Tuesday, July 15, 2008
by Pilirani Semu-Banda
Gladys Mawera's face is contorted with pain -– both she and her newborn baby survived a complicated birth three days ago -- but she has not been able to take the painkillers and antibiotics prescribed to her by the medical personnel at the Chiradzulu District Hospital in southern Malawi. The hospital has been without water for five days.
"I am disgusted with my own smell and that of my baby," says Mawera, who is still wrapped in bloodstained linens as she cradles her child. "There is literally not a drop of water around here," worries Mawera.
Chiradzulu hospital is one of the country's model hospitals. The medical facility was built with around $25 million funding from the European Union and boasts of a modern operating theatre, state-of-the art laboratory where sophisticated blood tests can be carried out, including monitoring the viral load in AIDS patients.
The 350-bed hospital provides some of the best HIV/AIDS treatment and care in Malawi with the help of international medical and humanitarian aid organization, Médécins Sans Frontières. These modern technological services are not easily found in most of Malawi's poor health facilities.
"We get people coming here from different parts of Malawi despite the fact that this is not a referral hospital; they mostly come because of the good HIV/AIDS services that we offer," says Chiradzulu hospital's deputy director Kennedy Kandaya.
But the hospital, which serves a catchment area of 300,000 people, has one intractable problem. Since opening its doors in June 2005, the hospital's water supply has been erratic. Kandaya says the scarcity of water at the hospital is this year reaching record levels with the medical facility going without pipe-borne water for up to a week at a time.
When the water is cut off, patients and medical staff alike are lucky to find so much as a cup of water to drink. Medical personnel at Chiradzulu cannot carry out theatre routines such as scrubbing or sterilising of equipment before and after an operation. The hospital has suspended major theatre operations and is now referring patients who must be operated on to other health facilities.
X-ray services are also suspended because of the water problems. The 17 staff houses located within the hospital compound have had no water supply for over a month.
"Both doctors and nurses here are having to go to work without taking a bath," says Kandaya.
The hospital is in a situation where it is running out of linen because everything has gotten dirty, according to the sister-in-charge of the hospital's labour ward Agnes Mhango.
"It's very sad to see women and children shivering and catching cold right within the hospital because we can't provide them with blankets," worries Mhango. Laundry is being done at another hospital, 60 kilometres away; the hospital is running up unbudgeted costs to transport materials and equipment to and fro.
Stealing out for water under cover of darkness
The hospital is encouraging the presence of guardians for patients – usually a relative who is able to assist -- to help the hospital in fetching water for patients from nearby boreholes meant for communities that live in area surrounding the health facility.
Mhango says in most cases, the guardians have to wait until night falls to use the community boreholes. "The real beneficiaries pay for the maintenance of the boreholes and they're not happy to see strangers drawing water from their facilities. The people from the hospital therefore have to wait until the owners of the boreholes are sleeping to collect water for the patients," says Mhango.
She says this is dangerous as the guardians face the threat of slipping and falling in the dark and of being bitten by snakes and dogs.
Mawera, however, does not have a guardian since her mother is dead. Women in Malawi are traditionally take responsibility to provide water for their families; there is no other woman who can fetch water for her as she recuperates in her smelly hospital bed.
"I am just praying that the water should come back soon so that I and my baby can wash up," says Mawera.
Poor planning at the root of the problem
The local authority blames the erratic water supply on the location of the hospital. The hospital was built at a place that is higher than the water reservoir for the area, according to the Director of Planning and Development for Chiradzulu district, Emmanuel Bulukutu. He admits that the planning department erred when it opted to use a reservoir that was there before the hospital.
"Ideally, we should have constructed a new reservoir to cater for the hospital," says Bulukutu.
He said there is need to upgrade the whole water system in the district to improve the pumping of water from the reservoir. Bulukutu says there is a proposal to construct a new dam on a higher ground which will be used as the hospital's new reservoir to satisfy the water demand. But as funds have not yet been set aside for this project, this is far from an immediate solution.
Meanwhile the EU has promised the construction of a borehole within the hospital premises as a short term solution to the water problems.