Archive for the ‘Bwaila Maternity Hospital’ Category

March 30^th 2011

Currently The Rose Project in partnership with Irish Aid, is funding a three year HIV counselling and testing programme in Lilongwe .  This programme is aimed at bringing counselling and testing to thirty four rural health centres surrounding Lilongwe city. The programme also has a strong focus on prevention of mother to child HIV transmission in pregnancy.

Results recently received from the programme are very promising.

Between September 2008 and Feb 2011:

·         11,605 patients have been referred for anti-retroviral treatment having tested positive at the health centre

·         Of whom  2,941 are pregnant women

·         312,390 people have been tested in total

Part of the programme ensures that those who test negative receive education on life styles-  highlighting the importance of remaining negative. 

This programme is being implemented by our partners at Lighthouse clinic, a clinic funded by The Rose Project in 2006

Lighthouse clinic is a HIV and AIDS outpatient facility which provides healthcare to some of the most economically and socially impoverished people living in the capital city and its surroundings.

Rachel has been working at the hospital for the past three years and was central to setting up the new Rose Project funded Bwaila Maternity Hospital.

I must admit having felt rather apprehensive during the last few days in UK after my yearly Christmas break but I was ready to return to Malawi. I felt strong and enthusiastic, but leaving the comfort and security of family to return to the huge challenges of living and working in one of the poorest countries in the world left me feeling somewhat fearful. So I returned to Bwaila. Having played such a substantial role in the setting up of the new Bwaila Maternity Unit it felt like going home as I walked through the doors of labour ward, that first day after nearly 6 weeks away, to be receive a great welcome from my midwife colleagues.

It had been a difficult December. The unit had been without regular medical cover leaving the midwives and clinical officers (a cadre of healthcare worker specific to Malawi. Clinical Officers undertake a four year training) to take full responsibility for the everyday running of what is probably the busiest maternity unit in Southern Africa.

Despite predictions that the work load at Bwaila Maternity would decrease substantially after the opening of the new tertiary care wing at the Lilongwe central  hospital ( Ethel Mutharika Maternity Wing) this has not proved to be the case and we continue to attend more than 1,000 births a month.

The high-risk mothers are now being transferred to the tertiary hospital. In addition the health centres  are sending their difficult cases directly to EMMW. However, we continue to have extremely sick women and emergencies to attend. I can honestly say that the past 6 weeks have been some of the busiest I have experienced since I arrived in Malawi 3 years ago.

January sees the start of the clinical placements for our midwifery students. This year with an increase in students being trained it also means an increase in the number of students needing close supervision and clinical teaching in the ward situation. We have also had a new set of interns and clinical officer students on the unit all of whom require supervision and teaching.

I decided on my return that I should make my priority during this time the teaching and supervision of students of all cadres. It has been a pleasure to work with the interns, most of whom are highly motivated and enthusiastic learners. They are quick to learn and quickly become essential to the safe medical coverage of the unit.

The student midwives are of varying levels of enthusiasm and competence. They have little input from the college staff due to shortage of tutors which means that their practical skills need to be taught by our own permanent midwifery staff. There is still some reluctance on the part of some of these to undertake this role, given their overstretched work situation.

Others truly do not have the necessary skills to pass on their knowledge to students. I have spent most of my time this past month dedicated to this. I enjoy this part of my work tremendously and find that my own enthusiasm plays a key part in effectively creating  greater  interest and understanding thus leading to better and more adequate care.

As well as teaching, very often I am the most experienced obstetric professional on the unit. This means that my expertise is being constantly sought to aid in difficult and emergency situations.  I was very pleased to welcome a new Nigerian registrar onto the unit. We have already worked together in the past. We refer to each other constantly which gives strength to the medical and midwifery cover. I truly feel that together the possibilities to effectuate change are more than ever present.

The Rose Project has been funding a senior clinical midwife tutor at Bwaila Maternity hospital for the past nine months. Rachel MacLeod has been teaching and mentoring existing staff, in an effort to address the high level of infant and maternal mortality at the hospital. Rachel is also involved in implementing the Prevention of Mother to Child HIV transmission programme which is operating at the hospital.

We are delighted to announce that UNICEF will support The Rose Project financially to continue with this initiative.

Sept 8th Lilongwe 2009

All is progressing well towards the opening of the new hospital with great excitement in the air I t is a real honour for the Rose Project to welcome former President of Ireland and UN High Comminissioner for Human Rights, to officially opening the hospital along with the Vice President of Malawi.  Dr Robinson  President of Realizing rights is championing the issue of maternal mortality

Whilst the building is ready the greatest challenge is the acute shortage of healthcare workers. The Rose Project along with a number of International partners including UNICEF is working to address the situation in particular the shortage of doctors and nurses. With the generous support of UNICEF we have employed a full time very experienced midwife Rachel Macleod, to work alongside her Malawian counterparts. Rachel’s made aim is to assist the senior nursing staff at the hospital, with up schilling of midwives and overseeing the smooth transition from old to  new maternity hospitals.

In addition the Royal college of Obstetricians and Gynaecologists (RCOG UK) is assisting The Rose Project to source medical staff from outside the country as a temporary measure,  with 12,000 annual births at the hospital  and only one full time resident obstetrician, all the assistance possible is needed. The good news is that the Malawian government is funding the College of Medicine to train more doctors however it will be a long time before there is a sufficient number. In addition it will be vital to ensure that the working conditions for these individuals is attractive otherwise when training is complete they will leave the country. There is an additional cadre of healthcare worker in Malawi, which does not exist n Europe. Clinical Officers carry out a four year training programme at the college of Health Sciences and deliver the bulk of medical care. These are very competent, though under acknowledged within the healthcare system. The Rose Project along with a number of national and international organisations  looking at ways to address this situation

Sept 9th 2009

A number of Irish donors including Denis O Brien visited the new hospital. They also visited the HIV clinic which is beside the new hospital. This clinic was funded by the Rose Project in 2006.The focus of care at the clinic is on Prevention of Mother to Child HIV transmission during pregnancy. Since the clinic opened 6,000 people have been placed on AIDS This clinic will work closely with the new maternity hospital in the area of mother to child HIV transmission

Sept 10th 2009

The meeting with the District medical Officer was focused on the need for the District to rise to the challenges the new hospital is presenting. This is very difficult due to the shortage of personnel. In a hugely under resoursed healthcare system, a new hospital is bound to present many difficulties, however Dr Ndovie is one of the most enthusiastic people I have worked with and so we are   fortunate. In the afternoon I visited the ministry of health and spoke with the chief district nursing officer who assured me that midwives finishing their training in both September and December will be joining the existing midwives at the new hospital. A total of 8 midwives will be allocated to the hospital but we need 40. To address the shortage the Rose Project is funding the sponsorship of additional nurses to train in midwifery at the university of Malawi. This programme will commence in December and will bring an additional 16 midwives to the force. Hopefully within the next two years the administration of the hospital will in a position to have a  three shift rota in place, each  shift for 8 hours. Presently there are only enough nurses to work a two shift rota, this leads to total exhaustion among the staff and  inevitable mistakes.

10th September 2009

Today, we organised a Chinese meal for all the senior nursing staff and it went off very well. Due to the staff shortages, we had the meal in the library next to the hospital rather in the Chinese restaurant.  It went very well and it was agreed by all to have been a good team building exercise .

11th Sept 2009

I visited the visited the College of Nursing.

The Rose Project is working with the department of nursing (Kamuzu College of Nursing) at the University of Malawi, on a midwife sponsorship programme.  We will fund extra midwives to be trained and in return the midwives will commit two years to the maternity hospital. This sponsorship programme will commence at the university in December 09 and the first group of midwives will join the staff at the maternity hospital, in December 2010

Sept 12th 2009

This morning I visited the  new Wellness Centre which is complete and the staff are fully installed. This is a new healthcare centre which the Rose Project has funded; it will be operated by The Malawian Association of Nurses and Midwives  with additional funding from the Norwegian Nurses Association. Healthcare workers in Malawi are severely overstretched and require support at many levels. The HIV pandemic has seriously overstretched an already challenged healthcare service. Many of the nurses  and midwives work 16 hour shifts due to the shortage of personnel. In addition many healthcare workers have become infected  through injuries in the work place such as needle stick.

In addition to providing holistic healthcare to the healthcare workers, this centre will also provide care to their families. The concept of a Wellness Centre is the brain child of the Swaziland Nurses Association where it has been in operation for five years and has proven to be most successful. Lesotho and Zambia followed suit and both these countries are experiencing a positive impact on the health force.

Sept 13th 2009

Finally this morning I finalised plans for the opening of the maternity hospital with Rachel our representative in Malawi, and ensured that all the invites had been delivered.

Mary