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The Guardian - UK
The Guardian - UK
World
Charles Pensulo in Lilongwe

‘Bring your own syringe’: Malawi’s medical supplies shortage at crisis point

A midwife listens to an unborn baby's heartbeat at Mauwa Health Centre labour ward, in Chiradzulu, southern Malawi
A midwife listens to an unborn baby's heartbeat at a health centre labour ward in Chiradzulu, southern Malawi. Photograph: Thoko Chikondi/AP

Health workers in Malawi claim the government is “ignoring” acute shortages of drugs and equipment that are crippling the country’s hospitals.

Patients have been asked to bring in their own syringes while the theatre and labour ward at the main Bwaila maternity hospital in the capital, Lilongwe – has faced temporary closures because “we don’t have equipment/supplies to work with”, according to a notice pasted to a wall. Regular power cuts are also impacting.

The government blamed the shortages on disruption by the pandemic and a shortage of foreign currency, but has more than halved the drug budget since 2019. In May, health ministry officials admitted they would struggle to source essential drugs as there wasn’t enough money.

One worker at Lilongwe’s Kamuzu central hospital, said the government was downplaying a “very big issue”.

“Gloves, syringes, giving sets [used to administer fluids], cotton, gauze and other essential supplies are in very short supply. Patients are being told to buy syringes when they go to the health centres. We continue to receive patients from health centres simply because they don’t have some essential supplies,” they said.

At a health centre in Mulanje, about 230 miles from the capital, women arriving for family planning implants were being sent buy syringes.

The Guardian reported last year how nearly half of Malawi’s district hospitals had closed their theatres because of a lack of anaesthetics.

The Association of Malawian Midwives and the National Organisation of Nurses accused the government of ignoring a worsening problem and instead “painting a rosy picture”.

“While our nurses and midwives are facing challenges on the ground, we find it very illogical for the authorities at the ministry of health to claim that everything is normal at health facilities,” the unions said in a statement.

“They should put measures in place to ensure that no lives are lost due to lack of supplies, fuel for prolonged blackouts.

“Nurses, midwives and other health professionals are unable to resuscitate patients needing oxygen therapy, put up intravenous infusions that provide a lifeline in acutely sick patients, young and old, due to poor lighting, professionally conduct deliveries in labour wards, suture tears and episiotomies, remove umbilical cords around babies’ necks, do manual removal of placentae, perform vacuum extractions.”

Joel Moyo, president of the Anaesthesia Association of Malawi, said hospitals cannot get drugs or are receiving expired medicines.

“For spinal needles we use on pregnant mothers, we are using local cannulas, which are not recommended. We don’t have some drugs for general surgeries and other supplies like syringes,” Moyo said.

The Ministry of Health blamed the Central Medical Stores Trust (CMST), which buys hospitals’ supplies.

Ministry spokesperson Adrian Chikumbe said: “The central medical stores has got a delegated authority to procure and store the drugs.”

The trust said it cannot buy from suppliers because of a forex shortage. Spokesperson Herbert Chandilanga added: “Each hospital orders drugs from us and we would need details of the drugs that are missing and the hospitals where the drugs are unavailable before commenting.”

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