19 June 2014

Mozambique: Marráre Hospital in Nampula Is Crumbling

While the Mozambican government continues to allocate a large part of the State Budget to the State Intelligence and Security Service (SISE), the Armed Forces (FADM) and the Ministry of National Defense, the Marráre General Hospital (HGM), in Nampula province, one of the oldest health facilities in the capital of the northern region of Mozambique, is in precarious conditions of operation due to gradual infrastructure collapse.

In addition, there insufficient medicine in stock for patients, especially for those who suffer from tuberculosis and HIV/AIDS. Patients and their relatives report that there are always pharmaceutical stock outs and the staff's treatment of patients is poor.

The hospital is located about 15 kilometers from Nampula city. The few working sections and equipment in the hospital are, quite simply, in deplorable condition.

Other distressing aspects are that the hospital has walls with large cracks that extend with each passing day; the paint is old, especially on the exterior; the roof, apart from being in a state of collapse, leaks water and conditions worsen during the rainy season. The window panes are also broken or missing completely.

In addition to these aspects that detract from the functioning of a establishment where patients are received, treated, and provided a state of physical, mental and psychological well-being, there is no morgue.

The departments reserved for consultations are insufficient, there are not enough essential materials to conduct consultations, and the Radiology unit is in precarious conditions of conservation. This is just a short list narrating the lamentable state the hospital is in.

In the past, the Marráre General Hospital was under the management of a religious institution in Nampula, but the local Government allegedly took over because the infrastructure is owned by the State.

At the time, the issue generated confusion among the authorities and the Archbishop in Nampula city, has since demanded the return of the building and healthcare management to the church.

HGM has 112 beds, compared to the required 300. The dirt road that gives access to that hospital is in ruin, which causes the patients transferred from Nampula Central Hospital (HCN) to not arrive in time in an emergency. Over the years, the government has not undertaken any maintenance of the facilities.

Angered by the situation and the inability of local government to provide means for adequate management and operation of HGM, the Nampula archiepiscopal authority painted the building, set up a potable water source, rehabilitated the laundromat and cafeteria, all of which minimized the suffering of patients and the health technicians who work there.

However, rehabilitation from the government is needed urgently. While talking with @Verdade, some admitted patients from this hospital do not hide their dissatisfaction with regard to the problems outlined above.

They also complained of alleged irregularities in the administration of medicines, quality of food and lack of drinking water.

According to the evidence collected at the scene, some patients ask their relatives to bring water from their homes for drinking and personal hygiene. Paula Rafael, Director of HGM, acknowledged the existence of the abovementioned problems and assured us that the government, the Provincial Directorate of Health, Women's Health Services and Social Action in Nampula are aware of the issues, but there are still no actions to resolve the situation.

The HGM Director explained that there is a government plan for the rehabilitation and expansion of the hospital, however, she is unaware of the start date, because people rarely talk about it.

Our interviewee is waiting for the project plans to become more concrete in order to give more dignity to health professionals working in the health unit and to also ensure the well-being of the patients.

Insufficient pediatric, cardiovascular diagnostic devices

The lack of resources not only affects HGM. The Nampula Central Hospital (HCN), the largest in the northern region of Mozambique, has no equipment to diagnosis cardiovascular diseases in children.

Therefore, they use devices intended for adults, which, in addition to making some health problems worse, does not guarantee reliable results. This is according to Health 4 Moz, a private law association that works in the area of development and humanitarian assistance in Mozambique.

Eduardo Silva, cardiologist, pediatrician and member of Health 4 Moz, confirms that the use of an unsuitable medical instrument used during pediatric cardiovascular tests puts the child's life at risk and can contribute to medical errors.

To reverse the scenario, Doctors without Borders have been in Nampula since June 11th training health professionals from various fields on screening and diagnosis procedures for cardiovascular disease.

Agostinho Joaquim, pediatrician of HCN, recognized the inadequacy of resources at the health unit where he works, having noted, also, that there are many difficulties in taking care of patients and health professionals are exposed to various risks while performing their daily activities.

It should be noted that recently Health 4 Moz, in partnership with the Lúrio University (UniLúrio) and the Faculty of Medicine from Porto University (Portugal), provided equipment to HCN and the 25 de Setembro Health Center to screen children for illnesses.

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