A Mobile Health Unit Multiplies Ministry

A letter from Barbara Nagy serving in Malawi

May 2016

Dear friends,

It is a Monday in late May, and the outpatient department at Nkhoma Hospital is dotted with colorful blobs vaguely reminiscent of duffelpuds, imaginary creatures from The Chronicles of Narnia, with their shoe-clad pseudopods protruding. It is cold, the outpatient department is overflowing, and people are scattered on the warm cement covered with zitenji (local cloth) waiting their turn to be seen. I serve as a physician at Nkhoma Hospital at the invitation of Church of Central Africa Presbyterian/Nkhoma Synod. Malaria season melds into pneumonia/asthma season without a break, due to our unseasonably late rains and prolonged mosquito-breeding period. We were the only health facility in our referral area not to have run out of basic medicines and supplies over the past six months, partly due to your faithfulness and support, and also due to the fanatical devotion of our deputy medical director and pharmacy to track every kwacha (Malawi currency) and pill and to tirelessly advocate for supplies. We were down to our last malaria pills and test kits before the government finally released an additional supply last month, and I actually checked my daughter Happy out of school early to rush them back to Nkhoma Hospital from Lilongwe, where people were waiting to be assisted.

Good feeding practices mural in Nkhoma’s Pediatrics Ward

We were blessed that mission teams from Western North Carolina recently brought more oxygen concentrators to replace worn-out machines that had been functioning for years without being switched off due to our high patient loads. These blessings come with a huge workload for the entire hospital as not one patient is ever turned away. Staff worked night and day for months to try to keep patients alive and help them to get well. Our visitors also painted beautiful murals in the children’s ward, emphasizing healthy ways to feed children and the importance of feeding children out of individual bowls so that their dietary intake can be observed. It is easy to overlook poor feeding in a sick or malnourished child when the cultural norm of eating out of a common bowl is practiced. We thank God continually for your support, for our wonderful mission teams, and for the devotion of our hospital staff.

Experiences such as these push us harder to go back to root causes of poverty and disease, to try to stem the flow of sick patients and to help healthy communities grow. Nkhoma Hospital was involved in an indoor residual spraying program in homes and schools this year as it has been for the past six years, with the aim of killing malaria-bearing mosquitos. We were only partially successful due to funding constraints, limited supplies of insecticides, and resistance of the mosquitos to a new insecticide used. As we believe this program has been associated with huge decreases in pediatric admissions for malaria, decreased deaths from malaria, and increased birth weights of newborn babies over the past six years, we are strongly committed to seeing it continue, but the cost for the upcoming year will be over $250,000.00 to cover close to 100,000 people.

Another main effort to attack root causes of poverty is a community development program called ASSET. This program has gotten a good start in our area, and communities have identified that the distance of travel to health services is the first major problem they want to address. The communities know that village health clinics can be established and are already at work burning bricks, carrying sand, and selecting building sites for homes for health workers to live in their communities. These health workers will be able to provide treatment for diarrhea, pneumonia, malaria, and newborn danger signs before children become critically ill. Our goal of providing reliable, high quality health services within five kilometers of every resident of our catchment area has just taken a huge step forward. We will rejoice if the number of children dying within the first few hours of arrival to the hospital can similarly take a huge step backwards, as this program shows its mettle.

We are overjoyed that the hospital’s outreach clinics will now have much needed support in the hard-to-reach areas, as funds have been raised by a group of my supporting churches to buy a mobile health unit. Health workers will use this unit to carry health services out to the most remote areas we serve, doubling the number of sites we can reach. Partnering with the village clinics being established through ASSET, the outreach clinics will increase prenatal services, family planning services, HIV counseling and testing, TB screening, nutrition services, growth monitoring and vaccinations, education and preventive health teaching. Outreach clinics will also provide an opportunity to partner with local congregations working with environmental and gender equality issues, alcoholism, human rights for albinos, and other sensitive cultural issues. I sincerely believe these efforts are the most significant things we can do to support healthy and caring communities in the areas we serve, and I am grateful beyond words for the support provided by the churches and individuals that made possible the purchase of the mobile health unit.

We think daily of the significant challenges of life in Malawi and of trying to work for justice and God’s kingdom in our midst. It is our joy and privilege to be supported and encouraged by you, and to know that God goes before us in all. Please pray for us and continue to support us as you are able.

Barbara Nagy for the Nkhoma community