Wouldn’t it be great if there wasn’t the need to support vulnerable communities in the way we do? If we could walk away from projects knowing they stand on their own feet, and will continue to do so? That’s one of our core drivers – building sustainable communities with opportunities for each to thrive. We want, perhaps counter-intuitively, to get to a point where we’re not needed.
Our work at St Andrew’s Hospital in Mtunthama is a fascinating example of this. We’ve supported them from the outset – they were fundamental in the establishment of Medic Malawi 25 years ago. From a small, overwhelmed clinic with limited capacity and breadth of expertise, we’ve been with them as they’ve grown to a regional medical centre with a range of clinics employing multiple healthcare professionals, providing planned and emergency care.
To begin with we gave regular financial contributions to build infrastructure, cover salaries, and purchase core equipment and supplies. This gave stability and the opportunity to expand, to provide an improving service to their region. But long-term this is not a sustainable model, a facility relying on hand-outs to cover month-by-month expenses.
Over time, we’ve worked with them to improve the business model, improving their IT and finance systems, and mentoring their management. Over the last few years, regular financial reviews have demonstrated their reducing reliance on donations to cover core costs, and their move to a position of self-support.
The hospital is now in a strong position and entirely capable of sustaining its core activities under its own governance and finance. They have achieved this through implementing efficient systems of governance and effectively managing their income generating activities. In 2025 they generated a surplus of £11,000 out of their turnover of £277,000, around 4%. This is a significant turn around from their reliance on donations and borrowing.
Does this mean our work here is done; that we walk away? Not at all. It means that we have helped them get to a position where they cover their core costs independently, and can now consider development proposals or emergency relief. Our new way of working with St Andrew’s includes developing protocols for partnering on upcoming projects, and seed-funding activities that have a clear plan and income generating potential. Focussing on sustainability, we hope to facilitate projects that will increase capacity and range of services while opening up new sources of income to keep them on track and proudly independent.
Over 25 years there’s been hurdles and tough times, but there’s been growth at the hospital and maturity in our relationship. We’re moving from giving hand-outs to opening doors. And we’ve only been able to put the time in to achieve that thanks to our supporters. Thank You!