Addressing maternal mortality…..
The Rose Project had hoped to open the new district maternity hospital (Bwaila) this month but as time progresses I realise that it will be another 6-8 weeks before the equipment is fully installed. The hospital itself looks wonderful and there is excitement in the air at the prospect of improved maternity facilities in the capital city Lilongwe.
This hospital will be run by the District Health Department and will be home to approximately 9,000 annual births. The existing hospital which resembles a shed, was built in 1939 to accommodate 4,000 annual births, There are now 12,000. there is only one obstetrician and three fully qualified midwives.
Some of the women deliver their infants onto stone floors and in some cases unassisted due to the shortage of healthcare workers.
It is important to note, that Malawi has one of the highest maternal mortality rates in the world with 100 maternal deaths per 100,000 births. Much of this is attributed to the acute shortage of healthcare workers, poor working conditions, low pay, the high number of women in poor health due to HIV infection and traditional practises. In the case of the latter, many women like to deliver in the rural areas attended by traditional birth attendants, unfortunately, many of these attendants do not have access to adequate training and are slow to refer women into hospital, when complications arise.
The majority of the meetings on this trip, were related to looking at ways to address this situation.
Caring for the carers
Clinical officers are a cadre of healthcare worker that was established many years ago in Malawi to deal with the shortage of medical doctors. These individuals carry out a four year training programme and in many medical institutions in Malawi they do the work of doctors. This cadre of healthcare worker is indispensable in Malawi but are inadequately supported within the healthcare system.
In Malawi there is one doctor per 100,000 people and 56 nurses per 100,000 people.
The Rose Project in partnership with a number of other organisations including the University of Malawi, Department of Medicine and Realising Rights: The Ethical Globalisation Initiative (New York) is looking at ways of addressing the situation through a number of initiatives.
Additionally, In partnership with the Norwegian and Malawian Nurses Associations, The Rose Project has funded a new healthcare clinic for healthcare workers again in Lilongwe the capital city. Many doctors, clinical officers and nurses are themselves unwell, some have become infected with HIV in the workplace, others are wrestling with the effects of working in appalling conditions with little or no support. This new clinic called the Wellness Centre, will address the needs of these workers in a holistic manner and also their families.
Wellness Centres are in operation in both Lesotho and Swaziland and have proven to be most effective in addressing the attrition rate of healthcare workers from these countries.
This centre will provide support for the staff at the new maternity hospital.
Prevention of Mother to Child Transmission in pregnancy
Finally Lighthouse clinic, a HIV facility which was funded in 2006 by The Rose Project, is doing wonderful work in the area of prevention of HIV Transmission in pregnancy. This clinic which is next door to the new maternity hospital will work closely with the hospital ensuring that all women who are HIV positive are cared for and that their infants and other family members.
In 2008, The Rose Project in partnership with Irish Aid, gave a grant of €880.000 to Lighthouse Clinic. The purpose of this grant is ensure that all expectant mothers attending the rural antenatal clinics, are tested for HIV and where positive, are offered the appropriate treatment. The programme will run over a three year period. So far 600 expectant mothers have been diagnosed with HIV and are receiving treatment.
As you can see from the above we are making progress in the areas of maternal mortality and HIV infection in pregnancy.