribes.
Large scale distributions shall remain a last resort. In this vein, the country leadership should be seen to be obedient to its own statutes which the Head of State swore to protect by oath of her Office
In December 2012, the Civil Society Agriculture Network (CISANET) released a press statement on the hunger situation in Malawi. Among many issues that were raised in the communiqué, CISANET pointed out some shortfalls being experienced in the response to the hunger situation in Malawi.
The communiqué also did advice against politicizing food in order to gain political mileage for the ruling elites. Three months down the line, the hunger situation has been exacerbated by floods and other natural disasters also coupled with lack of capacity for ADMARC to cope with the increasing demand for maize.
A lot of people are now spending hours on end on queues lining up and having travelled a long distance and sometimes spending more money for transport than the food they are buying only to buy 10kgs of maize being rationed by ADMARC.
CISANET feels this to be a mockery to the hunger situation and urgent action needs to be taken.
The price of maize has soured from the government recommended price of K3, 500/50kgs to K10, 000/50kgs making it unaffordable by the average poor family in rural and urban areas of Malawi. CISANET is aware of the current efforts being implemented by the government to distribute free flour (25kgs); and maize both to the people in the South and other areas that were mapped out by the Malawi vulnerability Assessment Committee (MVAC) report in its September 2012 assessment.
On December 26, 2012, the State President imposed a ban on maize export to avoid continued loss of maize outside the country.
However despite the ban, reports are still showing that massive amounts of maize are being smuggled outside Malawi using the uncharted routes and illegal means. The Nation Online of Friday 8th March 2013, quoting FEWSNET report, confirmed this.
CISANET is also aware that an amount of 10000MT was approved for ADMARC to draw down from National Strategic Grain Reserves (SGR) in December. It is therefore worrisome that we should have such shortages in most ADMARC markets. Government needs to assure the nation that there is enough food available in the country to run through for the rest of the lean season.
A recent visit to the National Food Reserves at Kanengo by the donors indicated that the country has sufficient food to feed itself, and the nation was assured of having enough in the strategic reserves. Ironically, barely a few days afterwards, the nation is informed differently and the leadership is now asking for outside support.
Such inconsistencies are a major cause of concern. 2.0 Policies In the constitution of Malawi, every person has a right to life and food is believed to be equated to life so that by denying people food, it is inadvertently denying that individual the right to life.
The country's leadership swore an oath to protect the constitution of Malawi and thus has an obligation to ensure that its citizens have adequate and healthy food for productive life.
The Food Security Policy of 2006 has several sections that commits government to ensuring that it is obligated to its citizens to provide them with food and to see that no practice either by government, political or otherwise interferes to deny anybody the freedom to enjoy food security.
In this regard, reference is made to the following sections of the policy: Section 1.2.2.4 Human rights: it states that: Cognisant of the provisions for the protection of human rights and freedoms as enshrined in the Constitution of Malawi, the right to adequate food is fully accepted as a human right. The right for everyone to have access to safe and nutritious food shall be observed in accordance with the fundamental right of everyone to be free from hunger.
The International Covenant on Economic, Social and Cultural Rights says, “the right to adequate food is fully realised when every individual, alone or in a community with others, has physical and economic access to adequate food or the means of its procurement"
Section 1.2.7 - protecting the right to food: it states that:
Government will be committed to ensuring that no government actions or those of private traders would reduce any Malawians access to safe nutritious food and that there is no discrimination in the buying and selling of food.
Section 1.2.8 - Social Protection it states that: Every person has the right to food security and a standard of living adequate for health.
Recognizing that there will always be a part of the society that will require social protection in order to meet their food requirements, government will provide distinctly targeted safety nets cautious of the need to avoid creating dependency and negative impacts.
In line with the Government’s National Safety Nets Strategy, social protection programmes shall be designed, in such a way that they complement the broader pro-poor growth strategy and also help people prevent, manage and cope with risk to reduce vulnerability.
They shall be designed to enable the vulnerable to gradually build up their assets so as to escape the threat of poverty in a sustainable way and to increase their resilience to shocks.
Against such policy provisions, government is mandated to ensure that its citizens are well protected and adequately provided for and that their dignity as human beings is respected. It is thus in light of this policy provision that government is called upon to rise up to the situation and provide appropriate response to the hunger situation.
Our stand
CISANET supports the current efforts taken by government to mitigate the hunger situation in the country.
Among other things we have seen political will by calling Malawians to mobilize resources. A number of organizations and individuals have come forth to contribute food and financial resources. This is a commendable starting point. We wish to unreservedly condemn forthwith all unscrupulous and inhuman acts of smuggling maize outside the country that should otherwise be used by our brothers and sisters in the country. We commend the efforts by the Malawi Police Services for tracking down and making arrests on some of these heartless and unpatriotic individuals.
We wish to condemn all private traders that are hoarding the food for one reason or the other to have a human heart and release the stocks to the market forthwith. In that vein, we wish to remind all those that are doing so, that under the provisions of the Food Security Policy of 2006, Government is empowered to take any action to stop this malpractice.
We condemn all possible acts that are leading to unwarranted profiteering and politicizing of the ongoing food distribution in the country and call upon all Malawians to sympathize with the hunger situation in the country. We call upon all Malawians of good will to rise beyond petty divisions and come together with a unity of purpose to assist the situation.
CISANET feels that more should be done by all concerned stakeholders to take a role in mitigation and responding to the hunger situation. As such, CISANET has put across the following as recommendations for moving on.
Our Recommendations
Government should avoid sending wrong or unconfirmed and some contradictory messages to the public as this causes undue panic and can spur speculations and distort market prices. Most recent reports indicate that both the President and the Minister of Agriculture issued statements to effect that there is inadequate maize stocks in the country against earlier statements issued when the donors visited the Strategic grain reserves, which indicated that there are sufficient amounts at the SGR.
We would like therefore to request that a Ministerial statement be issued that will state the situation of the Grain Reserves and also outline the gravity of the hunger situation and what the Government is doing about it. Government to issue instructions to ADMARC to immediately stop rationing maize to only 10kgs.
Increasing the ration to at least 25kgs. It is a pity to see that people with meager resources are travelling long distances and even paying more on transport than the food they are buying. This practice is deplorable and should be discouraged. We request Government to embark on restocking ADMARC markets that have no maize especially those that are in the rural areas.
Ironically, it still remains a wonder why maize being produced and bought from the village should be taken all the way to cities and towns and be taken back to the village during a time of stress like this one.
We are of the view that government would save a lot of costs if it made much use of the decentralized granaries that have been constructed in Luchenza, Mangochi and also stock up the ADMARC warehouses in all the Regions in time before the rains management of the SGRs.
Government has the capacity through the MVAC assessments to know way upfront which areas are going to be the hotspots and yet there is little preparedness done to stock up those areas in good time. Government to have a critical analysis on the causes of spiking food prices on the open market and address the issue.
Simple economic models will appeal to the reasoning that if maize is being bought in bulk from ADMARC and being sold a few meters away from the ADMARC selling points, it is suggestive of a deficit that has been created by the demand and that what ADMARC is supplying is not adequate otherwise if a market equilibrium is reached, then the private trader would not find a market.
It calls for simple reasoning that ADMARC through government should increase stocks in all its markets. If government cannot operate these silos and warehouses, then in the spirit of a private public partnership (PPP) outsource these services to the private sector to manage the silos and the warehouses.
Government to strengthen surveillance system so that the so called unscrupulous traders are tracked down and are appropriately panelized. It is a shame for government to go in the open to admit that the country continues to lose its maize stocks to unscrupulous traders while the same government has the law at hand and the right machinery to contain the situation.
We, therefore, appeal for a more vigilant surveillance system and increase border patrols to stop the pilferage of the maize.
Government should step up the efforts to pioneer a change in mentality for the people. Malawi has for the foreseeable past promoted in its policy the mentality of regarding maize as the only existing food in Malawi. It is high time that government through the appropriate political and technical muscle that it has promoted dietary diversification.
Government should continue to protect its people from being exploited by private traders through price regulation practices like enforceable minimum farm gate prices and also through ADMARC, influence the selling price for maize.
It should be known that food is life and every citizen has the right to food. As such government has the mandate to ensure that its people have access to food by employing all necessary means to protect the consumer regardless of the liberalized economy. Certain items in every economy are enviously guarded to safeguard the interest of the economy.
In Malawi, maize is one such commodity that must be properly regulated. Government will be doing that under its mandate to protect the right to food for its people. Forward looking, the country should promote policies that will promote adequate food production in the country.
While maize production has been supported through smallholder subsistence farming systems, except for the FISP program which unfortunately it is also politicized, maize production under the smallholder farming systems is an expensive option and does not bring profitable returns. The ministry of agriculture should consider other more productive options such as contract farming especially targeting those groups that can afford to buy.
Let the smallholders still produce for subsistence but experience has shown that producing maize through the conventional smallholder way is unproductive and not viable option to excite the market. Government should consider investing into proper technologies and supportive infrastructure that can support the agriculture industry.
The country has a high potential for irrigation but it lacks the supportive energy infrastructure to power the irrigation machines. There is already a lot that can be done which is not being tone to support agriculture production. The country must address these if the issue of food security has to be taken seriously in Malawi.
Response to the hunger situation should be well coordinated and left to the experts to do it.
Recently there has been a lot of talk about the countrys leadership being heavily involved in the food distribution and while this demonstrates good will from our leaders, it has been seen to be politically motivated with a number of stakeholders calling for the President not to be directly involved in the exercise. CISANET, believe that there are appropriate institutions that should be entrusted to handle the food distribution.
The Department of Disaster Management Affairs (DoDMA), under the Office of the Vice President and its partners such as the WFP and the JEFAP consortium has the capacity to coordinate the response to the hunger situation in Malawi. Wanton distribution of food as is being seen currently does not respect the response strategy and can lead to being wasteful and partisan.
The Food Security Policy of 2006 under section 1.2.8.1 Food aid states that all programmes shall be designed for desperately vulnerable people whose needs cannot be addressed through any meaningfully viable programmes other than being supported by special programmes like food aid. Efforts shall be made to ensure that food aid is not used for political purposes or as a means of forcing other concessions and bribes.
Large scale distributions shall remain a last resort. In this vein, the country leadership should be seen to be obedient to its own statutes which the Head of State swore to protect by oath of her Office
Thursday, May 9, 2013
Code of Ethics for the Medical Council of Malawi
Protecting the general public and guiding the medical profession
Section I : General Duties Of The Practitioners To The Public
Section II : Practitioners Relationship with Colleagues and Professional Associations
Section III : Practitioners in Private Practice
Section IV : Advertising
Section V : Types of Actions, which may Constitute Professional Misconduct and may result in Disciplinary Action
Section VI : Miscellaneous Provisions
FOREWORD
The Medical Council of Malawi is pleased to issue this revised edition of the Code of Ethics and Professional Conduct, which shall be observed, mutatis mutandis, by all medical practitioners, dentists, paramedicals and allied health professionals practicing in Malawi. The first edition was published in 1990. The Code of Ethics and Professional Conduct is promulgated by the Council in fulfillment of its functions as outlined in, and in the exercise of the powers vested in the Council by, Part IV, (Sections 10, 11, and 12) of the Medical Practitioners and Dentists Act, Chapter 36:01 of the Laws of Malawi.
This booklet cannot possibly be comprehensive as it is impossible to cover in a single volume all aspects of ethics and professional conduct which health professionals registrable by the Council are expected to abide by. The Council, therefore, advises practitioners when in doubt about ethical aspects of professional problems confronting them to base their decisions on their own consciences or to seek the advice of senior or more experienced colleagues, the Medical Association of Malawi, or the Council itself which may be contacted through its Registrar at P.O. Box 30787, Lilongwe 3. The Council, whose decision is final, will determine the appropriate conduct to have been followed in cases involving areas not specifically covered in this booklet.
This booklet is divided into six sections. The first section covers general issues relating to practitioner’s duties and obligations to the public. The second section deals with issues of practitioners’ relationship with colleagues and professional associations. The third section covers matters in relation to practitioners in private practice. Particular attention of the concerned persons is drawn to Section 3.2 which is on “informing the public about practices”. In keeping with the current trends, the Council feels that it is in the public interest for practitioners to make public announcements relating to their practices, such as change of premises, or clinic hours. To avoid possible abuse of this opportunity, drafts of such announcements should be submitted to the Council for clearance before they are circulated to the public.
The forth section discusses advertising at length as this is an important area in medical ethics and professional conduct. The fifth section outlines types of actions which may constitute professional misconduct and may result in disciplinary action being taken by Council.The sixth section deals withmiscellaneous matters such as issues of medical reports, practitioners’ connections with commercial enterprises and professional fees.
Practitioners may express their views, to the Council onany matters covered in this booklet for further consideration.
INTERPRETATION
In this code, unless the contrary intention appears:
“Immediate dependants” mean spouse, children and parents,
“Advertising” includes all those methods by which a practitioner is made known to the public either by himself or by others without his objection, in a manner which can be fairly regarded as having for its purpose the obtaining of patients or the promotion in other ways of the practitioner’s individual professional advantage,
(c) “Certification” includes any act whether concerned with medical certificates or documents, which must statutorily be signed by a medical practitioner, or other person so authorized,
(d)“A practitioner” means a medical practitioner, a dentist, a paramedical, or a person in the allied health profession,
(e)“Council” means the Medical Council of Malawi established under the Medical Practitioners and Dentists Act, Chapter 36:01 of the Laws of Malawi,
“Public Announcements” means……………………………………………
(d) “Medical Research” is a research that has its focus on health related
issues/problems with a view to identify solutions or new trends in
managing health problems
All references to the masculine gender connotes where appropriate reference to the female gender. Where there is he there is implied she
SECTION 1
1. GENERAL DUTIES OF THE PRACTITIONERS TO THE PUBLIC
Every practitioner shall:
Respect all aspects of human life, and shall do all that can reasonably be done to safeguard and improve the quality of human life, and shall not do anything which may cause suffering or terminate life.
Give such advice and treatment as is necessary to reduce the suffering of patients.
Treat patients or any persons accompanying or visiting a patient with due courtesy and respect for their inherent dignity.
Respect patients’ confidentiality, and shall keep secret all that the practitioner may learn in confidence from his patients or anyone acting on behalf of a patient in the course of the patient/practitioner relationship;
Provided that a Practitioner may, however, be required to reveal confidential information on patients in courts of law where the judicial ruling will prevail.
Not discriminate against any person on the basis of race, colour, sex, language, religion, political or other opinion, nationality, ethnic or social origin, disability, property, birth status, or any other status (to borrow from wording in the constitution).
At the time of being admitted as a member of the medical profession I solemnly pledge myself to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude which is their due;
I will practice my profession with conscience and dignity;
The health of the community and of my patients will be my first consideration;
I will respect the secrets which are confided in me, even after the patient has died;
I will maintain by all means in my power the honour and the noble traditions of the medical profession;
I will not permit consideration of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
I will remain the utmost respect for human life, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
I make these promises solemnly, freely and upon my honour.
SECTION 2
2. PRACTITIONERS RELATIONSHIP WITH COLLEAGUES AND PROFESSIONAL ASSOCIATIONS
2.1 Sharing of Knowledge and Skills with Colleagues
Practitioners shallshare developments in the medical field with their colleagues, and do all they can to promote medical knowledge, education and research. They shall, however, avoid any action, which may be regarded as self-praise, and shall not condemn their colleagues or use derogatory language about them.
2.2 Charging of Fees to another Practitioner
In view of the bond of fellowship that exists amongst all members of the profession, no matter where they qualify or practise, it is advisable not to charge fees directly for attending to another practitioner or his immediate dependants. This practice should be extended to nurses. There may be some exceptions to the uniform implementation of this advice. The Council expects practitioners to exercise discretion in this matter.
2.3 Requesting Advice from another Practitioner
A practitioner may formally request, with the patient’s or patient’s guardians consent, whenever possible, the opinion and advice of another medical practitioner or dentist who may or may not be a specialist. Such consultation should end when all the necessary visits are made, and a written report of the consultant’s opinion is made to the referring practitioner to whom the patient is returned for on-going care.
The Duties of Practitioners Regarding Consultations
It is the duty of the attending practitioner to accept the opportunity of a second opinion in any illness that is serious, obscure or difficult, or when consultation is desired by the patient or by persons authorized to act on the patient’s behalf. While the practitioner may choose the consultant he prefers, he shall not deny the patient the opportunity to be seen by a consultant of his choice although he may advise the patient, if he so thinks, that such a consultant does not have the qualifications or experience which the existing situation demands.
It is particularly advisable that the attending practitioner shall, whenever desirable and possible, secure consultation with a colleague when performing an operation or adopting a course of treatment which may entail considerable risk to life, particularly when the condition which is intended to be relieved by the treatment is in itself dangerous to life;
The practitioner shall be expected to report to appropriate authorities when there are grounds for suspecting that the patient has been subjected to an illegal procedure or is the victim of criminal poisoning.
Consultation shall be done in the best interest of the patient. The attending practitioner shall give the consultant a brief written history of the case before the consultant examines the patient. The consultant shall record his opinion whether on the hospital records and/or by a sealed letter addressed to the attending practitioner. The joint decision shall be communicated to the patient. If agreement as to diagnosis and treatment is not possible, a further opinion shall be sought and the patient and/or a member of his family shall be informed of this by the attending practitioner and the necessity for such action shall be explained.
2.5. Patients referred to Practitioners in Hospital and Feedback
When a patient has been sent either for out-patient examination and treatment or admission to a hospital under the consultant’s care, it is the duty of the consultant to report findings and discuss them with the attending practitioner so that the latter may have all possible advantage from the consultation. At the conclusion of the examination and treatment by the consultant the patient shall be referred to the attending practitioner with an adequate report for continued care.
2.6 A Practitioner as a Visitor
When a practitioner socially meets the patient of another practitioner, or visits him when ill, he must be careful not to be drawn into interference through suggestions or opinions. These shall never be expressed except in consultation with the attending practitioners, and that such consultations shall be done in the best interests of the patient.
2.7 Differences between Practitioners
Professional differences between practitioners, which after adequate discussion cannot be settled, shall be referred to the Registrar of the Council provided that where the complaint is on unprofessional conduct of a colleague, such complaint shall be referred in writing to the Registrar.
2.8 Medical Witnesses
Medical witnesses are expected to be motivated by a desire to assist courts in arriving at just decisions and not merely to further the interests of the party on whose behalf they have been summoned.
2.9 Succeeding another Practitioner
When one practitioner takes over total care for management of a patient, he shall make no adverse comments about the treatment already given.
2.10 Providing Temporary Cover for Other Practitioners
A practitioner providing temporary cover for other practitioners shall act in such a manner that he shall not jeopardize the welfare of patients, and patients’ confidentiality shall be respected at all times.
2.11 Relationship of Practitioners with Hospitals
Mutual understanding and cooperation between the medical profession and hospital management are most essential. Membership in an honorary attending staff capacity carries with it certain general responsibilities such as teaching and enlarging medical knowledge. Such a position should be held as a trust for the good of the medical profession. All members should make their contribution to the work required for the maintenance of high standards of hospital care.
Relationship of Practitioners with Nurses
The services provided by the nursing profession in the care of patients and prevention of illnesses are essential and complementary to the work of the medical profession. Therefore, it is the duty of practitioners, to support and, where necessary, consult nurses so that both professions while remaining true to their respective code of ethics will cooperate as a harmonious team so that optimum service is provided to patients.
For purposes of enhancing the professional relationship between the nurses and the practitioners, Practitioners shall familiarize themselves with the provisions of the Nurses and Midwives Act in order to appreciate the provisions and practices of the Nursing profession.
Relationship of Practitioners with Medical Associations
Practitioners shall associate themselves with local, national and international organizations to promote both their own and the general advancement in medical science and art.
2.14. Relationship of Practitioners with Practitioners in Training
It is unethical to delegate any work to another practitioner or nurse unless he is suitably qualified and experienced to undertake that work.
Registration on the interns’ register carries the same prescribing authority as full registration within the hospital in which the intern is employed.
Registered practitioners in training are responsible to their consultant or general practitioner supervisors. If they believe that the general advice they have been given is inapplicable to a particular situation or is not in the best interest of individual patients, they shall seek further specific clarification.
If necessary, they shall ask the consultants or general practitioners to take back their delegated authority and to take over management of the patients’ illness personally since the primary responsibility of junior practitioners in training posts is to patients. They shall therefore decline to do anything which they believe is not in the patients’ best interest.
2.15 The Practitioners Relationship with the Council
The Council is a legally constituted body which was established to serve the interest of the general public as well as those of practitioners in the country. The Council expects maximum cooperation from persons registrable by it. It is a legal requirement that all practitioners be registered with the Medical Council of Malawi and that their registration shall be renewed annually. Practitioners shall abide by all directives of the Council. Any acts or omissions, which can be interpreted as amounting to contempt of the Council, shall be avoided at all times. Offenders shall be liable to penalties as determined by the Council from time to time.
Relationship of The Practitioners With The Society
Practitioners shall conduct themselves in the community in a manner that upholds the integrity, dignity and ideals of their profession. They shall not allow themselves to be influenced by such factors as religion, socioeconomic considerations, race, or politics in the conduct of their professional practice. They shall also endeavor to do all in their power to promote the general well being of the community in which they live. Furthermore, all practitioners are expected to abide by the laws of Malawi.
SECTION 3
3. PRACTITIONERS IN PRIVATE PRACTICE
3.1 Setting up a Private Practice
3.1.1 Practitioners may set up a private practice by purchasing the goodwill of an existing private practice, by entering into an established partnership, or by putting up their “Plate”.
Provided that practitioners shall, in setting up their practices, not do damage to the practices of colleagues, particularly those with whom they have recently been engaged in professional associations.
Except for specialists in Pediatrics, Surgery, Medicine and Obstetrics/Gynaecology, Specialists in diagnostic fields including Radiology, Pathology, Anatomy and Hematology shall be required to undergo a minimum period of 6 weeks orientation in Pediatrics, Surgery, Medicine and Obstetrics/ Gynaecology at a Central Hospital prescribed by Medical Council of Malawi.
If a practitioner has been out of active practice for a continuous period of 3 years he shall be required to undergo an orientation at a Central Hospital prescribed by Medical Council of Malawi.
For those allied specialists in private practice and already doing general practice, they shall be expected to attend Continuing Medical Education in the fields that their colleagues are doing orientation in.
For those practitioners who have applied for specialist licenses, holders of such licences shall restrict their practice to the conditions set out in their licenses.
3.2 Informing the Public about Practices
Specialists commencing practices in particular specialties, or changing their area of practice may make public announcements after obtaining prior clearance of the announcements from the Council. They may also notify their colleagues of their availability for private consultations by sending sealed letters to those practitioners whom they might normally expect to be interested. They may include their home addresses and telephone numbers of the consulting premises where appointments can be arranged.
General practitioners who may need to notify their patients of a change of address, or of clinic hours, may send sealed circular letters to the patients of the practice, they may also make public announcements after prior clearance by the Council.
The format for letters announcing changes of practice arrangements or changes of specialist practice shall include the following information: -
The name of the practitioner;
Medical qualifications;
Title of the main specialty in the case of a specialist;
Brief details of the new clinic address and consulting hours if a general practitioner is altering his arrangements.
3.2.4. The drafts of the announcements made under (a), (b), (c), or (d) above, shall be submitted to the Medical council for clearance before they are circulated to the public.
3.4 Group Practices and Ethics
3.4.1 Whatever is right and becoming in a practitioner is equally right for any association of practitioners in clinics or other groups, and whatever is obligatory upon the individual is equally obligatory upon the group.
3.4.2 It is undesirable and not in keeping with the principles of the medical profession for medical practitioners to practice medicine in partnership with anyone not duly registered to practice medicine.
Emergency Calls
When several practitioners are called to attend an emergency or an accident, the first to arrive shall be considered to be in charge. However, he should withdraw in favour of any other practitioner preferred by the patient or a member of his family, if the patient is incapacitated, or the practitioner who is well conversant with the nature of the injury should take over.
In an event of an accident, or sudden illness any qualified medical practitioner shall assume the responsibility to assist the victim. It is unprofessional and unethical to ignore such an eventuality where one’s medical know-how would have made the difference between saving a life and the demise thereof.
SECTION 4
4. ADVERTISING
Introduction
The rationale for the Health Profession refraining from advertisement or self promotion is that the health care professional who is most successful at getting publicity may not necessarily be the most appropriate one to treat a patient. Patients and their relatives are very vulnerable to persuasive influences such as unprofessional advertising.
Practice shall not be gathered by any kind of solicitation, direct or indirect. The best advertisement of a practitioner is a well-merited reputation for ability and integrity in his profession.
Where a practitioner takes over the practice of another practitioner it is proper to notify all practitioners in the area of the change. It would not be unethical for the doctor whose practice is being taken over to notify his former patients of the take-over.
A practitioner shall not procure, sanction, be associated with or acquiesce in notices which commend his own or any practitioner’s skill, knowledge, services and qualifications, or which downgrade those of others.
Practitioners shall not boast of cures or indulge in self-praise to attract patients.
4.5 There shall be a clear differentiation between advertisement or self promotion and legitimate factual announcement of a service being provided without self aggrandizement or downgrading others.
4.7 Practitioners Relationship with Organizations that advertise their services to the Lay Public
If a practitioner owns or holds shares in an organization which advertises diagnostic or clinical services to the lay public, he shall:-
Not permit his own name to be used in advertisements to the lay public;
Ensure that advertisements are factual and do not advertise the practitioner’s qualities.
Practitioners in Relationship with Organizations which advertise to the Medical Professions, but not to the Lay Public
Practitioners who have a relationship with organizations which advertise to the medical profession but not to the general public shall ensure that such advertisements are sent under sealed cover, and are factual, and do not make unfavourable comparisons with other organizations.
Public References to Practitioners by Companies or Organizations
A practitioner shall take steps to avoid the publication of reports, notices or notepaper issued by a company or organization and drawing attention to professional attainments of a practitioner in their employment.
Questions of Advertising arising from Articles, or Books, Broadcasting or Television Appearances by Practitioners
Practitioners who write to magazines or journals addressed to the lay public, articles or columns which offer advice on common medical conditions or problems, or who are involved in television or radio programmes dealing with such matters, shall not use language, which might be construed as advertisement or self-promotion or denigrating other practitioners.
Notice Boards, Door Plates and Signposts
Advertising may arise from notices or announcements displayed, circulated or made public by a practitioner in connection with his own practice if such notices or announcements materially exceed the limits customarily observed by the profession in Malawi. It is important that the public be informed of the location of a practitioner’s premises, but in choosing the wording and size of a sign, the practitioner shall abide by the following criteria:
a sign or doorplate shallnot be ostentatious in size and form. Door plate signs shall not exceed 40cm by 40cm and roadside signs shall not exceed 1m by 0.5m.
it is acceptable for the information on the practitioner’s plate to be repeated in a second language if necessary;
a plate shall not carry more than the practitioner’s names, qualifications and clinic hours;
The Geneva Convention prohibits the use of the Red Cross or similar sign. Clinics or surgeries shall not use the Red Cross, provided that a green cross may be used to symbolize such a facility.
No notices or signposts shall be larger, or repeated more frequently than is necessary to indicate to patients the location of the premises;
No notices or signposts shall be used to draw public attention to the services of one practice at the expense of others.
4.12. Names of Clinics
In selecting a name for a clinic or a medical centre, or a collective title for a group or partnership, practitioners shall;
avoid the use of a name which could be interpreted as implying that the services provided in that clinic or by that partnership have received some official recognition not extended to other local practitioners.
Avoid the use of fancy names, which may be misleading, a name shall be deemed as misleading if:
it contains a material misrepresentation of fact or law or omits a fact necessary to make the statement considered as a whole not materially misleading,
is likely to create an unjusfied expectation about results the practitioner can achieve or states or implies that the practitioner can achieve results by means that violates the rules of professional conduct or other law; or
4.12.2.3 compares the practitioners services with other practitioner’s services, unless comparison can be factually substantiated
4.12.3 The Medical Council shall in the exercise of its discretion deny use of a name deemed unacceptable. The use of terms such as “clinic” or “surgery” is acceptable.
4.13. Directories and Lists of Practitioners
An entry of practitioners’ names in a telephone directory shall appear in the ordinary small typeface. The practitioner shall neither request nor allow any entry in a special typeface or any description other than his qualifications or, in the case of a specialist, his specialty. It is permissible for a practitioner’s name to be included in a handbook of local information, provided that the list is open to the whole profession in the area and that the publication of the names is not dependent on the payment of a fee.
Canvassing
Canvassing for the purpose of obtaining patients, whether done directly or through an agent, and association with or employment by persons or organizations which canvass is unethical. It is also unethical to talk in a derogatory manner about the professional skills, knowledge, qualification or services of another practitioner.
Communication with the Laity on Medical Subjects
All opinions on medical subjects which are communicated to the laity by any medium be it a public meeting, the lay press, radio or television shall represent what is the generally accepted opinion of the medical profession.
SECTION 5
5. TYPES OF ACTIONS WHICH MAY CONSTITUTE PROFESSIONAL MISCONDUCT AND MAY RESULT IN DISCIPLINARY ACTION
Termination of Pregnancy
The Laws of Malawi prohibit the termination of pregnancy on demand. Practitioners found guilty of procuring or attempting to procure abortions or miscarriages are liable to severe penalties under the Penal Code (Cap: 7:01). In all cases of illegal termination of pregnancies, the penalty shall be suspension or erasure from a register.
5.2 Issuance of False Reports and Certificates
There are instances when members of the public require certain reports or certificates to be signed and issued by a duly qualified and registered practitioner on the presumption that the truth of such statements can be accepted without question. Practitioners must be meticulous in making sure that the certificates they issue are accurate in their statements of fact. They must resist all requests to issue false certificates. Reasonable care should be taken in completing such documents.
Before filling any certificate requiring examination a practitioner shall carry out such medical examination on that person. Before
filling any form that a particular service has been carried out on a person, a practitioner so authorized shall provide such service.
5.3. Unethical Prescribing and Use of Drugs
Practitioners are expected to be fully conversant with the provisions of the regulatory Acts relevant to their profession such as the Pharmacy, Medicines and Poisons Act and the Dangerous Drugs Act. The Council urges all practitioners to study these Acts, and in case of doubt, to seek advice from the Chairman or Registrar of the Council. Practitioners must always be mindful of their privileged positions in relation to dangerous drugs as well as the scheduled ones and should avoid their unethical use. They should be conversant with side effects and interactions of all drugs. Practitioners shall take all reasonable steps to communicate the side effects and interactions of drugs to their patient/ client. No drugs, which have expired according to manufacturers’specifications, shall be dispensed to patients.
5.4 Patents
A practitioner shall not make use of, or recommend any remedy, the principal ingredients of which are not disclosed to the profession.
5.5. Association with Improper Systems or Methods of Treatment
It is unethical for a practitioner to be associated with any system or method of treatment, which is not evidence – based.
5.6 Managing patients without Informed Consent
The Council urges all practitioners to ensure that as far as possible informed consent is obtained before any procedure is carried out on a patient. Where the procedure is a major one, a written consent shall be obtained. In obtaining informed consent a practitioner shall explain the full nature, extent and potential complications of the procedure to be carried out on the patient.
Provided that;
In the case of persons who may be unable to give informed consent including minors, unconscious or psychiatric patients, the most senior practitioner in consultation with the parent or guardian may give consent for the procedure or treatment, and such consent should as far as possible be witnessed by a second practitioner. In the event of differing opinion between the parent or guardian and the practitioner, the practitioner’s stand shall prevail in the best interest of the concerned person.
Abuse of Professional Confidence
A practitioner shall not disclose to a third party information, which he obtained in confidence from a patient in the course of the professional relationship between the patient and the practitioner.
Provided that in the following circumstances, the confidential information may be disclosed to a third party:
Where there is a valid consent from the patient or his legal adviser or guardian, provided that information may be given to a relative or appropriate person if in the circumstances of the case in question it is reasonably undesirable on medical grounds to seek the patient’s consent;
Where the information may be required by law;
Where public interest persuades a practitioner that his duty to the community overrides that to his patients; and
In the interests of research and medical education, information may be divulged, but at all times the patient’s name shall not be revealed.
A practitioner shall always be prepared to justify his action whenever he disclosed confidential information.
Abuse of Relationships between Practitioners and Patients
Abuses of the practitioner/patient relationship include:
having carnal knowledge or maintaining improper emotional or sexual relationships with the patient in the course of the practitioner/patient relationship; and
Abuse of financial opportunities which may occur as a result of:
improperly obtaining money from patients, or from medical insurance schemes,
improperly sanctioning payments or financial claims under insurance schemes, workmen’s compensation schemes, civil suit cases or any other authorities,
splitting of fees, for example between consultants and general practitioners,
in the case of a treatment which involves more than one specialist in the same discipline only the original practitioner shall charge the approved fees for the treatment which he will then share with the additional practitioner; or in the case of a treatment involving more than one specialist in different disciplines only the original specialist shall send the bill for the approved fees indicating the appropriate proportions for the additional specialists, depending on their individual contributions to that treatment,
improper prescription ofdrugs or appliances in which a practitioner has a financial interest;
practitioners should not taking advantage of patients’ dependence on them to get disproportionate benefits for their services.
5.9 Disregard of Personal Responsibilities to Patients for their Care and Treatment
5.9.1 Negligence in Diagnosis or Treatment
The Council has a duty to protect the public by ensuring that practitioners do not relinquish their personal responsibilities for their patients, for example by: -
failing to be present at their usual places of work without notifying patients or making alternative arrangements for patients to be attended to;
failing to visit their patients when called upon to do so without making alternative arrangements. Practitioners shall make every effort to see quickly persons whom they have accepted as patients;
unskillful or careless treatment of a complaint which has been properly diagnosed;
failing to warn patients of the dangers of certain treatments;
gross and/or prolonged neglect of duties;
attempting to carry out procedures for which the practitioner has not adequate training or experience leading to more suffering for the patient. Exceptions may occur in case of emergency, if the practitioner can show that he acted to save life, there being no competent practitioner available in the area for him to consult with.
5.10. Associating with Unregistered Persons
It is unethical for a duly qualified and registered practitioner to be associated professionally with a person who is not duly qualified and registered to practice medicine.
5.11. Conduct Derogatory to the Reputation of the Profession
Undesirable modes of personal behavior may arise from abuse of alcohol, breaches of the Pharmacy, Medicine and Poisons Act and the Dangerous Drugs Act, or some other offences committed by the use of drugs. Members of the profession shall avoid appearing in public while under the influence of alcohol and they must certainly not be at work with their patients while intoxicated.
The commission of offences of false pretences, forgery, misdemeanors fraud, indecent behaviour, assault or felonies, which reflect adversely on the profession’s standing in the public eye, should be avoided. The Council takes a serious view of assaults or indecent acts in the course of a practitioners’ duties. The Council may take disciplinary action where a practitioner has been convicted for any offence in a court of law.
5.12 Improper Attempts to Profit (Advertising, Canvassing and Related Professional Offences)
These offences may be committed at the expense of professional colleagues by canvassing for patients, or advertising. Practitioners should avoid doing anything, which may be interpreted as an attempt to attract patients to them or to undermine the reputation of colleagues.
SECTION 6
6. MISCELLANEOUS PROVISIONS
6.1. Issuance of Medical Reports
Practitioners are relied upon to issue medical reports for a variety of purposes on the assumption that the truth of the report can be accepted without question. A practitioner shall exercise care in issuing reports and similar documents, and shall not include in them statements that he has not taken appropriate steps to verify.
6.2. Forms and Certificates
According to Section 12 of the International Code of Medical Ethics of the World Medical Association, “A doctor owes to his patient the absolute secrecy on all which has been confided to him or which he knows because of the confidence entrusted to him.”In all forms where medical reports are to be filled in by practitioners there shall be included a declaration to be signed by the patient or a responsible relative or guardian stating that assent is given to the practitioner to supply the information requested. It is also strongly recommended that these forms and/or declarations be supplied in duplicate to permit the practitioner to retain a copy.
All forms and certificates filled by a practitioner must clearly bare the name of the practitioner in block letters; the qualifications of the practitioner; the usual signature of the practitioner; the area of specialization of the practitioner and the official stamp with a date and registration number.
A competent practitioner recognized by the institution must complete all forms and medical certificates that will be used for legal purposes (such as insurance forms, employment forms, and court cases).
6.3. Connections with Commercial Enterprises
6.3.1. A practitioner shallnot associate himself with commerce in such a way as to let it influence, or appear to influence, his attitude towards the treatment of his patients.
6.3.2 A practitioner shall not allow a business to add to his professional status.
6.3.3 A practitioner shall refrain from writing a testimonial on a commercial product unless he receives a legally enforceable consent from an appropriate regulatory body.
6.3.4 There shall be no direct association of a practitioner with any commercial enterprise engaged in the manufacture or sale of any substance which is claimed to be of value in the prevention or treatment of disease, and which is recommended to the public in such a fashion as to be calculated to encourage the practice of self-diagnosis and self-medication or is of undisclosed nature or composition.
6.3.5. A practitioner shall not be associated with any system or method of treatment, which is not under medical control.
6.4 Professional Fees
The only basis on which a fee may be charged to a patient or on which any medical practitioner may receive money, is that of work actually done for the patient, and such patient must receive a direct statement from the medical practitioner concerned.
In case where in the opinion of the attending medical practitioner the services of one or more consultants are required, each consultant shall render his account and submit his receipt individually.
Each practitioner shall send his account to the patient individually. If however, a surgeon has a regular assistant at operations he may pay him directly. When the assistant has referred the patient to the operating surgeon the assistant shall send a statement of his fee directly to the patient.
If fees are collected by an organized clinic, medical group, medical partnership or practitioner employing regular assistants, each such organization is in effect regarded as an individual who acts in that capacity. The same principle applies when the clinic and hospital are combined and operate under the same ownership.
When a third person or organization enters into a financial arrangement between patients and medical practitioners, practitioners should render an individual account to the third person or organization concerned. If more than one practitioner is carrying out professional services, a statement to the patient by a third person or organization should show the amount paid to each practitioner.
Practitioners shall adhere strictly to the practice of their profession, disassociating themselves from the dispensing of all commodities relating to the practice of medicine and the profits derived from them. In places where those with special training or qualifications are not available, dispensing of such commodities may be undertaken in accordance with the Pharmacy, Medicine, and Poisons Act.
A practitioner’s statement to the patient shall show clearly and separately his professional fee and the charge for the commodity dispensed.
Practitioners shall not have proprietary interest in preparations or appliances, which they may recommend to patients.
Where practitioners, a medical group or a clinic of surgery, own and occupy an office building, it should not be considered unethical for them to rent space to businesses or individuals under the following provisions:
that the rent charged is the normal or going rent for that similar space;
that there is neither real nor implied endorsement of the business carried on by the tenant; and
that other than normal rent, there be no profit of any kind, direct or hidden, derived from the tenant concerned.
6.5 Medical Research
All medical research shall be conducted in the best interest of the patient and must be conducted ethically following the national and international research guidelines and policies e.g.World Medical Association (WMA) declaration of Helsinki). All medical research done in Malawi shall undergo an independent scientific and ethical review by recognized national bodies. Practitioners conducting Medical research must be registered with the Council. In the case of clinical trials where drugs are involved, permission for approval shall be sought from the Pharmacy Medicine and Poisons Board. All institutions where medical research is to be conducted are mandated to enforce this regulation.
OTHER COMMENTS
The Medical Council of Malawi shall put in place a CPD framework and enforce its implementation.
Section I : General Duties Of The Practitioners To The Public
Section II : Practitioners Relationship with Colleagues and Professional Associations
Section III : Practitioners in Private Practice
Section IV : Advertising
Section V : Types of Actions, which may Constitute Professional Misconduct and may result in Disciplinary Action
Section VI : Miscellaneous Provisions
FOREWORD
The Medical Council of Malawi is pleased to issue this revised edition of the Code of Ethics and Professional Conduct, which shall be observed, mutatis mutandis, by all medical practitioners, dentists, paramedicals and allied health professionals practicing in Malawi. The first edition was published in 1990. The Code of Ethics and Professional Conduct is promulgated by the Council in fulfillment of its functions as outlined in, and in the exercise of the powers vested in the Council by, Part IV, (Sections 10, 11, and 12) of the Medical Practitioners and Dentists Act, Chapter 36:01 of the Laws of Malawi.
This booklet cannot possibly be comprehensive as it is impossible to cover in a single volume all aspects of ethics and professional conduct which health professionals registrable by the Council are expected to abide by. The Council, therefore, advises practitioners when in doubt about ethical aspects of professional problems confronting them to base their decisions on their own consciences or to seek the advice of senior or more experienced colleagues, the Medical Association of Malawi, or the Council itself which may be contacted through its Registrar at P.O. Box 30787, Lilongwe 3. The Council, whose decision is final, will determine the appropriate conduct to have been followed in cases involving areas not specifically covered in this booklet.
This booklet is divided into six sections. The first section covers general issues relating to practitioner’s duties and obligations to the public. The second section deals with issues of practitioners’ relationship with colleagues and professional associations. The third section covers matters in relation to practitioners in private practice. Particular attention of the concerned persons is drawn to Section 3.2 which is on “informing the public about practices”. In keeping with the current trends, the Council feels that it is in the public interest for practitioners to make public announcements relating to their practices, such as change of premises, or clinic hours. To avoid possible abuse of this opportunity, drafts of such announcements should be submitted to the Council for clearance before they are circulated to the public.
The forth section discusses advertising at length as this is an important area in medical ethics and professional conduct. The fifth section outlines types of actions which may constitute professional misconduct and may result in disciplinary action being taken by Council.The sixth section deals withmiscellaneous matters such as issues of medical reports, practitioners’ connections with commercial enterprises and professional fees.
Practitioners may express their views, to the Council onany matters covered in this booklet for further consideration.
INTERPRETATION
In this code, unless the contrary intention appears:
“Immediate dependants” mean spouse, children and parents,
“Advertising” includes all those methods by which a practitioner is made known to the public either by himself or by others without his objection, in a manner which can be fairly regarded as having for its purpose the obtaining of patients or the promotion in other ways of the practitioner’s individual professional advantage,
(c) “Certification” includes any act whether concerned with medical certificates or documents, which must statutorily be signed by a medical practitioner, or other person so authorized,
(d)“A practitioner” means a medical practitioner, a dentist, a paramedical, or a person in the allied health profession,
(e)“Council” means the Medical Council of Malawi established under the Medical Practitioners and Dentists Act, Chapter 36:01 of the Laws of Malawi,
“Public Announcements” means……………………………………………
(d) “Medical Research” is a research that has its focus on health related
issues/problems with a view to identify solutions or new trends in
managing health problems
All references to the masculine gender connotes where appropriate reference to the female gender. Where there is he there is implied she
SECTION 1
1. GENERAL DUTIES OF THE PRACTITIONERS TO THE PUBLIC
Every practitioner shall:
Respect all aspects of human life, and shall do all that can reasonably be done to safeguard and improve the quality of human life, and shall not do anything which may cause suffering or terminate life.
Give such advice and treatment as is necessary to reduce the suffering of patients.
Treat patients or any persons accompanying or visiting a patient with due courtesy and respect for their inherent dignity.
Respect patients’ confidentiality, and shall keep secret all that the practitioner may learn in confidence from his patients or anyone acting on behalf of a patient in the course of the patient/practitioner relationship;
Provided that a Practitioner may, however, be required to reveal confidential information on patients in courts of law where the judicial ruling will prevail.
Not discriminate against any person on the basis of race, colour, sex, language, religion, political or other opinion, nationality, ethnic or social origin, disability, property, birth status, or any other status (to borrow from wording in the constitution).
At the time of being admitted as a member of the medical profession I solemnly pledge myself to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude which is their due;
I will practice my profession with conscience and dignity;
The health of the community and of my patients will be my first consideration;
I will respect the secrets which are confided in me, even after the patient has died;
I will maintain by all means in my power the honour and the noble traditions of the medical profession;
I will not permit consideration of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
I will remain the utmost respect for human life, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
I make these promises solemnly, freely and upon my honour.
SECTION 2
2. PRACTITIONERS RELATIONSHIP WITH COLLEAGUES AND PROFESSIONAL ASSOCIATIONS
2.1 Sharing of Knowledge and Skills with Colleagues
Practitioners shallshare developments in the medical field with their colleagues, and do all they can to promote medical knowledge, education and research. They shall, however, avoid any action, which may be regarded as self-praise, and shall not condemn their colleagues or use derogatory language about them.
2.2 Charging of Fees to another Practitioner
In view of the bond of fellowship that exists amongst all members of the profession, no matter where they qualify or practise, it is advisable not to charge fees directly for attending to another practitioner or his immediate dependants. This practice should be extended to nurses. There may be some exceptions to the uniform implementation of this advice. The Council expects practitioners to exercise discretion in this matter.
2.3 Requesting Advice from another Practitioner
A practitioner may formally request, with the patient’s or patient’s guardians consent, whenever possible, the opinion and advice of another medical practitioner or dentist who may or may not be a specialist. Such consultation should end when all the necessary visits are made, and a written report of the consultant’s opinion is made to the referring practitioner to whom the patient is returned for on-going care.
The Duties of Practitioners Regarding Consultations
It is the duty of the attending practitioner to accept the opportunity of a second opinion in any illness that is serious, obscure or difficult, or when consultation is desired by the patient or by persons authorized to act on the patient’s behalf. While the practitioner may choose the consultant he prefers, he shall not deny the patient the opportunity to be seen by a consultant of his choice although he may advise the patient, if he so thinks, that such a consultant does not have the qualifications or experience which the existing situation demands.
It is particularly advisable that the attending practitioner shall, whenever desirable and possible, secure consultation with a colleague when performing an operation or adopting a course of treatment which may entail considerable risk to life, particularly when the condition which is intended to be relieved by the treatment is in itself dangerous to life;
The practitioner shall be expected to report to appropriate authorities when there are grounds for suspecting that the patient has been subjected to an illegal procedure or is the victim of criminal poisoning.
Consultation shall be done in the best interest of the patient. The attending practitioner shall give the consultant a brief written history of the case before the consultant examines the patient. The consultant shall record his opinion whether on the hospital records and/or by a sealed letter addressed to the attending practitioner. The joint decision shall be communicated to the patient. If agreement as to diagnosis and treatment is not possible, a further opinion shall be sought and the patient and/or a member of his family shall be informed of this by the attending practitioner and the necessity for such action shall be explained.
2.5. Patients referred to Practitioners in Hospital and Feedback
When a patient has been sent either for out-patient examination and treatment or admission to a hospital under the consultant’s care, it is the duty of the consultant to report findings and discuss them with the attending practitioner so that the latter may have all possible advantage from the consultation. At the conclusion of the examination and treatment by the consultant the patient shall be referred to the attending practitioner with an adequate report for continued care.
2.6 A Practitioner as a Visitor
When a practitioner socially meets the patient of another practitioner, or visits him when ill, he must be careful not to be drawn into interference through suggestions or opinions. These shall never be expressed except in consultation with the attending practitioners, and that such consultations shall be done in the best interests of the patient.
2.7 Differences between Practitioners
Professional differences between practitioners, which after adequate discussion cannot be settled, shall be referred to the Registrar of the Council provided that where the complaint is on unprofessional conduct of a colleague, such complaint shall be referred in writing to the Registrar.
2.8 Medical Witnesses
Medical witnesses are expected to be motivated by a desire to assist courts in arriving at just decisions and not merely to further the interests of the party on whose behalf they have been summoned.
2.9 Succeeding another Practitioner
When one practitioner takes over total care for management of a patient, he shall make no adverse comments about the treatment already given.
2.10 Providing Temporary Cover for Other Practitioners
A practitioner providing temporary cover for other practitioners shall act in such a manner that he shall not jeopardize the welfare of patients, and patients’ confidentiality shall be respected at all times.
2.11 Relationship of Practitioners with Hospitals
Mutual understanding and cooperation between the medical profession and hospital management are most essential. Membership in an honorary attending staff capacity carries with it certain general responsibilities such as teaching and enlarging medical knowledge. Such a position should be held as a trust for the good of the medical profession. All members should make their contribution to the work required for the maintenance of high standards of hospital care.
Relationship of Practitioners with Nurses
The services provided by the nursing profession in the care of patients and prevention of illnesses are essential and complementary to the work of the medical profession. Therefore, it is the duty of practitioners, to support and, where necessary, consult nurses so that both professions while remaining true to their respective code of ethics will cooperate as a harmonious team so that optimum service is provided to patients.
For purposes of enhancing the professional relationship between the nurses and the practitioners, Practitioners shall familiarize themselves with the provisions of the Nurses and Midwives Act in order to appreciate the provisions and practices of the Nursing profession.
Relationship of Practitioners with Medical Associations
Practitioners shall associate themselves with local, national and international organizations to promote both their own and the general advancement in medical science and art.
2.14. Relationship of Practitioners with Practitioners in Training
It is unethical to delegate any work to another practitioner or nurse unless he is suitably qualified and experienced to undertake that work.
Registration on the interns’ register carries the same prescribing authority as full registration within the hospital in which the intern is employed.
Registered practitioners in training are responsible to their consultant or general practitioner supervisors. If they believe that the general advice they have been given is inapplicable to a particular situation or is not in the best interest of individual patients, they shall seek further specific clarification.
If necessary, they shall ask the consultants or general practitioners to take back their delegated authority and to take over management of the patients’ illness personally since the primary responsibility of junior practitioners in training posts is to patients. They shall therefore decline to do anything which they believe is not in the patients’ best interest.
2.15 The Practitioners Relationship with the Council
The Council is a legally constituted body which was established to serve the interest of the general public as well as those of practitioners in the country. The Council expects maximum cooperation from persons registrable by it. It is a legal requirement that all practitioners be registered with the Medical Council of Malawi and that their registration shall be renewed annually. Practitioners shall abide by all directives of the Council. Any acts or omissions, which can be interpreted as amounting to contempt of the Council, shall be avoided at all times. Offenders shall be liable to penalties as determined by the Council from time to time.
Relationship of The Practitioners With The Society
Practitioners shall conduct themselves in the community in a manner that upholds the integrity, dignity and ideals of their profession. They shall not allow themselves to be influenced by such factors as religion, socioeconomic considerations, race, or politics in the conduct of their professional practice. They shall also endeavor to do all in their power to promote the general well being of the community in which they live. Furthermore, all practitioners are expected to abide by the laws of Malawi.
SECTION 3
3. PRACTITIONERS IN PRIVATE PRACTICE
3.1 Setting up a Private Practice
3.1.1 Practitioners may set up a private practice by purchasing the goodwill of an existing private practice, by entering into an established partnership, or by putting up their “Plate”.
Provided that practitioners shall, in setting up their practices, not do damage to the practices of colleagues, particularly those with whom they have recently been engaged in professional associations.
Except for specialists in Pediatrics, Surgery, Medicine and Obstetrics/Gynaecology, Specialists in diagnostic fields including Radiology, Pathology, Anatomy and Hematology shall be required to undergo a minimum period of 6 weeks orientation in Pediatrics, Surgery, Medicine and Obstetrics/ Gynaecology at a Central Hospital prescribed by Medical Council of Malawi.
If a practitioner has been out of active practice for a continuous period of 3 years he shall be required to undergo an orientation at a Central Hospital prescribed by Medical Council of Malawi.
For those allied specialists in private practice and already doing general practice, they shall be expected to attend Continuing Medical Education in the fields that their colleagues are doing orientation in.
For those practitioners who have applied for specialist licenses, holders of such licences shall restrict their practice to the conditions set out in their licenses.
3.2 Informing the Public about Practices
Specialists commencing practices in particular specialties, or changing their area of practice may make public announcements after obtaining prior clearance of the announcements from the Council. They may also notify their colleagues of their availability for private consultations by sending sealed letters to those practitioners whom they might normally expect to be interested. They may include their home addresses and telephone numbers of the consulting premises where appointments can be arranged.
General practitioners who may need to notify their patients of a change of address, or of clinic hours, may send sealed circular letters to the patients of the practice, they may also make public announcements after prior clearance by the Council.
The format for letters announcing changes of practice arrangements or changes of specialist practice shall include the following information: -
The name of the practitioner;
Medical qualifications;
Title of the main specialty in the case of a specialist;
Brief details of the new clinic address and consulting hours if a general practitioner is altering his arrangements.
3.2.4. The drafts of the announcements made under (a), (b), (c), or (d) above, shall be submitted to the Medical council for clearance before they are circulated to the public.
3.4 Group Practices and Ethics
3.4.1 Whatever is right and becoming in a practitioner is equally right for any association of practitioners in clinics or other groups, and whatever is obligatory upon the individual is equally obligatory upon the group.
3.4.2 It is undesirable and not in keeping with the principles of the medical profession for medical practitioners to practice medicine in partnership with anyone not duly registered to practice medicine.
Emergency Calls
When several practitioners are called to attend an emergency or an accident, the first to arrive shall be considered to be in charge. However, he should withdraw in favour of any other practitioner preferred by the patient or a member of his family, if the patient is incapacitated, or the practitioner who is well conversant with the nature of the injury should take over.
In an event of an accident, or sudden illness any qualified medical practitioner shall assume the responsibility to assist the victim. It is unprofessional and unethical to ignore such an eventuality where one’s medical know-how would have made the difference between saving a life and the demise thereof.
SECTION 4
4. ADVERTISING
Introduction
The rationale for the Health Profession refraining from advertisement or self promotion is that the health care professional who is most successful at getting publicity may not necessarily be the most appropriate one to treat a patient. Patients and their relatives are very vulnerable to persuasive influences such as unprofessional advertising.
Practice shall not be gathered by any kind of solicitation, direct or indirect. The best advertisement of a practitioner is a well-merited reputation for ability and integrity in his profession.
Where a practitioner takes over the practice of another practitioner it is proper to notify all practitioners in the area of the change. It would not be unethical for the doctor whose practice is being taken over to notify his former patients of the take-over.
A practitioner shall not procure, sanction, be associated with or acquiesce in notices which commend his own or any practitioner’s skill, knowledge, services and qualifications, or which downgrade those of others.
Practitioners shall not boast of cures or indulge in self-praise to attract patients.
4.5 There shall be a clear differentiation between advertisement or self promotion and legitimate factual announcement of a service being provided without self aggrandizement or downgrading others.
4.7 Practitioners Relationship with Organizations that advertise their services to the Lay Public
If a practitioner owns or holds shares in an organization which advertises diagnostic or clinical services to the lay public, he shall:-
Not permit his own name to be used in advertisements to the lay public;
Ensure that advertisements are factual and do not advertise the practitioner’s qualities.
Practitioners in Relationship with Organizations which advertise to the Medical Professions, but not to the Lay Public
Practitioners who have a relationship with organizations which advertise to the medical profession but not to the general public shall ensure that such advertisements are sent under sealed cover, and are factual, and do not make unfavourable comparisons with other organizations.
Public References to Practitioners by Companies or Organizations
A practitioner shall take steps to avoid the publication of reports, notices or notepaper issued by a company or organization and drawing attention to professional attainments of a practitioner in their employment.
Questions of Advertising arising from Articles, or Books, Broadcasting or Television Appearances by Practitioners
Practitioners who write to magazines or journals addressed to the lay public, articles or columns which offer advice on common medical conditions or problems, or who are involved in television or radio programmes dealing with such matters, shall not use language, which might be construed as advertisement or self-promotion or denigrating other practitioners.
Notice Boards, Door Plates and Signposts
Advertising may arise from notices or announcements displayed, circulated or made public by a practitioner in connection with his own practice if such notices or announcements materially exceed the limits customarily observed by the profession in Malawi. It is important that the public be informed of the location of a practitioner’s premises, but in choosing the wording and size of a sign, the practitioner shall abide by the following criteria:
a sign or doorplate shallnot be ostentatious in size and form. Door plate signs shall not exceed 40cm by 40cm and roadside signs shall not exceed 1m by 0.5m.
it is acceptable for the information on the practitioner’s plate to be repeated in a second language if necessary;
a plate shall not carry more than the practitioner’s names, qualifications and clinic hours;
The Geneva Convention prohibits the use of the Red Cross or similar sign. Clinics or surgeries shall not use the Red Cross, provided that a green cross may be used to symbolize such a facility.
No notices or signposts shall be larger, or repeated more frequently than is necessary to indicate to patients the location of the premises;
No notices or signposts shall be used to draw public attention to the services of one practice at the expense of others.
4.12. Names of Clinics
In selecting a name for a clinic or a medical centre, or a collective title for a group or partnership, practitioners shall;
avoid the use of a name which could be interpreted as implying that the services provided in that clinic or by that partnership have received some official recognition not extended to other local practitioners.
Avoid the use of fancy names, which may be misleading, a name shall be deemed as misleading if:
it contains a material misrepresentation of fact or law or omits a fact necessary to make the statement considered as a whole not materially misleading,
is likely to create an unjusfied expectation about results the practitioner can achieve or states or implies that the practitioner can achieve results by means that violates the rules of professional conduct or other law; or
4.12.2.3 compares the practitioners services with other practitioner’s services, unless comparison can be factually substantiated
4.12.3 The Medical Council shall in the exercise of its discretion deny use of a name deemed unacceptable. The use of terms such as “clinic” or “surgery” is acceptable.
4.13. Directories and Lists of Practitioners
An entry of practitioners’ names in a telephone directory shall appear in the ordinary small typeface. The practitioner shall neither request nor allow any entry in a special typeface or any description other than his qualifications or, in the case of a specialist, his specialty. It is permissible for a practitioner’s name to be included in a handbook of local information, provided that the list is open to the whole profession in the area and that the publication of the names is not dependent on the payment of a fee.
Canvassing
Canvassing for the purpose of obtaining patients, whether done directly or through an agent, and association with or employment by persons or organizations which canvass is unethical. It is also unethical to talk in a derogatory manner about the professional skills, knowledge, qualification or services of another practitioner.
Communication with the Laity on Medical Subjects
All opinions on medical subjects which are communicated to the laity by any medium be it a public meeting, the lay press, radio or television shall represent what is the generally accepted opinion of the medical profession.
SECTION 5
5. TYPES OF ACTIONS WHICH MAY CONSTITUTE PROFESSIONAL MISCONDUCT AND MAY RESULT IN DISCIPLINARY ACTION
Termination of Pregnancy
The Laws of Malawi prohibit the termination of pregnancy on demand. Practitioners found guilty of procuring or attempting to procure abortions or miscarriages are liable to severe penalties under the Penal Code (Cap: 7:01). In all cases of illegal termination of pregnancies, the penalty shall be suspension or erasure from a register.
5.2 Issuance of False Reports and Certificates
There are instances when members of the public require certain reports or certificates to be signed and issued by a duly qualified and registered practitioner on the presumption that the truth of such statements can be accepted without question. Practitioners must be meticulous in making sure that the certificates they issue are accurate in their statements of fact. They must resist all requests to issue false certificates. Reasonable care should be taken in completing such documents.
Before filling any certificate requiring examination a practitioner shall carry out such medical examination on that person. Before
filling any form that a particular service has been carried out on a person, a practitioner so authorized shall provide such service.
5.3. Unethical Prescribing and Use of Drugs
Practitioners are expected to be fully conversant with the provisions of the regulatory Acts relevant to their profession such as the Pharmacy, Medicines and Poisons Act and the Dangerous Drugs Act. The Council urges all practitioners to study these Acts, and in case of doubt, to seek advice from the Chairman or Registrar of the Council. Practitioners must always be mindful of their privileged positions in relation to dangerous drugs as well as the scheduled ones and should avoid their unethical use. They should be conversant with side effects and interactions of all drugs. Practitioners shall take all reasonable steps to communicate the side effects and interactions of drugs to their patient/ client. No drugs, which have expired according to manufacturers’specifications, shall be dispensed to patients.
5.4 Patents
A practitioner shall not make use of, or recommend any remedy, the principal ingredients of which are not disclosed to the profession.
5.5. Association with Improper Systems or Methods of Treatment
It is unethical for a practitioner to be associated with any system or method of treatment, which is not evidence – based.
5.6 Managing patients without Informed Consent
The Council urges all practitioners to ensure that as far as possible informed consent is obtained before any procedure is carried out on a patient. Where the procedure is a major one, a written consent shall be obtained. In obtaining informed consent a practitioner shall explain the full nature, extent and potential complications of the procedure to be carried out on the patient.
Provided that;
In the case of persons who may be unable to give informed consent including minors, unconscious or psychiatric patients, the most senior practitioner in consultation with the parent or guardian may give consent for the procedure or treatment, and such consent should as far as possible be witnessed by a second practitioner. In the event of differing opinion between the parent or guardian and the practitioner, the practitioner’s stand shall prevail in the best interest of the concerned person.
Abuse of Professional Confidence
A practitioner shall not disclose to a third party information, which he obtained in confidence from a patient in the course of the professional relationship between the patient and the practitioner.
Provided that in the following circumstances, the confidential information may be disclosed to a third party:
Where there is a valid consent from the patient or his legal adviser or guardian, provided that information may be given to a relative or appropriate person if in the circumstances of the case in question it is reasonably undesirable on medical grounds to seek the patient’s consent;
Where the information may be required by law;
Where public interest persuades a practitioner that his duty to the community overrides that to his patients; and
In the interests of research and medical education, information may be divulged, but at all times the patient’s name shall not be revealed.
A practitioner shall always be prepared to justify his action whenever he disclosed confidential information.
Abuse of Relationships between Practitioners and Patients
Abuses of the practitioner/patient relationship include:
having carnal knowledge or maintaining improper emotional or sexual relationships with the patient in the course of the practitioner/patient relationship; and
Abuse of financial opportunities which may occur as a result of:
improperly obtaining money from patients, or from medical insurance schemes,
improperly sanctioning payments or financial claims under insurance schemes, workmen’s compensation schemes, civil suit cases or any other authorities,
splitting of fees, for example between consultants and general practitioners,
in the case of a treatment which involves more than one specialist in the same discipline only the original practitioner shall charge the approved fees for the treatment which he will then share with the additional practitioner; or in the case of a treatment involving more than one specialist in different disciplines only the original specialist shall send the bill for the approved fees indicating the appropriate proportions for the additional specialists, depending on their individual contributions to that treatment,
improper prescription ofdrugs or appliances in which a practitioner has a financial interest;
practitioners should not taking advantage of patients’ dependence on them to get disproportionate benefits for their services.
5.9 Disregard of Personal Responsibilities to Patients for their Care and Treatment
5.9.1 Negligence in Diagnosis or Treatment
The Council has a duty to protect the public by ensuring that practitioners do not relinquish their personal responsibilities for their patients, for example by: -
failing to be present at their usual places of work without notifying patients or making alternative arrangements for patients to be attended to;
failing to visit their patients when called upon to do so without making alternative arrangements. Practitioners shall make every effort to see quickly persons whom they have accepted as patients;
unskillful or careless treatment of a complaint which has been properly diagnosed;
failing to warn patients of the dangers of certain treatments;
gross and/or prolonged neglect of duties;
attempting to carry out procedures for which the practitioner has not adequate training or experience leading to more suffering for the patient. Exceptions may occur in case of emergency, if the practitioner can show that he acted to save life, there being no competent practitioner available in the area for him to consult with.
5.10. Associating with Unregistered Persons
It is unethical for a duly qualified and registered practitioner to be associated professionally with a person who is not duly qualified and registered to practice medicine.
5.11. Conduct Derogatory to the Reputation of the Profession
Undesirable modes of personal behavior may arise from abuse of alcohol, breaches of the Pharmacy, Medicine and Poisons Act and the Dangerous Drugs Act, or some other offences committed by the use of drugs. Members of the profession shall avoid appearing in public while under the influence of alcohol and they must certainly not be at work with their patients while intoxicated.
The commission of offences of false pretences, forgery, misdemeanors fraud, indecent behaviour, assault or felonies, which reflect adversely on the profession’s standing in the public eye, should be avoided. The Council takes a serious view of assaults or indecent acts in the course of a practitioners’ duties. The Council may take disciplinary action where a practitioner has been convicted for any offence in a court of law.
5.12 Improper Attempts to Profit (Advertising, Canvassing and Related Professional Offences)
These offences may be committed at the expense of professional colleagues by canvassing for patients, or advertising. Practitioners should avoid doing anything, which may be interpreted as an attempt to attract patients to them or to undermine the reputation of colleagues.
SECTION 6
6. MISCELLANEOUS PROVISIONS
6.1. Issuance of Medical Reports
Practitioners are relied upon to issue medical reports for a variety of purposes on the assumption that the truth of the report can be accepted without question. A practitioner shall exercise care in issuing reports and similar documents, and shall not include in them statements that he has not taken appropriate steps to verify.
6.2. Forms and Certificates
According to Section 12 of the International Code of Medical Ethics of the World Medical Association, “A doctor owes to his patient the absolute secrecy on all which has been confided to him or which he knows because of the confidence entrusted to him.”In all forms where medical reports are to be filled in by practitioners there shall be included a declaration to be signed by the patient or a responsible relative or guardian stating that assent is given to the practitioner to supply the information requested. It is also strongly recommended that these forms and/or declarations be supplied in duplicate to permit the practitioner to retain a copy.
All forms and certificates filled by a practitioner must clearly bare the name of the practitioner in block letters; the qualifications of the practitioner; the usual signature of the practitioner; the area of specialization of the practitioner and the official stamp with a date and registration number.
A competent practitioner recognized by the institution must complete all forms and medical certificates that will be used for legal purposes (such as insurance forms, employment forms, and court cases).
6.3. Connections with Commercial Enterprises
6.3.1. A practitioner shallnot associate himself with commerce in such a way as to let it influence, or appear to influence, his attitude towards the treatment of his patients.
6.3.2 A practitioner shall not allow a business to add to his professional status.
6.3.3 A practitioner shall refrain from writing a testimonial on a commercial product unless he receives a legally enforceable consent from an appropriate regulatory body.
6.3.4 There shall be no direct association of a practitioner with any commercial enterprise engaged in the manufacture or sale of any substance which is claimed to be of value in the prevention or treatment of disease, and which is recommended to the public in such a fashion as to be calculated to encourage the practice of self-diagnosis and self-medication or is of undisclosed nature or composition.
6.3.5. A practitioner shall not be associated with any system or method of treatment, which is not under medical control.
6.4 Professional Fees
The only basis on which a fee may be charged to a patient or on which any medical practitioner may receive money, is that of work actually done for the patient, and such patient must receive a direct statement from the medical practitioner concerned.
In case where in the opinion of the attending medical practitioner the services of one or more consultants are required, each consultant shall render his account and submit his receipt individually.
Each practitioner shall send his account to the patient individually. If however, a surgeon has a regular assistant at operations he may pay him directly. When the assistant has referred the patient to the operating surgeon the assistant shall send a statement of his fee directly to the patient.
If fees are collected by an organized clinic, medical group, medical partnership or practitioner employing regular assistants, each such organization is in effect regarded as an individual who acts in that capacity. The same principle applies when the clinic and hospital are combined and operate under the same ownership.
When a third person or organization enters into a financial arrangement between patients and medical practitioners, practitioners should render an individual account to the third person or organization concerned. If more than one practitioner is carrying out professional services, a statement to the patient by a third person or organization should show the amount paid to each practitioner.
Practitioners shall adhere strictly to the practice of their profession, disassociating themselves from the dispensing of all commodities relating to the practice of medicine and the profits derived from them. In places where those with special training or qualifications are not available, dispensing of such commodities may be undertaken in accordance with the Pharmacy, Medicine, and Poisons Act.
A practitioner’s statement to the patient shall show clearly and separately his professional fee and the charge for the commodity dispensed.
Practitioners shall not have proprietary interest in preparations or appliances, which they may recommend to patients.
Where practitioners, a medical group or a clinic of surgery, own and occupy an office building, it should not be considered unethical for them to rent space to businesses or individuals under the following provisions:
that the rent charged is the normal or going rent for that similar space;
that there is neither real nor implied endorsement of the business carried on by the tenant; and
that other than normal rent, there be no profit of any kind, direct or hidden, derived from the tenant concerned.
6.5 Medical Research
All medical research shall be conducted in the best interest of the patient and must be conducted ethically following the national and international research guidelines and policies e.g.World Medical Association (WMA) declaration of Helsinki). All medical research done in Malawi shall undergo an independent scientific and ethical review by recognized national bodies. Practitioners conducting Medical research must be registered with the Council. In the case of clinical trials where drugs are involved, permission for approval shall be sought from the Pharmacy Medicine and Poisons Board. All institutions where medical research is to be conducted are mandated to enforce this regulation.
OTHER COMMENTS
The Medical Council of Malawi shall put in place a CPD framework and enforce its implementation.
Wednesday, May 8, 2013
150 Years of Humanitarian Action for the Red Cross
The year 2013 marks the 150 year anniversary of the birth of the Red Cross Red Crescent Movement. On 8th May, World Red Cross Red Crescent Day, we celebrate together 150 years of humanitarian action and the Red Cross Red Crescent’s continued relevance, locally and globally, in today’s changing world.
150 years after the birth of the Red Cross Red Crescent Movement, we continue to provide relevant and timely humanitarian service to vulnerable communities and are committed to doing so now and into the future. Together and building on each other's strengths, our 187 Red Cross Red Crescent National Societies, the International Federation of Red Cross and Red Crescent Societies (IFRC) and the International Committee of the Red Cross (ICRC) mobilize the power of humanity – to help people prepare for, respond to and recover from crisis – now and well into the future.
The Red Cross Red Crescent is the world’s largest humanitarian network, made up of millions of volunteers and professionals working in close proximity with those in need. Over the past decade, Red Cross Red Crescent volunteers and staff have supported more than 160 million people in emergency response, ranging from disaster to civil unrest. The Red Cross Red Crescent is at the foundation of international humanitarian action and of modern international humanitarian law. In 1863, Henry Dunant’s ideas, presented in his landmark book A memory of Solferino, were transformed into reality with the creation of the ICRC and the establishment of the first National Societies, followed in 1864 by the adoption of the First Geneva Convention. Today, his ideas remain pillars for the Movement, giving it strength and purpose.
All Red Cross Red Crescent action is driven by humanitarian values such as neutrality, protection of human dignity and respect for diversity, which are embedded in the seven Fundamental Principles of the Red Cross Red Crescent Movement. In our changing world these Fundamental Principles – and how they guide our work – are relevant more than ever before. Our volunteers and staff are driven by principles that go beyond geographical, religious or cultural borders. Our Fundamental Principles make up the ethical framework which guide us in our continued service to vulnerable people everywhere, regardless of nationality, race, gender, religious beliefs, class and political opinions.
The seven Fundamental Principles are: humanity, impartiality, neutrality, independence, voluntary service, unity and universality.
Red Cross Red Crescent volunteers will continue to empower their local communities. And it is local communities that will shape the global agenda. We are truly global in our composition and presence as a network, yet local in our approach, thanks to our strong anchoring in local communities. The global humanitarian agenda will ultimately be set by the people who understand the needs and solutions best – the local volunteers on the ground, community members and individuals who have been affected by hardship. Red Cross Red Crescent volunteers and staff worldwide reach more than 150 million people each year through programmes in health, disaster risk reduction, social inclusion and more.
The voices of millions of people and their humanitarian needs are represented through these programmes and the Red Cross Red Crescent volunteers and staff who support them. Our volunteers enable change to happen from within communities, in tune with local needs, aspirations and contexts. 13 million Red Cross Red Crescent volunteers contribute six billion US dollars in economic value through the services they deliver worldwide.
In our fast-changing world, young people will lead positive change. Half of the 13 million Red Cross Red Crescent volunteers worldwide are youth. They are innovators embracing new ideas and technologies faster than any generation before them. Young people are values-driven. They believe in equality and non-violence and want to act with meaning and with purpose in life. They are agents of change, across generations and ideologies, promoting a culture of non-violence and peace, for example as we saw in the Arab Spring.
Thousands of young people worldwide have been trained as peer educators in the Red Cross Red Crescent ‘Youth as Agents of Behavioural Change’ (YABC) programme, in which they are equipped with skills such as mediation and non-violent communication. YABC empowers young people to take leadership roles and inspire a positive transformation of mindsets, attitudes and behaviours within themselves and their community.
Looking to the future, as humanitarian needs evolve, so too will the Red Cross Red Crescent. In the 150 years since our founding, the nature of war and other crisis has continuously evolved, raising new challenges for humanitarian action. Today, as it has always done, the Red Cross Red Crescent Movement builds on its history, adapting its humanitarian response to face new challenges, with the sole ambition of serving the most vulnerable. Amongst the challenges facing humanitarian action today is an increase in natural disasters and health emergencies, the continuous lack of respect for international humanitarian law, problems of safe access to health care in many countries and difficulties for humanitarian actors to reach people in need in certain contexts.
Reaching people in need is a serious challenge in certain conflict situations. Thousands of people living in areas of Afghanistan, Somalia, Democratic Republic of the Congo or Syria receive scarce humanitarian aid because of insecurity or political barriers. Ensuring that fighting parties understand that we do not take sides and are only interested in helping impartially those suffering is the key for reaching people who need our help, especially in conflict situations. Whether it is by using new technologies to improve our response or adapting to climate change in programme delivery, we will always seek innovative and impactful approaches in serving the vulnerable.
The number of natural disasters reported from 1970 to 2010 increased by 500 per cent. In response, in 2010, the Red Cross Red Crescent trained more than 17 million people in disaster risk reduction and climate change preparedness to help communities adapt to this changing threat.- RED CROSS
From the Mouth of Julius Malema
President Zuma has presided over textbooks crisis, Marikana massacre, police brutality, mass unemployment and the killing of our soldiers in the CAR and everyone is scared to confront him on those grave matters. The Prime Minister of the CAR Nicolas Tiangaye said here in South Africa that the relationship between South Africa and ex-president Bozize was personalized, meaning that our soldiers died in the CAR because of personalized relationship.
Now because of other personalized relationship and President Zuma's nephew business dealings in the Democratic Republic of Congo, our soldiers will be donated to another war, which has potential to cause instability in our own country. The protest actions of DRC citizens to ANC Head Offices, Luthuli House and other many events reveals that South Africa is imposing itself on the DRC and such will sacrifice and compromise our legitimacy in the continent. This is due to a directionless President, whom everyone is scared to question, hence the developments in our Airbase.
Now that the incident has happened, we call on the South African National Prosecutions Authority to charge the Gupta family with high treason for initiating and pushing through efforts that led to the usage of our military airbase despite the disapproval by the Minister of Defence. Attempts to use a key national security point without approval by relevant authorities is treason.
It is plain foolishness and naïveté to ever believe that some junior officers, including Police Reservists are the guilty ones on this case because they were just carrying instructions of Highest authority. If the NPA is not in the pockets of the Guptas, like many are, it will proceed to lay charges of treason against the Gupta family for undermining and threatening national security. Unions are also quiet over victimization of Police, Police Reservists and Traffic Cops by Senior Officials and will be the first ones to cry counter-revolution when alternate Unions emerge- May 5, 2013 Statement issued by Julius Maleman on behalf of Economic Freedom Fighters.
Saturday, May 4, 2013
The Declaration of Table Mountain
WORLD ASSOCIATION OF NEWSPAPERS
Declaration of Table Mountain
Abolishing “Insult Laws” in Africa and Setting Free Press Higher on the Agenda
The World Association of Newspapers and the World Editors Forum, meeting at the 60th World Newspaper Congress and 14th World Editors Forum Conference in Cape Town, South Africa, from 3 to 6 June 2007,
Note that in country after country, the African press is crippled by a panoply of repressive measures, from the jailing and persecution of journalists to the widespread scourge of 'insult laws' and criminal defamation which are used, ruthlessly, by governments to prevent critical appraisal of their performance and to deprive the public from information about their misdemeanours,
State their conviction that Africa urgently needs a strong, free and independent press to act as a watchdog over public institutions,
Consider that press freedom remains a key to the establishment of good governance and durable economic, political, social and cultural development, prosperity and peace in Africa, and to the fight against corruption, famine, poverty, violent conflict, disease, and lack of education,
Reaffirm our responsibility as the global representative organisations of the owners, publishers and editors of the world's press to conduct “aggressive and persistent campaigning against press freedom violations
and restrictions”,
Reaffirm our commitment to freedom of the press as a basic human right as well as an indispensable constituent of democracy in every country,including those in Africa,
Note that Article 19 of the Universal Declaration of Human Rights guarantees freedom of expression as a fundamental right, and emphasise that freedom of expression is essential to the realization of other rights set
forth in international human rights instruments,
Recall that those principles have been restated and endorsed in the 2002 Declaration on Principles of Freedom of Expression in Africa, adopted by the African Commission on Human and Peoples' Rights and the African
Union, thus requiring member states of the African Union to uphold and maintain press freedom,
Recall also the 1991 Windhoek Declaration on Promoting an Independent and Pluralistic African Press,
Observe that despite numerous opportunities for a free press to emerge from national independence, fully-fledged press freedom still does not exist in many African countries and that murder, imprisonment, torture,
banning, censorship and legislative edict are the norm in many countries,
Recognise that these crude forms of repression are bolstered by the deliberate exclusion of certain newspapers from state-advertising placement, the burden of high import taxes on equipment and newsprint
and unfair competition from state-owned media,
Note that despite the adoption of press freedom protocols and the repression of that freedom on a wide scale in Africa, the African Union in instituting its African Peer Review Mechanism under the NEPAD (New Partnership for Africa's Development) programme has excluded the fostering of a free and independent press as a key requirement in the assessment of good governance in the countries of the continent, and
Identify as the greatest scourge of press freedom on the continent the continued implementation of “insult laws,” which outlaw criticism of politicians and those in authority, and criminal defamation legislation,
both of which are used indiscriminately in the vast majority of African states that maintain them and which have as their prime motive the ``locking up of information'',
Declare that
African states must recognise the indivisibility of press freedom and their responsibility to respect their commitments to African and international protocols upholding the freedom, independence and safety of the press,
and
To further that aim by, as a matter of urgency, abolishing ``insult'' and criminal defamation laws which in the five months of this year have caused the harassment, arrest and/or imprisonment of 229 editors,
reporters, broadcasters and online journalists in 27 African countries (as outlined in the annexure to this declaration),
Call on African governments as a matter of urgency to review and abolish all other laws that restrict press freedom,
Call on African governments that have jailed journalists for their professional activities to free them immediately and to allow the return to their countries of journalists who have been forced into exile,
Condemn all forms of repression of African media that allows for banning of newspapers and the use of other devices such as levying import duties on newsprint and printing materials and withholding advertising,
Call on African states to promote the highest standards of press freedom in furtherance of the principles proclaimed in Article 19 of the Universal Declaration of Human Rights and other protocols and to provide
constitutional guarantees of freedom of the press,
Call on the African Union immediately to include in the criteria for “good governance” in the African Peer Review Mechanism the vital requirement that a country promotes free and independent media,
Call on international institutions to promote progress in press freedom in Africa in the next decade, through such steps as assisting newspapers in the areas of legal defence, skills development and access to capital and equipment,
Welcome moves towards a global fund for African media development and recommends that such an initiative gives priority attention to media legal reform and in particular the campaign to rid the continent of “insult” and criminal defamation laws,
Commit WAN and WEF to expand their existing activities in regard to press freedom and development in Africa in the coming decade.
WAN and WEF make this declaration from Table Mountain at the southern tip of Africa as an earnest appeal to all Africans to recognise that the political and economic progress they seek flourishes in a climate offreedom and where the press is free and independent of governmental,political or economic control.
This Declaration shall be presented to: The Secretary-General of the United Nations with the request that it be presented to the UN General Assembly; to the UNESCO Director-General with the request that it be placed before the General Conference of UNESCO; and to the Chairperson of the African Union Commission with the request that it be distributed to all members of the African Union so that it can be endorsed by the AU at its next summit meeting of heads of state.
Cape Town, 3 June 2007
Declaration of Table Mountain
Abolishing “Insult Laws” in Africa and Setting Free Press Higher on the Agenda
The World Association of Newspapers and the World Editors Forum, meeting at the 60th World Newspaper Congress and 14th World Editors Forum Conference in Cape Town, South Africa, from 3 to 6 June 2007,
Note that in country after country, the African press is crippled by a panoply of repressive measures, from the jailing and persecution of journalists to the widespread scourge of 'insult laws' and criminal defamation which are used, ruthlessly, by governments to prevent critical appraisal of their performance and to deprive the public from information about their misdemeanours,
State their conviction that Africa urgently needs a strong, free and independent press to act as a watchdog over public institutions,
Consider that press freedom remains a key to the establishment of good governance and durable economic, political, social and cultural development, prosperity and peace in Africa, and to the fight against corruption, famine, poverty, violent conflict, disease, and lack of education,
Reaffirm our responsibility as the global representative organisations of the owners, publishers and editors of the world's press to conduct “aggressive and persistent campaigning against press freedom violations
and restrictions”,
Reaffirm our commitment to freedom of the press as a basic human right as well as an indispensable constituent of democracy in every country,including those in Africa,
Note that Article 19 of the Universal Declaration of Human Rights guarantees freedom of expression as a fundamental right, and emphasise that freedom of expression is essential to the realization of other rights set
forth in international human rights instruments,
Recall that those principles have been restated and endorsed in the 2002 Declaration on Principles of Freedom of Expression in Africa, adopted by the African Commission on Human and Peoples' Rights and the African
Union, thus requiring member states of the African Union to uphold and maintain press freedom,
Recall also the 1991 Windhoek Declaration on Promoting an Independent and Pluralistic African Press,
Observe that despite numerous opportunities for a free press to emerge from national independence, fully-fledged press freedom still does not exist in many African countries and that murder, imprisonment, torture,
banning, censorship and legislative edict are the norm in many countries,
Recognise that these crude forms of repression are bolstered by the deliberate exclusion of certain newspapers from state-advertising placement, the burden of high import taxes on equipment and newsprint
and unfair competition from state-owned media,
Note that despite the adoption of press freedom protocols and the repression of that freedom on a wide scale in Africa, the African Union in instituting its African Peer Review Mechanism under the NEPAD (New Partnership for Africa's Development) programme has excluded the fostering of a free and independent press as a key requirement in the assessment of good governance in the countries of the continent, and
Identify as the greatest scourge of press freedom on the continent the continued implementation of “insult laws,” which outlaw criticism of politicians and those in authority, and criminal defamation legislation,
both of which are used indiscriminately in the vast majority of African states that maintain them and which have as their prime motive the ``locking up of information'',
Declare that
African states must recognise the indivisibility of press freedom and their responsibility to respect their commitments to African and international protocols upholding the freedom, independence and safety of the press,
and
To further that aim by, as a matter of urgency, abolishing ``insult'' and criminal defamation laws which in the five months of this year have caused the harassment, arrest and/or imprisonment of 229 editors,
reporters, broadcasters and online journalists in 27 African countries (as outlined in the annexure to this declaration),
Call on African governments as a matter of urgency to review and abolish all other laws that restrict press freedom,
Call on African governments that have jailed journalists for their professional activities to free them immediately and to allow the return to their countries of journalists who have been forced into exile,
Condemn all forms of repression of African media that allows for banning of newspapers and the use of other devices such as levying import duties on newsprint and printing materials and withholding advertising,
Call on African states to promote the highest standards of press freedom in furtherance of the principles proclaimed in Article 19 of the Universal Declaration of Human Rights and other protocols and to provide
constitutional guarantees of freedom of the press,
Call on the African Union immediately to include in the criteria for “good governance” in the African Peer Review Mechanism the vital requirement that a country promotes free and independent media,
Call on international institutions to promote progress in press freedom in Africa in the next decade, through such steps as assisting newspapers in the areas of legal defence, skills development and access to capital and equipment,
Welcome moves towards a global fund for African media development and recommends that such an initiative gives priority attention to media legal reform and in particular the campaign to rid the continent of “insult” and criminal defamation laws,
Commit WAN and WEF to expand their existing activities in regard to press freedom and development in Africa in the coming decade.
WAN and WEF make this declaration from Table Mountain at the southern tip of Africa as an earnest appeal to all Africans to recognise that the political and economic progress they seek flourishes in a climate offreedom and where the press is free and independent of governmental,political or economic control.
This Declaration shall be presented to: The Secretary-General of the United Nations with the request that it be presented to the UN General Assembly; to the UNESCO Director-General with the request that it be placed before the General Conference of UNESCO; and to the Chairperson of the African Union Commission with the request that it be distributed to all members of the African Union so that it can be endorsed by the AU at its next summit meeting of heads of state.
Cape Town, 3 June 2007
HUMAN RIGHTS CONSULTATIVE COMMITTEE'S OPEN LETTER TO PRESIDENT JOYCE BANDA - CONCERNS ON THE STATE OF FUNDAMENTAL RIGHTS AND FREEDOMS
HUMAN RIGHTS CONSULTATIVE COMMITTEE (HRCC)
PRESS STATEMENT
Thursday / 3rd May, 2013.
OPEN LETTER TO PRESIDENT JOYCE BANDA - CONCERNS ON THE STATE OF FUNDAMENTAL RIGHTS AND FREEDOMS
It is with much delight that, on behalf of the Board, Members and Staff of Human Rights Consultative Committee (HRCC), we take this opportunity to express our heartfelt pleasure on your continued effort to maintain this country’s peace amidst the current economic, financial and food security challenges. The recurrent natural disasters like floods have not spared this country this year.
The Floods in Karonga, Phalome and Salima have rendered many homeless, destitute and threatened the livelihoods and security of ordinary citizens in these areas.
As if this is not enough, for a country that is dependent on agriculture, there have been a number of challenges faced in the agriculture and food security sector:
Hunger versus scarcity of maize where people particularly women were sleeping on long queues some with babies on their back at ADMARC deports;
Floods in some areas that shall affect maize yields;
Supply of bad farm inputs (seeds) in some areas in the country
People prematurely selling maize which is still in the fields in order to make ends meet.
These practices that have taken place in some parts of this country may also affect the availability of food this year and livelihoods of many local citizens. We at HRCC regard the right to food as one of the most fundamental human rights. No meaningful sustainable development – and poverty reduction programme can be achieved if people do not have enough food.
Once again, please accept, Your Excellency, our warmest appreciation for the efforts, and responses that government has made to mitigate these challenges.
Your Excellency, HRCC, a grouping of 97 civil society organizations working to protect and promote good governance, human rights and democracy in Malawi, observes with concern that despite the so many government efforts to improve the livelihoods of Malawians there has been a clampdown of fundamental human rights particularly freedom of expression such as touting of journalists by the government from expressing their views on issues of national interest and threatening and intimidating some individual Malawians.
Your Excellency, We at HRCC considers it a matter of deep regret and great embarrassment that intimidation, harassment and abuse of the media seem to be rising again in Malawi.
We at HRCC have observed the tension between the media and the state house which has worsened since a delegation from the media called on you on 22nd April 2013 to present the Table Mountain Declaration which proposes the abolition of insult laws in Africa ahead of the World Press Freedom Day, May 3. We were appalled to learn that you had stopped reading Malawian newspapers because they are full of hatred towards you and could kill you the way they did with late President Bingu wa Mutharika. If what the media reported is what was said then we fear for freedom of expression and the media in this country. A media that kills is the worst thing that can ever happen to a democracy. Coming from a state president, we are so disturbed because we do not know what the consequences of a media that kills would be.
We were however; pleased hearing from the same reports that you had assured the media and therefore Malawians that you would look into the matter by declaring: “In as far as press freedom is concerned you have a friend in me.”
Our fears seem to have been vindicated when we heard that you had refused to sign the Declaration of Table Mountain which is intended to abolish “Insult Laws” in Africa to allow for Free Press.
This was confirmed by the state house when the Media Institute of Southern Africa (MISA Malawi) made a statement informing Malawians about the development. The declaration which was put together by Media leaders under the auspices of the world Association of Newspapers and News Publishers and the world Editors guarantees that African governments will respect media freedom. We feel obliged and our duty to reconsider your decision your Excellency. We therefore appeal to you your Excellency to sign the declaration as a commitment to ensure fundamental human rights through freedom of the press.
The denial to sign the declaration draws back the efforts you have made in the past 12 months since you became Malawi’s State President towards enhancing democracy in Malawi. HRCC remembers very well your previous commitment to freedom of the press when you impressed upon parliament to repeal section 46 of the penal code and pushed for the removal of VAT on News Print and Newspapers.
We hope through your statesmanship and exemplary leadership that you your Excellency will promote the freedom of expression that is enshrined in the Constitution and that you shall attach top priority to the protection of citizens’ rights and freedoms.
Section 35 of the Malawi constitution clearly states that every person has the right to freedom of opinion and expression; this right includes the right to hold opinions without interference and to seek, receive and impart information and ideas through any media regardless of frontiers.
Your excellency, HRCC believes that Public bodies have an obligation to disclose information and every member of the public has a corresponding right to receive information; “information” includes all records held by a public body, regardless of the form in which it is stored as stated on Article 19 of the Universal Declaration of Human Rights (UDHR),
The International Covenant on Civil and Political Rights (ICCPR), 5 a formally binding legal treaty, further guarantees the right to freedom of opinion and expression also at Article 19, in terms very similar to the UDHR. Malawi ratified the ICCPR in December 1993. By ratifying the ICCPR, State Parties agree to refrain from interfering with the rights protected therein, including the right to freedom of expression. However, the ICCPR also places an obligation on State Parties to take positive steps to ensure that rights, including freedom of expression and information, are respected.
Lastly, Your Excellency, HRCC will give you all the necessary support as you push your vision of Economic recovery plan particularly on issues that focus on human development such as food security, education, health, peace, unity, promotion and protection of human rights and as you deal with the so many challenges facing this country.
God Bless Malawi and Keep It a Land of Peace.
Signed
Mrs Margaret Ali Baldwin Chiyamwaka
VICE CHAIRPERSON NATIONAL COORDINATOR
ABOUT HRCC
The Human Rights Consultative Committee (HRCC) is a network of 97 civil society organizations (CSOs) comprising local civil society organizations with interest in the areas of protection of people’s rights, promotion of the human rights agenda, and safeguarding good governance and the rule of law. Established in July, 1995, the network was an initiative of church institutions, human rights NGOs and the Malawi Law Society in order to address issues around human rights, advocacy and information sharing among civil society organizations.
HRCC has a nationwide outreach with its members spread in all the districts of Malawi. HRCC has three categories of members: full members, associate members; and affiliate members. In addition, there are partners that work with HRCC on key developmental issues and currently there are four partners.
The Human Rights Consultative Committee which was established during the period Malawi was going through a transition from a single party to political pluralism is a legally registered organization under the Company’s Registration Act. The HRCC secretariat was established with support from the Danish Institute for Human Rights with the aim of coordinating the activities of the network. The driving values of HRCC formation are as follows:
Promoting civil and political rights.
Responding to the need for driving the democratization process, and creating awareness on constitutional and human rights issues.
Harmonizing the interventions of civil society organizations working on human rights in order to take advantage of economies of scale, reducing duplication of efforts, and maximizing efficiency gains.
SPEECH BY BRITISH HIGH COMMISSIONER TO MALAWI MICHAEL NEVIN ON WORLD PRESS FREEDOM DAY
I would like to welcome to this reception tonight the National Press Club, the Media Institute of Southern Africa (Malawi Chapter) and all others connected with the media as we lead up to World Press Freedom Day on 3 May. The theme of this year's World Press Freedom Day is “Safe to Speak: Securing Freedom of Expression in All Media”. In particular, this theme highlights the issues of safety of journalists, combating impunity for crimes against freedom of expression, and securing a free and open internet as the precondition for safety online.
Condolences
But before we look at this theme further, I would like us all to take a moment to remember those journalists around the world who have been killed, injured or kidnapped simply because of the work that they were doing. I would like also to remember Elizabeth Banda, who worked at Nation Publications before her recent untimely death. And my neighbour and colleague Anthony Livuza, who passed away last week. I selected Anthony for a UK Government Chevening Scholarship when I was last posted here to Malawi and so I am particularly saddened by his passing.
UK a Strong Supporter of Freedom of Expression
The UK government is a strong supporter of freedom of expression. Indeed, freedom of expression on the Internet is one of the Foreign Office’s global thematic human rights priorities. A free media and freedom of opinion and expression are integral to ensuring that citizens can exercise their full democratic rights. Freedom of expression is fundamental to building democracy. Citizens must be allowed to discuss and debate issues, to challenge their governments and make informed decisions. Journalists, bloggers, media organisations and individuals must be allowed to operate and to express themselves freely and safely and within international standards.
Governments need to respond to legitimate aspirations with reform, not repression. Encouraging an open and effective press serves to improve the environment for long-term social, political and economic stability and development.
Freedom of Expression and Media Responsibility – the UK
When there are debates about the media, they often focus on the role of the media and its responsibilities. The balance between freedom of expression and opinion and ethical reporting is a constant and evolving debate. That debate has been spotlighted most recently in the UK with the Leveson Inquiry. In 2011 the Leveson Inquiry was established to look in to, as one of its two main objectives:"the culture, practices and ethics of the press, including contacts between the press and politicians and the press and the police; it is to consider the extent to which the current regulatory regime has failed and whether there has been a failure to act upon any previous warnings about media misconduct."
The inquiry came on the back of increasing public concern over the methods by which the media obtained information and concerns over media intrusion into private lives, as well as the relationship between the media, politicians and police. Of particular concern was “phone hacking”, the illegal means by which some in the media accessed private phone data and phone messages in the pursuit of a story. Perhaps most notoriously, the phone of Milly Dowler, a schoolgirl who was kidnapped and killed in the UK, was found to be hacked after her death by a journalist working for the News of the World.
The debate following Lord Justice Leveson’s report revealed a keen sense in the UK of wanting to protect our long tradition of upholding freedom of expression and opinion. John Milton in the 1600s and later John Stuart Mills in the 1800s were leading proponents of that principle in the UK. Yet, many felt there needed to be stronger measures to ensure that journalism ethics and standards were upheld. And that the current Press Complaints Commission arrangements were not working.
The Leveson Inquiry Report tackled that issue head on. The Prime Minister welcomed many of the findings of the Report, but had serious misgivings about “crossing the Rubicon” of legislation to regulate the press. Other leading politicians had different views. Following cross-party discussions, there was agreement on a Royal Charter that should help deliver a new robust, but independent, system of press regulation in the UK, without the need for statutory regulation. Debate continues today, with media houses offering their own proposals supporting the principle of media freedom while recognising the importance of responsible journalistic methods.
Malawi
Malawi is no stranger to similar debates. When I was last posted here 10 years ago, the strength or weakness of the Media Council of Malawi was a constant discussion point. The role of MACRA and whether it was, or had the potential to be, used for political control was another topic. Self-censorship by journalists, editors and media outlets was said to be commonplace. Malawi’s history over the last few years has demonstrated that those debates are still relevant. I welcome the formation of the National Press Club to help promote such debates and to consider how to protect freedom of expression, opinion and reporting while upholding ethics and journalistic standards.
I welcome also the recent engagement of H.E. The President Joyce Banda with media associations, including MISA. Such meetings perhaps recall the spirit of that well-known phrase “I disagree with what you say, but I will defend to the death your right to say it”. I am heartened by the President’s statement that the media has a friend in State House. I hope that such engagement will continue. I know from personal experience that I cannot expect the media to agree with what I say. I can become frustrated sometimes with the coverage and opinion. But that is democracy. Engagement is more likely to help get one’s message across than non-engagement and I know that reporters value not just the quote but the explanations behind policies and opinions.
This government has already made important strides to reverse Malawi’s recent decline in international freedom of the press rankings. The government’s resolve to lift the so-called “bad laws”, particularly Section 46 of the Penal Code, has rightly been applauded internationally.
Could the Government go further? Perhaps. I encourage the Government to consider the proposals that MISA has made to update Malawi’s laws in order to remove or modernise a legal framework that some would say runs counter to principles of media freedom. I welcome too the Minister of Information’s commitment to taking forward the Access to Information Bill. It would be a fitting tribute to Anthony Livuza if the Bill was passed. Malawi will have to consider what is workable and affordable. Journalists and campaigners cannot expect every Government document to appear on a website. The point of the Access to Information Bill is to support a dynamic society, which has the promotion of information and accountability as a key enabler for development. It should be part of a broader strategy to push information out to the people as a means to grow the nation, embracing the principles of Open Government.
Malawi Broadcasting Corporation
There is a wonderful opportunity also to change the perception of bias on political and social affairs of the Malawi Broadcasting Corporation. Too many successive governments have restricted and frustrated the capable journalists, editors and producers at MBC from delivering balanced coverage and debate. The underlying and sometimes overt threat of dismissal for an employee — whether from MBC or any other media outlet — through political pressure from any side surely has no place in today’s Malawi. Intimidation and threats are wrong and we will make our views known if we suspect it.
I therefore welcome the government’s engagement with MISA on public broadcasting reform and the commitment to uphold MBC’s independence. The lead up to next year’s tripartite elections offers an opportunity to prove that Malawi and MBC has embraced that principle.
Media Responsibility and Challenges
Of course, there has to be a balance. The media itself, if it is to retain its credibility (and avoid expensive civil lawsuits), has an interest in promoting and enforcing ethics and high journalistic standards. It is in the media’s interest to show that self-regulation is effective; that quality control is a key principle of any media organisation; that the upkeep of journalistic standards and ethics are a central philosophy of the organisation; and that those standards are rigorously promoted and upheld. It means working against corruption within the media, delivering on-going professional training to journalists and, for editors and sub-editors, maintaining standards and leadership that journalists can aspire to. It also means taking time to better understand and develop expertise in an issue, for example around economics or business contract law, if ill-informed reporting is not to damage the country’s development or reputation. Perhaps the National Press Club has a role here too, ensuring peer support and pressure to uphold Codes of Standards and Ethics and inviting speakers to deliver tutorials on complex issues.
I recognise the challenges to achieving all of that. The Malawi media’s commercial base is fragile and prone to loss of revenue arising from disputes with the government of the day. Social media should be a key component of any media outlet’s strategy, yet it also challenges the traditional media to adapt if it is to survive. Journalism is a profession, yet too many journalists do not see their profession as a career able to support their families. The pressure to deliver the story quickly is huge.
International partners like the UK can support training, capacity building, sponsor radio programmes and place advertising in media outlets. We can defend the media when it is under pressure. We can make ourselves available to the media. I do not think we could or should directly subsidise media outlets. Far better that we help create the economic and knowledge environment that can engender and sustain a growing media sector. But perhaps we could do more to provide private sector development advice to the media, just as we do in other sectors for Malawi’s development.
Conclusion
Society should be in no doubt that without a vibrant media, there will not be a vibrant country. Malawi needs the media to flourish. It is integral to democracy, development and justice. Just ask Ms Chigolo what she thinks of The Daily Times and Gabriel Kamlomo after they highlighted her story, leading to her freedom from prison. Just ask the Malawi people whether they value The Nation highlighting potential fraud and corruption, or querying procurement decisions and processes around irrigation and other development contracts. Ask the rural people how they value MBC, Zodiac, Joy or community radios for raising the issues they care about, alongside Capital Radio and FM101’s more urban based coverage.
10 years ago, one of my roles here was press spokesperson for the British government in Malawi. I also helped deliver some support to the media. I am glad to be able to say that in my opinion standards have improved, particularly in business and investigative journalism. The media sector is still fragile, and I sense that the media needs to deliver more relevant content in a more dynamic and exciting way to an increasingly young and worldly wise population. But with MISA, the National Press Club and other organisations, and hopefully with government support, the media has the ability to develop and to continue its leading role as defender and promoter of the nation’s interests.
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