Saturday, August 14, 2010

Women struggling to claim back safe motherhood

BY FRAZER POTANI a correspondent

Imagine you are not a celebrity but find yourself on national television!

This happened to Kawale resident Judith Shaba in Lilongwe City.

Shaba was some weeks ago beamed on Malawi Television (TVM) complaining that her baby died allegedly due to a health worker’s negligence at Kawale Health Centre during labour.

Even Judith’s husband, Bester, was seen on same TVM threatening to take legal action against the alleged health worker involved.

One may understand the couple’s anger and shock if he/she goes to Kawale Health Centre.

The same health centre where their baby died has visible writings on its walls encouraging more interaction between a mother and her baby through breast feeding.

The health centre therefore, is the last place to let pregnant woman lose her baby to advance its campaign of strengthening bonds between mothers and babies.

A random interview with residents seeking treatment from Kawale Health Centre revealed they get ill-treated by health workers.

A Kawale resident on condition of anonymity said he went to Kawale Health Centre to seek treatment after an attack by thugs on his way back from work late September hence lost money, mobile phone and vital portable materials and reported the matter to the police.

“But I returned without getting treatment instead went to a private clinic because the way a health worker talked to me it was as if the thugs attacked me out of my own wish,” he said adding that since then he does not go to seek treatment from the health centre.

Another Kawale resident also former nurse now a successful business woman running a restaurant and a tailoring shop in Lilongwe also said went to Kawale Health Centre with a relative.

“She was attacked by cerebral malaria but we left without her getting treatment because I was shocked by what one health worker did,” she said.

The former nurse disclosed that she witnessed a health worker at Kawale collecting health passports from patients who were standing on a queue to assist them.

“But after one patient on queue complained that health workers were slow while she was in pain, the health worker got angry, shouted at them and threw the health passports at the crowd,” she said adding that the crowd had to scramble for their passports in the process.

“My sick relative’s health passport was torn into pieces in the process,” she said adding that she no longer also goes to Kawale Health Centre for treatment.
“But as a former health worker I think the starting point to solve the problem is for government to construct more health centres in Lilongwe City and deploy adequate staff, drugs and equipment,” she said.
She disclosed that Kawale Health Centre is overwhelmed by many patients requiring treatment because they flock from Areas 22, 23, 24, Chilinde, Kaliyeka, Mchesi and many more townships.

“How do you expect a health centre to provide adequate, quality health service to the needy including treat patients with compassion when its staff is overwhelmed by many clients against inadequate staff, drugs and equipment?” she queried.

Unless health workers in public health institutions countrywide are however, friendly to pregnant women, government’s campaign to discourage deliveries elsewhere will not yield results.

Hawa Muhammadi, 42, a mother of nine from Chowe Area in Mangochi for example said she was ill-treated by a female nurse in a public hospital.

“During my fifth pregnancy a female nurse talked to me abusively before slapping me on the face for failing to follow her instructions due to severe pain,” she said.

Hawa disclosed her experience when, in a snap survey in Mangochi, the Blantyre based Centre for Reproductive Health Department (CRHD) took journalists on a media tour to that district.

Principal Secretary (PS) for Health Chris Kang’ombe said one problem contributing to some health workers’ bad attitude towards patients in public hospitals was pressure of work due to staff shortage.

He said government has laid strategies to recruit more health workers and will do everything to improve mothers’ and babies’ health.

Kang’ombe welcomed bad attitude health workers’ exposure however, also called journalists to motivate health workers doing their job professionally by highlighting them in the media.

White Ribbon Alliance for Safe Motherhood (WRASM) – Malawi Chairperson Darlington Harawa disclosed that Malawi’s maternal statistics were gloomy.

“Maternal Mortality is at 807 per 100,000 live births. In simple mathematics this translates close to 16 women dying every day due to maternal health related complications,” he said.

Vice President Joyce Banda said during labour pregnant women go between thin line between life and death and even experienced it herself.

“I am told I collapsed because I lost blood and it was Dr. Chiphangwi who was called to save my life,” Banda told a crowd during Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) launch in Mchinji.

“I then asked myself the question: What would have happened if there is no doctor?” queried Banda.

The Washington based Population Reference Bureau (PRB) says a mother’s death in poor developing countries like Malawi increases death risk for her under five children by 50 percent.

However, Ministry of Health’s Senior Reproductive Health Officer, Prisca Masepuka said Malawian women can still claim back their safe motherhood joy if everyone in the community including men support pregnant women during and after delivery.

(Ends)

Business Guest

OG Plastics Managing Director: Abdul Wahab Jagot.
Manufacturing and exporting are some of the most important components of the country’s economy. In this edition, WATIPASO MZUNGU JNR talks to the Managing Director of OG Plastic Industries Limited; manufacturers and exporters of plastic products Abdul Wahab Jagot. Excerpts:


Q. Can you give me a brief background of your company?

OG Plastic Industries was established in 2008 with a vision to be the market leader in manufacturing and exportation of polypropylene and polythene bags in Malawi. We want to achieve our vision through the combined use of highly skilled and committed workforce, advanced technology, and efficient customer service.

Q. How big is your workforce?

Currently, we’ve 260 people working in our factory. We envisage that this workforce will greatly increase as we expand production capacity.

Q. How can you describe the plastic industry?
The industry is viable especially when i have enough expirience of market and production also in the wake that we are able to export someof our products to other countries in the region and earn foreign exchange for the country. On our part, we've been in the industry for this short period of time, as compared to others who have been in the industry for over two decades. Our success and achievement has greatly encouraged us and it is our hope that we should attain our vision in the short term.

Q. How is the plastic industry contributing to the economy of this country?

As alluded to earlier, we regard the industry as contributing greatly on foreign exchange savings since agriculturalists don't need to import bags from abroad since they can buy them locally at a cheaper price. In the past when Malawi didn't have an industry such as this, country used to lose a lot of money (forex) when importing bags from the region. By the same token, our exports to Mozambique, Zimbabwe and Zambia help to generate foreign exchange for the country. We're also contributing to the economy of this country through Value Added Tax (VAT). In addition, we feel that we are making a great contribution towards poverty reduction through employment.

Q. What are the challenges?

Our major challenge in the short term is that we cannot expand machine capacity and increase productivity levels due to lack of adequate technical expertise. This will be addressed in the long term by our in-house human resource development initiatives coupled with training outside the country.

The other challenge is that transportation of our raw materials through Beira and Nacala encounters some delays and this poses disruptions to our production. This is why we applaud government for initiating the Nsanje Port.

Since we are relatively new, our third challenge is to create awareness of our existence and our quality products on the market. We are addressing this through aggressive market campaigns and advertising.

Q. Where do you get the raw materials?

Our raw materials come from South Africa, Saudi Arabia, South Korea, India and United States of America.

Q. What are you next plans?

From August 2010, we intend to diversify our range of products to include the production of many household products such as basins, buckets, plates, mugs and jugs. The idea is to provide durable and newly designed plasticware products for the comfort of our custmers in their homes.

Q. Can you sum up?

I would like to thank our customers for buying our products and also i am thankful to my prodction team. I would like to assure our valuable customers of our desire to give them the best plastic products possible. I think we’ve achieved a lot in product quality so that by November 2010, our company will have ISO 9001: 2008 certificate. This means that our products will be recognized at an international level.

Coping with Aids in limited-resource settings

BY WATIPASO MZUNGU JNR

Although HIV and Aids has spared no one, poor people are the most vulnerable.

AIDS has caused households to dissolve as parents die and children are sent to relatives for care and upbringing. The disease also strips families of their assets and income earners, further impoverishing the poor.

In most cases, older people are heavily affected as they're forced to care for their sick children and are often left to look after orphaned grandchildren.

Grandparents left caring for the sick face the burden of providing financial, emotional and psychological support at a time when they would be expecting to receive such support as their energy levels drop with older age.

Further, HIV and Aids contribute to food insecurity as agricultural work is neglected or abandoned due to household illness.

HIV/Aids diminishes agricultural output and it is thought that by 2020, Malawi’s agricultural workforce will be 14% smaller than it would have been without the disease.

“Our fields are idle because there is nobody to cultivate them. We don't have machinery for farming, thus if we are sick, or caring for sick family members, we have no time to spend working in the fields," said a Blantyre-based widow, Ellen Kandikole.

Blantyre District Coordinator for Save the Children Panji Kajani said the most unfortunate response to a death in poorer households is removing the children (especially girls) from school.

“Often school uniforms and fees become unaffordable for such families and the child's labour and income-generating potential are required in the household,” said Kajani.

How Aids affects children

As parents and family members fall sick, children take responsibility to earn an income, produce food, and care for family members. It is harder for these children to access adequate nutrition, basic healthcare, housing and clothing.

In such a situation, children may be forced to abandon their education. Girls may turn to prostitution to earn a living.

How the pandemic impacts on economy

Aids affects the economy by reducing the labour supply through increased mortality and illness. Amongst those who are able to work, productivity is likely to decline as a result of HIV-related illness.

Government income also declines, as tax revenues fall and governments are pressured to increase their spending to deal with the expanding HIV epidemic.

International Committeee for the Development of People (CISP) in-come generating activities (IGA) expert Maclean Mtokota says in such a situation families that are infected and affected can raise their economic base by participating in small and medium enterprises (SMEs).

Mtokota explains that SMEs are an important source of employment, particularly for low-skilled workers, as well as women and young people.

“In such a situation, SMEs become the only sure way for earning an independent among people living with HIV and Aids. In some countries, SMEs have proved to be crucial in local development and income generation to mitigate the impact of HIV and Aids on poor households,” says the IGA expert.

How much should PLWHAs be assisted?

Although antiretroviral drugs have helped thousands of Malawians, hundreds of thousands of people still need the life-prolonging medication. However, the challenge to infected people is lack of financial resources for buying nutritious food on the market.

When he tested HIV positive over six years ago, George Bannet, 43, of Machinjili in Blantyre had no source of money let alone someone who could provide him care.

His wife had died two years earlier with unknown disease. Initially, Bannet, who was too sickly the time his wife passed away, dreaded going for HIV Testing and Counselling (HTC) fearing the prospects of testing HIV positive.

“I thought I'd become the object of taunt if I tested positive. I also feared for my children's future,” Bannet said.

But with assistance from Save the Children, Bannet managed to go for the test. He was immediately put on anti-retroviral drugs (ARVs) because his CD4 had drastically declined to lower levels.

Today, he is enjoying good health and optimistic about the future: “I hope to continue working hard and assist fellow PLWHAs. Besides, I’m currently building the future for my children.”

Bannet is lucky because his children have already started receiving educational and psychological support from Save the Children Programme and Malawi Girl Guide Association (Magga).

Project Malawi Country Coordinator Claudio Tonin explains that in the past individualistic approach to the fight against HIV/Aids and its impact has not benefited the people they served.

Tonin says with funding from an Italian leading bank called Itensa San Paolo, Project Malawi devised an inclusive approach in order to arrest the spread of the virus while at the same time lessening the pain among the infected and affected persons.

“Infected people have to be supported in all areas of need. It is not enough to provide them with ARVs when they cannot access nutritious meals. There is need also to help their children who can't access education because of financial resources,” says he.

Thus under Project Malawi the initiative has fused together Save the Children, CISP, Community of Saint Egidio's Dream Program, Malawi Girl Guide Association (Magga) and the Department of Nutrition, HIV and Aids in the Office of the President and Cabinet (OPC) so that people living with the virus can be assisted in all aspects of need.

Tonin explains: “These organisations have different approaches and goals that aim at complementing the other. Working under one umbrella makes the fight against Aids and its impact more complete and successful.”

Tonin says the primary goal of the project was to pilot strategies for strengthening each country’s capacity to scale up comprehensive HIV/Aids programs by providing care and treatment in an effective, affordable way.

Project Malawi believes these difficulties can strongly limit the patient’s adherence to the therapy and, therefore, make it less effective.

Thus in all Dream centres, people living with HIV and Aids can access quality medical and nutritional support at no cost.

“After providing them with nutritious meals, we refer our clients interested in businesses to CISP for training. For children that need school sponsorships, we refer them Save the Children,” he said.

This holistic approach to dealing with HIV and Aids pandemic and its impacts has lessened fears among PLWHAs and, therefore, increased adherence to the drugs.

Thus trauma and hardship that children affected by HIV and AIDS are forced to bear are reduced.

Principal Secretary for Nutrition, HIV and Aids, Dr. Mary Shawa states that the partnership was influential in the reduction of the prevalence rate.

“I don't think we could have realized this success if we worked individually,” said Shawa.

END

Safe motherhood fight is everyone's responsibility

BY WATIPASO MZUNGU JNR

“Imagine a world without useless wastes of money and with a concrete development for all the communities of developing countries. Imagine a world where expatriates earn the same salary of locals, where health services are free to everyone, where funds from donor community and international funding agencies are really destined to the final beneficiaries and they will produce finally some results. We are living in a completely different world”.

These are the words of Dr. Mario Bacchiocchi, executive director of Centre of Health Education and Health Appropriate Technologies (CESTAS), an Italian-Malawian non-governmental organization, which has joined government efforts in the promotion of safe motherhood, fighting drug and alcohol abuse, among other programmes.

Bacchiocchi notes that during his time in Africa, he has noted some NGOs, which have invested a lot of money in projects with less benefit to the lives of the intended beneficiaries. This represents how huge amounts of public resources are being wasted and mismanaged.

While most of the local NGOs are operating in urban areas, their services are desperately needed in the rural areas where a larger population is illiterate. Women of the child-bearing ages need information on life-saving antenatal care.

Women in the villages rarely seek professional help during pregnancy. There are several factors that deter them from doing so.

Often they lack the time to visit health centers. Access to professional healthcare is a nightmare for many people in the rural areas because of lack of health centres in such places.

The situation sometimes forces determined women to spend almost all the day walking to the nearby health centre to seek professional antenatal care services.

In some instances, lack of knowledge on the importance of such services also contributes to women’s failure to seek professional help during pregnancy.

Improvements in local health care play a central role in reducing African child mortality rates and preserving mothers' lives. But making these improvements will require bringing information and training to local communities, mothers, and healthcare providers across the country.

CESTAS boss believes this cannot be the case if the civil society joined government in mobilizing and implementing safe motherhood programmes.

In some countries like Nigeria, through traditional dances and songs, the civil society managed to attract women to their consultation areas, where they deliver messages on the importance of seeking antenatal care services during pregnancy.

In Bacchiocchi’s thinking, men can also meet with healthcare personnel, who could be conducting on-site routine checks, dispense drugs, provide reproductive health and family planning information, and make referrals to health centers as necessary.

Settings such as markets and community centres can also allow for outreach to all community members, including adolescents, mothers and fathers.

“There is a huge necessity to be focused on specific intervention and to be able to have the needed continuity and long-term action without jumping from one program to another just because of available funds or institutional opportunities,” says he.

“I never understand why other organizations are not partnering with government in the fight against maternal and neonatal deaths. I have often approached the donor community on this issue, but rarely do they seem interested to fund projects of such nature,” mourns Bacchiocchi.

With funding from UNICEF, CESTAS has managed to introduce and maintain in-service training courses for midwives and health workers who work at Bwaila and Kamuzu Central Hospitals in Lilongwe and Dowa District Hospital in Dowa.

These courses have helped health workers in improving the delivery of essential maternal and neonatal care to their clients.

“CESTAS attaches greater importance to the training of health personnel for them to provide quality healthcare to the patients,” says Bacchiocchi.

“We ensure there is on-going in-service training for all midwives and health operators at Bwaila, Dowa and KCH through different training curricula, which have been designed by the same target group in collaboration with the Reproductive Health Unit (RHU) and the Lilongwe and Dowa’s District Health Offices (DHOs),” he adds.

And with support from UNICEF CESTAS intends to extend its outreach and training activities to Community Rural Health Centres in selected Zones of Lilongwe District.

The organization will has also signed an agreement with the Nelson Mandela Foundation in South Africa that will see KCH, Bwaila and Dowa hospitals receiving a donation of motorcycle ambulances.

END

Girl, 17, prefers prostitution than school, marriage

BY WATIPASO MZUNGU JNR
She was explicit in her statement. She would rather be a prostitute than somebody’s wife.

At only 17, Mercy Chande, from Ngasale Village in the area of Traditional Authority Nsamala in Balaka is already a “tried and tested” prostitute at the boma.

Some of Mercy’s clients are twice the age of her father, but none has been disappointed with her service, she told me.

“My friend, Mwatitha, introduced me into this trade when I was about 15. It’s risky, but I’ve to do it for money,” said Chande in an exclusive interview just outside Uncle Time Pub at Balaka.

“Sometimes I feel pity for myself. It’s not true that at my age I should be running around with men of my father’s age. But what can I do?” she asked.

Mercy does not harbour any ambition now; she has lost hope in life. Although she would like to do a business of some sort, but doesn’t know where to get money for capital.

“I know there’s Youth Enterprise Development Fund (Yedf), but I don’t qualify for it. I don’t have money for membership fee,” she explained.

Balaka is known to be the home of music, but is fast becoming the home of adolescent prostitutes. Just take a night walk at the boma and you will appreciate how far Malawi is in ridding our streets of night queens.

What is more worrying is the fact that the majority of these commercial sex workers are children of school-going age, but don’t attend school.

It is everybody’s ambition to get a decent employment soon after finishing education.

But school no longer pays dividends, Mercy contended, that she would rather continue with her nocturnal trade. In her confession, lack of employment was one of the driving forces behind her going into prostitution.

With funding from Unicef, Nkhadze Alive Youth Organization (Nayorg) is implementing a number of programmes in Balaka, Ntcheu, Machinga, Mangochi and Zomba whose aim is to help the youths to nurture their inborn talents into a source of employment.

Nayorg executive director Charles Sinetre said Sunday that the problem of unemployment has become so critical in Malawi and is forcing many young people to lose hope for the future.

Sinetre, however, advised the youths to develop a new approach to the problem by nurturing their inborn talents and turn them (talents) into self-employments.

He observed that using their own human resources, young people can manage to create self-employments in their localities.

“We’ve discovered that most of the visions and ambitions that young people harbour in their adolescence do not necessarily end into reality.

“So we’re saying instead of the youths playing football as a sport, why can’t they take it as their career at the same time?” said Sinetre.

“I’m a living witness to this fact; 90 percent of the country’s musicians have not gone for music school, but are able to impress their audience. So we’re saying; these inborn talents that young people have can be the best source of employment if well nurtured,” he added.

Mercy has heard about Nkhadze Alive Youth Organization (Nayorg) and the youth programmes it is implementing in Balaka. But she confessed that she has never thought of approaching the organization for assistance.

She feared that even if she may have a talent, Nayorg would not be interested to help her because she is illiterate.

But Sinetre stated that Mercy was one of the reasons for Nayorg’s existence.

“We exist to help such as her. Prostitution is not the best option; she should feel free to come and receive our assistance in whatever form,” he called.

END