Being HIV positive, Msipu looks a bit malnourished but still she has some reason to smile as she is lucky to access high quality HIV services from the district health facility as well as at Lisungwi Community Hospital which is just within her home area.
While there is a clinic that proved HIV services including Anti-Retroviral Treatment within her village, Msipu has to travel to the main hospital to have her regular CD4 count taken as per her treatment plan.
This afternoon Lunch will only be some cooked cassava enjoyed with some fresh tangerines. After accessing her services she will have to wait until later in the afternoon when an ambulance will descend to Lisungwi in another horrible ride.
Despite all this horrible experience, Msipu just like many patients in this southern Malawian district still has some reason to be happy as she has some assurance that she will get quality specialized HIV treatment from the hospital.
Unlike the many patients that tested positive to HIV before 2005 when American Charity Partners in Health started operating in the district patients like Zeferia still have some hope as they are assured of quality HIV treatment services.
However many patients in this remote Malawian district are worried with the poor road network which they say is affecting the effective health delivery systems.
“The quality services we get at the hospital have made many people to start seeking HIV counselling and testing however we are very worried with the long distances we at times have to travel to Neno when in need of specific services, “she said.
Msipu’s fears echoes those of Angella Letizia Projects Manager for Partners in Health in Neno.
Letizia said PIH has been operating in Neno since 2005 and has successfully initiated over 4000 patients on ART with a less than 10 percent death rate.
However Letizia bemoans the bad road net work which she said was affecting the effective management of health systems in Neno.
“While we have managed to successfully put over 4000 patients on anti-retroviral treatment our major concern has been the poor road network which is affecting our operations in the district, “she said.
Sam Njolomole external relations manager for the American charity said the bad roads were a very worrying factor in the implementation of their services.
“Ambulances take long to reach the main hospital and we have cases where patients have died because they did not reach the hospital in time, “he said.
Njolomole said patients coming from long distances have to travel a day before their appointment day to get medication.
Neno is not the only district in Malawi where patients are facing the law deal of travelling long distances to access medical care. Just like Neno, Ntchisi district is one of the districts where patients travel long distances to access quality medical care.
Doreen Nyondo, midwife nurse at Malomo Health Centre in Ntchisi said in an interview many women in Malomo fail to access neonatal services due the long distances they travel to reach the clinic.
She said some of the women at times fail to make it to the health centre and have been reported delivering their children on their way to the clinic.
Nyondo said while the clinic has witnessed a development in the health seeking behaviour of pregnant women from the time the Malawi Health Equity Network started implementing a health service delivery project in the district, patients were still facing the law deal of travelling long distances to a health facility.
“Pregnant women in our catchment area now understand the importance of attending to neonatal clinics however the long distances these women travel to a health establishment makes it difficult for them to access the service, “she said.
Some patients that Journaids interviewed at the Malomo Health Centre said they had travelled from Kamba and Chasolo villages which are some 18 to 21km from the clinic.
“Patients from villages like Kamba and Chasolo depart their homes at around one in the morning and arrive here at four, “said Stella Denis in interview.
Thokozani Mukhuna Senior Medical Assistant at Malomo Health Centre said that noticing that some patients were travelling long distances, he starts working at as early as four in the morning so that they can access the medical services.
“Realizing that some of these patients are travelling long distances and are usually at the clinic at as early as one in the morning I have been starting work at four in the morning so that these people that travel long distances have to be treated in time for their travel back home, “he said.
He said that the challenge with the arrangement was that it never gave him chance to adequately rest and he at times attends to patients while very tired.
“I at times attend to patients very tired, but as a professional and at the same time a human being I feel concerned to see a patient that is seeking my services suffering, “he said.
He said at times he has to attend to 200 to 300 patients in a twelve hour work day.
Mukhuna said that while the staff at the clinic is trying its best to meet the patients demand, the current staffing levels at the health centre would not meet the demands of the population of over 50,000 patients that are within the hospitals catchment area.
However, Mukhuna was optimistic that things will soon change following the access to health service project that the Malawi Health Equity Network (MEHN) are doing in the district.
The MEHN access to health care services has since had some positive impacts as was witnessed by the improvement in the patient doctor relationship.
“When I was just coming in the area the relationship between the community and hospital staff was very bad, such that at certain points I some hospital staff were beaten, but the access to health services project MEHN is implementing has changed the situation, “he said.
Meanwhile, the village health facility advisory committee at Malomo says it is satisfied with the way the services are being offered at the clinic.
However the committee members interviewed said they were very concerned that the health facility does not have adequate medical equipments.
Staliko Kamthuzi, Chairperson of the committee said it was shocking to see that the health facility was lucking simple utilities like mattresses at its wards in the maternity wing.
“The community has for the recent past been having very good working relationships with the staff at the hospital and we are now only worried of the state of the hospital, “he said.
Weak and shaking with the June cold weather, Zeferia Msipu braves the 12km ride in the clouded ambulance to Neno District Hospital. Pressed against other 14 passengers in a car that would feel clouded with eight, She still has to make this painful journey on the bumpy gullied road if she has to keep on living a healthy life.
Being HIV positive, Msipu looks a bit malnourished but still she has some reason to smile as she is lucky to access high quality HIV services from the district health facility as well as at Lisungwi Community Hospital which is just within her home area.
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