From an email dated Feb 2005
“Today all wards are full. In the Paediatric Ward, each bed has two children and others are lying on the floor. In General ward, others too are lying on the floor. There is congestion. Increasing numbers are coming for tooth extraction.
HIV/AIDS. St. Andrews is doing Voluntary Counselling and Testing. ARV drugs are being given to those who have had VCT and are infected. We have applied to Global Strategies for HIV Prevention for free Nevirapine drugs for pregnant mothers to prevent transmitting HIV to new-born babies.
Some other tests carried out in the Laboratory are: Haemoglobin, Malaria Parasites, Stool analysis, Urine analysis.
FOUNDATIONS. We have just started the Semi-detached house. There has been heavy rains that it was difficult to transport building materials to the site. We have submitted the Theatre plan to the Planners.
HOSPITAL ITEMS. The Ultra-Sound Scanner is functioning. Pregnant women etc are being scanned right here at St. Andrews Clinic. We are proud of it. We can see the hospital growing. God bless you people.
MR ST. ANDREWS CLINIC. An epileptic man, 55 years old, was burnt in a fire during a fit in 2001.He comes twice weekly to receive dressings to cover the wound on his heel. To date he has had some 700 dressings and used 2.1 kilometres of bandages. Finally he has agreed to have a skin graft done under local anaesthetic. By day 8 the skin will be cured. The name Mr St.Andrews comes after the usual coming to the Clinic twice weekly.
Mr. St. Andrew’s Clinic is on the left. He and his family are supported by a family at St.Andrew’s Church.
MANUAL VACCUM ASPIRATION. Japaigo(NGO) are going to train our staff on the MVA programme.
Your prayers are bringing the staff together. We preach about love and staff are trying hard to maintain good relationship with one another.Generally, there is peace within the staff members. May the good Lord be honoured.”
The Clinic is full; the guardian shelter has been completely taken over by the NRU and an alternative must be built; the Operating Theatre is an urgent priority; short-term housing for orphans is now a necessity. Whilst we have some funds for capital projects, the original 100 Club, set up to meet basic costs of medicines, consumables and salaries, can now fund only a proportion of those costs (for example growth in patient numbers and services offered requires more than twice the staff of two years ago). If you are not already a member of the “100 Club” and would like to support Medic Malawi in a regular way, do please contact us.
Newsletter: September 2004
St. Andrew’s Hospital, now officially designated a Rural Health Centre, goes from strength to strength. The Outpatients’ Dept. is treating between 40 and 70 patients a day, mainly for malaria, diarrhoea, pneumonia, accidents and an increasing number for meningitis. Admissions are running at 3 to 4 a day, usually with serious conditions of the above ailments, but also with upper respiratory infections. Many young children are admitted with severe anaemia.
A Medical Assistant has been appointed. Not only is he able to diagnose and treat most illnesses, but he is also a Dental Technician; thus we are now able to offer some dental services to patients, which is a great step forward as there were no dental facilities in the Mtunthama area.
The Maternity Unit runs ante-natal clinics twice a week, with 50 to 70 expectant mothers attending each clinic, and deliveries are between 2 and 5 a day, though the current record is 8 babies born during just one night!
The NRU (Nutrition Rehabilitation Unit) is now the only Unit of its kind operating in the whole of the Kasungu District. Much help is coming from UNICEF, Action against Hunger, CHAM, and Norwegian Church Aid. Between them, these organisations are assisting with the provision of maize flour, cooking oil, milk, blankets, mosquito nets and some medical supplies. This of course takes some of the pressure off Medic Malawi and allows us to extend the programme. We now have two Homecraft workers who teach nutrition, hygiene, child care and so on. Once a week there is a “demonstration meal”. Mothers are taught about nutritious foods, their children are given a meal in the NRU, and then they take home with them sufficient food for the child(ren) for one well balanced meal each day for the next week. This not only ensures food for the child, but encourages the mothers to return the following week for the child(ren) to be checked and fed. Twice a week there are under-5 immunisation programmes in the fight against measles, polio and TB.
At the end of July we purchased a second ambulance, and this will allow us to set up Outreach Clinics. These clinics will operate once or twice a month, taking medical care to those living in areas where it would otherwise be unavailable. In addition, we hope to be able to establish effective follow-up programmes for children who have been discharged from the NRU.
The Medical Laboratory is now complete, and basic equipment has been purchased to allow for testing for malaria and bilharzia. As funds allow(!) the level of equipment will be improved enabling a higher level of quick and accurate diagnosis of a wider range of ailments. No longer will patients need to be referred to Kasungu Hospital for testing. This will save time and thus ensure more rapid treatment.
All the water supplied to the Hospital comes from the bore-hole which was sunk last year. The water is pumped to holding tanks from where it flows by gravity to the Hospital. This ensures a guaranteed supply of pure water, no matter what happens to the national grid. There have been problems, however, with the provision of a generator, and sadly we have had to take the contractor to court for breach of contract. We await the outcome of the case.
As yet we have not been able to obtain funding to build an Operating Theatre. This is, of course, a big project requiring something in the region of £25,000, as well as the costs of equipment. Currently, though the medical staff have all the skills to carry out surgical procedures they do not have the necessary facilities and so have to refer patients to Kasungu Hospital, which entails a road journey of 30 kilometres. Probably the most common surgical procedure would be Caesarean section, but many other procedures could be undertaken if only we had the facilities.
Education is the key to the future of Malawi. In purely health care terms, 40% of women who die in childbirth would survive if they delivered in Hospital. There is still a dependence upon the Traditional Birth Attendant in the villages, and in cases of haemorrhage, for example, by the time the problem is apparent it is too late to move the patient to Hospital, and so she dies. The family of a woman who was the victim of a stroke refused to allow her to be treated in St. Andrew’s on the grounds that her parents had suffered strokes and so members of the family must be fated to die in that way – the family insisted on taking her back to the village to die without treatment. A little girl bitten by a puff adder was taken to the witch doctor. Only after 12 days, when it was apparent that the witch doctor’s treatment was ineffectual, was the girl brought to St. Andrew’s. By that time the snake-bite had become infected, her foot was gangrenous and it was necessary to amputate three toes. Later she was transferred to Lilongwe Central Hospital where the rest of her foot was amputated. At least she survived. These examples emphasise the need to extend the health education programmes, and to take them out into the villages. We already have the work done by the Homecare workers; a demonstration garden to show people how to grow crops more effectively; we are assisting in an irrigation project to permit the growing of more than one crop of maize a year; the beginnings of the Outreach clinics and follow up programmes for the under-5 clinics; we aim to set up over the next twelve months a poultry unit for eggs and meat and a dairy goat unit which will serve both as a source of food and an agricultural training unit, so that people will learn how to make the most of these resources.
A Primary school has been established. The Government Primary School in Mtunthama has up to 100 children in each class (that is NOT a misprint!). The new school has no more than 10 children in each class, though this will of course increase, but the aim is to ensure real care for the children with quality teaching, and so class numbers will be limited. The fees are currently £45 a year. A number of the children are orphans, brought up by extended family or foster parents in the village and helped by the Mothers’ Union. By raising funds from their sewing/knitting projects , the Mothers’ Union subsidise the costs of bringing up the orphans, thus allowing them to grow up in a family environment. If you would like to sponsor a child at Primary School for £45 a year, please let us know.
The St. Faith’s Kindergarten is thriving, with about 40 children, half of whom are orphans, attending each day. They play, learn songs and rhymes in Chichewa and English, and are fed(!). A recent donation from a lady in Dawlish has bought toys, including a tricycle, paid for tea, milk and sugar for the children, and enabled the helpers to be paid. (They are meant to be paid a nominal sum, but whilst funds were not available they simply worked as volunteers.)
Increasingly people from UK are seeking to spend time at St. Andrew’s. All pay their own fares and living costs. One girl worked for three months in the NRU and Secondary School; a group of 11 young people went for a fortnight in July, working in the Hospital, the Secondary School and the Kindergarten, and during their time built a store for maize so that we have supplies ready for the onset of the inevitable food shortage later in the year. A Maths teacher has just returned from a month’s teaching. Another small group, including a trainee paediatric nurse, is there for about five weeks working in the Hospital, the school and the NRU.
What began as a relatively small project with about 10 staff in August 2001 is now a thriving Hospital unit with a staff of over 40, a programme for the care of orphans within the community, Primary and Secondary Schools and a Kindergarten. Costs increase, further expansion and development are essential to serve the community, but with your continued help Medic Malawi can go forward to meet those needs.
Thank you for your support.
New Projects
1. Medical Laboratory
The Maternity unit, constructed last year with the help of DFID, and which provides ante- and post-natal care as well as delivery facilities, is currently being connected to the existing buildings by a brick-built corridor. Incorporated into the construction work is the Laboratory area. This will give much improvement to the levels of early diagnosis, especially in cases of Malaria, Bilharzia, HIV and other STD’s. Building is well under way and will be completed in the very near future.
Equipping the Laboratory will be a major task, but we have already been promised a Microscope by the Rag Committee of University College London. Other essential equipment includes:
Blood bank; Glucometer; Centrifuge machine; Haemoglobinometer; Science lab clock; Bunsen burners; ind-lab thermometer; various kinds of pipette; test tubes; autoclave test-tube racks; Rotater; various types of test kits; blood bags.
2. Visits
Increasingly people are seeking to spend some time at St. Andrew’s. All pay their own fares and living costs. One girl has just travelled to Mtunthama to work for three months in the school and clinic; a group of 11 young people will be going for a fortnight in July, using their skills in the fields of teaching, general administration and ICT, and building maintenance work; a Maths teacher will be there for about a month in late July/August, and yet another group, including a trainee paediatric nurse, will be visiting for five or six weeks in August/September.
3. Operating Theatre
Application has been made to a large company working in the Mtunthama region, many of whose employees use the St. Andrew’s facilities, for assistance in the building of an Operating Theatre. The company has so far made encouraging noises, and we await what we hope will be confirmation that work can begin on this important development.
4. Letter from Malawi
We have received a letter from Peter Minjale, Clinical Officer at St. Andrew’s Clinic. Peter’s fiancée, Jacqueline Mose, is a nurse at St. Andrew’s Clinic. They hope to be married this year. Click here to read the letter.
Newsletter: September 2003
Recent developments have been particularly exciting. During July and August two groups, each of about twelve Medic Malawi supporters, visited the Clinic to see for themselves just what has been achieved. The first group were able to attend the official hand-over of the new units donated by the Department for International Development. This ceremony took place on 10 July, when the British High Commissioner for Malawi, Mr. Norman Ling, handed over the keys to the new buildings. The units have since been modified to provide a superb Maternity Unit incorporating ante-natal care, Health Education, post-natal ward and a magnificent Delivery Room which can cater for up to three deliveries at any one time. This new facility releases space in the original building, so that we now have a laundry/store room equipped with washing machines, and a room specifically for an Ultra-sound scanner donated by the North Devon Hospital Trust. Two days after this ceremony the buildings were consecrated by Rt Rev. Peter Nyanja, Bishop of Lake Malawi.
The bore-hole for the provision of reliable and pure water has been drilled after some problems in locating a suitable site. Eventually permission was obtained from the Senior Chief to drill on land not belonging to the Clinic, and the bore-hole was sunk successfully. By the time this newsletter is published the necessary equipment should be in place, and the water will be supplying all the Clinic’s requirements.
The supply of electricity has always been unreliable, and earlier this year the grid, as well as being frequently intermittent, shut down virtually every evening for several hours. Consequently, and in view of the ever-increasing number of patients being admitted as well as the growing requirements of the Maternity Unit, it was decided to buy and install a diesel generator powerful enough to meet all anticipated demands for electricity for the foreseeable future. The generator will switch on automatically in the event of a power failure.
We have needed an ambulance for some time, not the conventional UK ambulance, but a four-wheel drive vehicle which can negotiate the difficult terrain even during the rainy season. Thanks to the efforts of the Devonport Apollo Choir in Plymouth we now have a suitable 4×4.
New accommodation has been built for the increased number of staff. We are fortunate in having a Peace Corps volunteer who will divide her time between St. Andrew’s and the nearby government clinic, another example of how closely we are able to work with the local health services to enhance the quality of health care in the area. The staffing levels have gone up, and we now have two Clinical Officers and five nurse/midwives as well as ancillary staff and administration.
St. Andrew’s is making an enormous difference to people’s lives; the picture below gives an indication of just how busy the Outpatient Dept. is – and this in the “healthiest” time of the year!
The “100 Club” has still not reached 100 members, but with tax relief the amount contributed by the “100 Club” enables us to pay almost all the balance of salaries remaining after the CHAM (Christian Health Association of Malawi) subsidy.
Finally, our thanks to all who do so much to help this needy area of Africa.
May God bless you all.
Dot and Mac Forsyth
Newsletter: June 2003
It is with great sadness that we have to report the death in March of Emmanuel, the seven year old son of Frank and Eunice Dzantenge whom many of you will know. Apparently Emmanuel was playing with his friends when he jumped into some water on a building site near his school and was drowned. Frank and Eunice have coped remarkably well, strengthened by their faith and by the many messages of support they have received.
There has been great progress at St.Andrew’s Hospital, Mtunthama since our last Newsletter in October 2002. As a result of the grant from DFID the new Maternity Unit is now open and the first babies have been born there.
The Operating Theatre, part of the same grant-funded development is now complete and awaiting equipment. The original Guardian Shelter has been extended in order to provide additional space and facilities the Under-5 nutrition programme which goes from strength to strength. Action Against Hunger visits the programme each week for staff training and also assists with food supplies, and other food donors are the Anglican Dioceses of Lake Malawi and the Norwegian Government through the good offices of CHAM (Christian Health Association of Malawi). Unfortunately Eleanor Bardsley, the English volunteer nurse who has done so much to establish and develop the Under-5 programme will be leaving at the end of June; she will be sorely missed. The bore-hole has been drilled, the holding tanks have been purchased, and we now await the delivery and installation of the pump. The entrance canopy to provide additional protection during the rainy season has been completed.
In the Mtunthama region this year’s crop has been better than last year’s, and so the adult feeding programme ended in April; unfortunately the better harvest is not mirrored throughout the country.
Plans for the future
In order to equip the Operating Theatre and to complete the equipping of the Maternity Unit an application has been made for financial support to USPG in London. If this does not bear fruit then we shall have to seek funding elsewhere.
Up to ten more medical staff will be needed as the new facilities come into full operation, and of course that means we shall have to set about the building of more staff accommodation. Again we are now seeking funding for this.
The electricity supply in Malawi is erratic at best, and with the new units it is essential that we now look to install a diesel generator to provide power during electricity cuts. Costs have not yet been ascertained, but they will be significant!
Thanks to the efforts of the Devonport Apollo Choir in Plymouth, who have supported us through several concerts, we are now in a position to buy a second-hand four-wheel drive vehicle as an ambulance. This will be available at the end of June.
Two groups of supporters will be travelling to Mtunthama in July to see for themselves what has been happening and to work at the Hospital and school.
As ever, we thank you for your continuing support.
May God bless you all.
Dot and Mac Forsyth