Projects - Malawi

Malawi Project

The Health Frontiers (HF) project in Malawi is aimed at helping to adress a stark reality: Malawi has the worst maternal mortality of any non-conflict country in the world. We are helping at what the locals still call Bottom Hospital, at the bottom of a hill in the capital city of Lilongwe. Its new name is Bwaila Hospital, part of the Malawi government's Kamuzu Central Hospital complex.

Mothers feeding their babies in the nursery at Bwaila Hospital

At Bwaila, 12,000 babies are delivered per year, an average of 33 per day, but that can run to 60 in a 24 hour period. On a typical weekday in the labor ward, there are two or three midwives on duty, one clinical officer, and maybe one doctor. It is not uncommon for one midwife to be dealing simultaneously with 3 or 4 deliveries. There is one operating theater, so when there are multiple deliveries with complications, the women waiting may lose their babies, or may themselves die.

Our involvement in Malawi started several years ago when two former HF volunteers, Dr. Kristine Torjesen and Dr. Brian Bramson, then working in Malawi, became aware of the desperate needs at Bwaila. Kristine volunteered as much time as she could, and alerted the HF family to some of the most urgent needs. Since their return to the United States, HF has joined a loose association of concerned individuals and organizations in Lilongwe, called the Chitenje Maternity Trust, which has embarked on a concerted effort to reverse the tragedy at Bwaila.

Critical care nursery at Bwaila Hospital

The goals of the Chitenje Trust range from addressing critical shortages in medical supplies all the way to building and staffing a new maternity hospital. HF is supporting these efforts in modest ways that draw on our special strengths.

First, we will continue to identify the most urgent material needs at Bwaila and try to meet them. Our contributions have been used to fix the plumbing in the labor ward, operating theater and nursery, so the sinks and drains can function for hand washing and waste disposal post-delivery. Heaters and humidifiers have been purchased for the newborn unit, where the babies lie in open beds and warmth is essential, especially for the pre-term infants.

Second, we are supporting plans by the Chitenje Trust to increase health care staff in the labor ward through salary support and professional development. This is critically needed, since many Malawian health personnel are attracted away from government jobs by the higher salaries paid in the private sector and in foreign aid organizations. It makes no sense to improve facilities or supplies if no staff are available to care for the mothers and babies. HF has had experience with human resource development in other settings, and is glad to be involved in helping to develop and implement this essential program.

Finally, HF is open to the possibility that there exists an extraordinary midwife or physician, perhaps more than one, from a rich country like our own who might consider volunteering a year or more of his or her life to the work at Bwaila. This could be a profound learning experience, initially supporting both the desperate patients and the overwhelmed staff. It would likely evolve into staff training programs, and could conceivably move toward the volunteer facilitation of a formal professional training effort, akin to what the long-term volunteers have done with the HF project in Laos.

Outside entrance to Bwaila Maternity Ward

Malawi Project

Further Reading and Resources