27th October 2009: Read the diary of founder Mary Donohoe on the opening of the maternity hospital in Bwaila and the successful meetings in subsequent days27th October, 2009
My journey began in Cape Town, where I attended the Royal College of Obstetricians and Gynaecologists one day workshop on Millennium Development Goals 4&5. These goals address infant and maternal mortality respectively. I was somewhat disappointed with the conference, as after each presentation no time was allocated for questions. This was particularly regrettable in relation to the presentation on Malawi, as there was a senior obstetrician presently working in Lilongwe, who could have contributed substantially to the presentation.
I arrived in Lilongwe, with board member Father Enda Mc Donagh who I had met up with in Johannesburg. Fr Mc Donagh has been an advisor to The Rose Project from the beginning and brings a wealth of experience and knowledge, given his time as advisor with Caritas International HIV section.
We began the morning with a visit to the old hospital. For anyone not familiar with this facility, it is difficult to take on board the appalling conditions, with many women lying on the floor and giving birth also on the stone floor. From here we went straight to the new hospital-what a contrast. Then we met with the clinical staff at the Lighthouse clinic which is next door. This HIV and AIDS clinic which was funded by The Rose Project, opened its doors December 1st World AIDS Day 2006. Since its opening, it has placed 8,000 patients on treatment, many of them expectant mothers.
We then headed to the new Wellness Centre, a healthcare facility funded by The Rose Project for healthcare workers, many of whom themselves are sick and need support and treatment. Holistic care will also be available to their families. Wellness Centres are the brainchild of the Swaziland Nurses Association and are now in operation in Zambia, Lesotho, Malawi and Uganda. They have been successful in supporting healthcare workers and in turn reducing the attrition rate from these countries. We met Dorothy Ngoma the Director of the Wellness Centre in Malawi and discussed the plans for the official opening.
We then headed to the rural HIV and AIDS programme in Likuni, this programmes which The Rose Project and CAFOD (sister agency of Trocaire) co-fund is experiencing difficulties due to cuts in funding. Whilst the patients receiving treatment are doing well and Home Based Care is not as much in demand, other critical issues are coming to the foreground, such as child abuse and domestic violence. These are areas which The Rose Project and CAFOD will seek to address in the coming months
In the afternoon, three members of the board arrived and joined me at the Irish Embassy for a reception at 7pm. The Irish ambassador, Mary Robinson and the vice President attended the reception. It was a good opportunity to meet other individuals and organisations working in the area of healthcare in Lilongwe.
Following the reception Mary Robinson joined me and the other board members for dinner.
Opening of the new 146 bed Bewail maternity hospital.
This was a stressful morning, as my computer crashed and I lost part of my speech, however thankfully Julie my daughter managed successfully against a ticking clock, to sort out the problem out. In addition, The Rose Project members had not anticipated was that all traffic would be stopped to allow the President’s car to move freely as the opening was a state occasion with full honours!
This produced complete chaos, with road blockages within miles of the hospital. As a result we had we considerable difficulty in reaching the hospital on time.
Thankfully, Billy our taxi driver put on his hazard lights and overtook all the cars until we were stopped by the police, at the round about before the hospital. Billy assured the police that we were VIP’s attending the opening and we got through. However the car behind had a little more difficulty in persuading the policeman and it was not until Julie produced my speech to him, which began by addressing the Honourable Vice President Joyce Banda ,that he allowed them through!
The event was absolutely wonderful and it was clear great effort had gone into the organisation. There was singing, dancing and theatre all carrying themes with an emphasis on the human rights aspect of maternal mortality. Malawi has one of the highest rates of maternal mortality in the world and this is for the most part due to the lack of healthcare available to women in pregnancy. Shortage of healthcare workers and infrastructure are the principal obstacles.
There were a large number of humanitarian organisations at the event, many interested in building on the work of The Rose Project in Lilongwe-both at a rural and district level.
After a wonderful morning we headed to a restaurant for lunch and entertained Rachel our representative in Lilongwe, who has worked around the clock to get the hospital ready on time for the opening. Dr Ndovie the district Health Officer also joined us.
The Vice President joined Dorothy Ngoma and other members of the Malawian Association of Nurses and Midwives to open the new Rose Project funded Wellness Centre. Dorothy is the Director.
This centre will focus on holistic care for healthcare professionals and their families. Due to the level of illness created by the HIV pandemic, healthcare workers in many African countries suffer from stress. In addition many are themselves unwell and require medical care in a confidential environment. Wellness Centres is an initiative of the Swaziland Nurses Association and are operational in Lesotho Zambia and Uganda where they have been successful in addressing poor healthcare amongst workers. In addition these centres have been successful in addressing the attrition rate. There will be a satellite Wellness Centre at the new maternity hospital.
The medical sub committee of The Rose Project met with the clinical staff of Lighthouse, to examine the results of the first year of the HIV counselling and testing in the rural health centres, this programme has a strong emphasis on Prevention of Mother to Chi8ld HIV Transmission. Possibilities were discussed on how the programme could be further enhanced. With 90,000 people having been tested in the first year of the three year programme and 4,000 referred for treatment, it was agreed that the first year has been a success.
The Lighthouse staff explained that each test carried out is of huge importance whether positive or negative. In a country where HIV prevalence is so high, each person who tests negative is given a pack with all the important information on how to remain negative. Of course those who test positive receive extensive counselling for both themselves and their families.
The Rose Project group headed started out early to visit one of the district health care centres in Lilongwe. Here we saw at first hand the HIV counselling and testing in Rural Areas programme which The Rose Project is funding with Irish Aid. This programme presently runs from 28 centres and is in its second year. We hope to expand to the remaining 13 centre this year. We have provided Lighthouse who is running the programme with extra motor bikes and this will make things easier to organise.
To date 90,000people have been tested, those who have tested negative are counselled on how to remain negative- in a country with had a HIV infection rate of 15% and in some areas higher, this is very important. Additionally this is the first entry into the medical system for many people who are in need to medical care.
For those who test positive a counselling treatment and care programme is commenced. 4,000 have tested positive many of whom are young expectant mothers. If these mothers are placed on treatment at 26 weeks firstly they will be cared for, in addition the chance of transmitting the virus to their infant is almost eliminated.
I had a meeting with Dr Address Malatta, Principal of Nursing at the University of Malawi, about the plans for The Rose Project and Haukeland University Hospital to fund the training of additional midwives through the University. This programme will start in December 2010 and when the training is complete these midwives will work at the new maternity hospital for a minimum of two years.
Trip to the rural clinic
This morning, Julie my daughter and Fr Enda accompanied me once again to the rural HIV and Aids programme in Likuni district. Massiye and Margaret the programme co-ordinators introduced us to a support group and we spoke with many of the members. Years ago all these people would have been in very poor health as there were no AIDS drugs available to economically poor people. However with the advent of drugs to Malawi in 2004, the situation has dramatically improved.
The principal issue for the female members was domestic abuse and it was very difficult to hear their individual accounts of this violence. There were also men attending the group with their equally pressing issues.
However there was certain hesitancy among some of the women to speak in front of men for fear of further difficulties. Malawi is remarkable patriarchal, in terms of governance and social organisation.
Some of the women in the group were expecting a child and are on The Rose Project funded prevention of mother to child HIV transmission programme.
This afternoon we visited the Wildlife Sanctuary and saw many beautiful animals that have been injured in some way. The area of captivity is huge and a beautiful sylvan setting. It was coming up to sundown and light in the sanctuary was spectacular.
A fitting end to a successful trip