Chitimbe Hospital is lucky for many reasons; it is on a fairly main road that snakes around the coast of Lake Malawi so there is lots of passing traffic, it has good transport links to towns and cities, the village it sits in has a newly built water pump and there is a large orphanage and school where care and education is bestowed upon as many local children that can be spared from work as possible. Perhaps most importantly it is also on the main tourist route through the country. All in all it is a comparatively affluent and educated part of rural Malawi.
In the lobby of the modern building a large group of adults are sat on concrete benches, laughing and chatting, reminiscing with old friends. It was more like a coffee morning that a hospital waiting room. They must be visiting friends, I decided.
Pushing through the main door, I was greeted by the head nurse, a man young in age but clearly troubled by life. I thanked him for taking the time to meet with me and questioned whether he needed to prioritise the queue outside. I was assured that the doctor was dealing with them.
The large room was whitewashed concrete and simple, a pin board showcasing a few signs was the only decoration, a series of small doors led off to doctors offices, and a corridor led to the two external wards.
‘Today is the Aids clinic’ he informed me. ‘There are many outside that have travelled for 20 miles, walking through the night, just to get treatment’. It was then that it dawned on me, the people waiting outside weren’t here to visit their relatives, they were here for treatment for the biggest epidemic illness on the continent. I marvelled at their upbeat nature at having such a devastating illness, but then wondered if there was almost a blasé attitude towards having this illness.
I was shown into one of the offices. A wooden chair and matching desk, strewn with patient details, and a simple metal lock up box for a medicine cabinet were all that filled the room. The doctor,kindly taking time out from his patients, explained that this was the only clinic for 30 miles and due to a lack of local transport, and money to pay for it even if it existed, it was only a fraction of the people with AIDS in the area that visited the clinic.
‘The poorest people that were at the outer limits of the clinics area cannot afford to have a day or two of work to attend’ he explained ‘but not coming for treatment hurts them more in the long run as the adults die young and leave children no more than 12 as heads of the family and having to provide for their younger siblings. We are trying hard to educate these young people to try and stop this cycle but it is hard if they are working to make money rather than going to school’.
‘They are not the only ones who are struggling for money. The hospital runs off of donations from charities. We often have power cuts and we cannot afford to keep the generators running, we can’t even afford basic medicines.’
He opened the medicine cabinet to show only a handful of drugs inside. Most worryingly there weren’t any pain killers or bandages left as even these basic medical essentials were unattainable here. The dire lack of basic equipment and medicines blew me away, no wonder infections were rife, and small cuts could lead to amputations. How were they meant to care for and treat the huge range of medical needs of the people in rural Malawi without them.
Without thinking, I tipped out the back pocket of the backpack I had with me, several packets of paracetamol and ibuprofen spilled out. I quickly gathered them up and thrust them into the doctor’s hand.
‘Here, your needs are far more than mine’.
A rap on the door announced the arrival of the next patient and so I was guided by the head nurse on to the Maternity ward.
The ward was dark and cool, there were no nurses but one lady sat on the edge of a bed with a small baby in her arms, the next bed occupied by a lady nursing twins. The twins were the smallest babies I had ever seen, they looked so delicate and frail, not yet ready for this world. We struck up a conversation with the two mothers and I discovered that the twins had been born in the middle of the night in the dark as the hospital had run out of fuel for the generator. They were born six weeks early due to complications with the pregnancy and weighed just under 5lbs each.
I was given the privilege of holding Esther, the oldest by 4 minutes. She weighed nothing, I was terrified of breaking her.
After talking with these new mums for a little while I made my way out of the hospital, as much to ensure I was not taking up the staff’s valuable time. I was a wreck, I just could not appreciate how hard it was for the staff to care for so many with so little.
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