A surprisingly beautiful place, landlocked Malawi remains one of the poorest countries on earth. In spite of all the harsh challenges, the people of Malawi remain peaceful, friendly and helpful.
Malawi’s landlocked position leaves it reliant upon road transportation for imported goods, recent fuel price increases have therefore virtually doubled the cost of living. With a high dependence on agriculture, food shortages become inevitable when the seasonal rains fail.
Why are we in Malawi?
- Malawi is the 7th poorest country in the world.
- Population figures vary but are thought to be around 14 million; of those 750,000 are orphans, a figure increasing by 65,000 a year.
- More than 65% of the population lives below the poverty line.
- Life expectancy in Malawi is still only between 44-51 years.
- 110 babies out of every 1000 die before 5 years of age (i.e. 11%).
- The last decade saw 59% of its Malawi-born doctors practice outside the country.
- There are only 2 physicians for every 100,000 people.
- There are only 59 nurses for every 100,000 people.
- 48% of children in Malawi are chronically malnourished.
- Almost half of the population is under 15 years old and many of these are orphans.
(Sources: Malawi Demographic and Health Survey 2010 Preliminary Report + WHO)
Why a focus on Rural health?
Only 16% live in urban areas, mainly in the cities of Lilongwe, Blantyre and a handful of smaller towns. The remainder live in rural areas where the population density is one of the highest in Africa (six times that of neighbouring Zambia for example).
Only 57% of the rural population have access to safe water in comparison to 90% of the urban population. Access to sanitation is considerably lower with only 15% to 30% of the rural population having access to a latrine. As a result water-related diseases, including cholera and typhoid, are common; a problem exacerbated by the rapid spread of HIV/AIDS.
I walked 7 km to get here today. Look at this queue – this is going to take me hours. There’s not enough medical staff. The government needs to bring us more doctors, nurses and clinical officers to come and work here.”
– Aloysio, 32, patient in Thyolo, Malawi
- The chronic lack of health workers in government clinics partly results from people leaving for ‘greener pastures,’ taking higher-paying jobs in the private sector or overseas.
- Inadequate salaries and poor working conditions, which lead to ‘brain drain,’ attrition, and an inability to attract new health workers.
- About half of the 165 medical doctors working in Malawi are in central hospitals in urban areas.
- There are severe shortages in rural areas, where nurses are also lacking.
- The vacancy rate for nurses in rural areas is approximately 60%.
- Chronic shortages across the spectrum of health staff, has led to the creation of health surveillance assistants (HSAs).
- However, the HSAs only receive 10 weeks of training and are responsible for multiple tasks including: immunisation, dispensing of essential drugs, and, more recently, HIV testing and counselling.
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