Malawi: Greedy Malawi Clinicians Turn Mbingwa Heath Centre Into Prison for Mothers

4 December 2019

Mbingwa Health Centre was purposely constructed to help Malawi achieve Universal Health Coverage (UHC) goal through provision of quality healthcare services in Traditional Authorities (T/As) Kayembe and Chakhaza in Dowa district.

Mbingwa Health Centre being turned into a prison for poor women. - Photo by Watipaso Mzungu, Nyasa Times Lutisiya Banda: I am a traditional birth attendant here because I am the one delivering the women. - Photo by Watipaso Mzungu, Nyasa Times A mother waiting to have her child treated at Mbingwa Under-Five Clinic as the dog takes shelter at the waiting bay. - Photo by Watipaso Mzungu, Nyasa Times I stopped delivering babies at Mbingwa Health Centre because of workers cruelty. - Photo by Watipaso Mzungu, Nyasa Times The health centre management committee meeting in progress

Located some 80 kilometres to the north of Malawi's capital, Lilongwe, the clinic provides outpatient, maternal, neonatal and postnatal care services to the locals that surround the facility.

However, the Nyasa Times investigation on Thursday established that the health workers are slowly turning the maternity wing of the clinic into a prison where underprivileged mothers and their families are facing jungle justice.

By 12 noon of the November 28, 2019, the health workers were detaining seven mothers who were serving custodial sentences for failing to pay a MK5, 000 [approximately US$7] fine for allegedly delivering at the facility, but in the absence of a midwife or nurse.

Mayi Phiri, one of the mothers we found detained at the clinic, said her family is too poor to pay the fine; hence, she settled to serve a custodial sentence in default.

Phiri said poor mothers are being subjected to public humiliation and emotional torture.

"We sleep in that unprotected room and our newborns are exposed to mosquito bites because there are no nets there. And when we try to reason with the 'doctors', they just shout at us. I really wish they could release us so that we can take good care of our newborns at home other than exposing them to malaria in that unprotected room," she complained.

Enet Mwambakulu of Chim'phiza Village in T/A Kayembe said she stopped delivering at the clinic because of the unbecoming behaviour of the health workers.

"I delivered my first child there, but I was never attended to until the child died. I was very traumatised and I will never forget that incident," said Mwambakulu.

One of the guardians, Lusitiya Banda, of Chilim'mimba Village in T/A Kayembe, said the behaviour of midwives at this facility leaves a lot to be desired of a healthcare worker.

Banda said apart from reporting for duties whilst drunk, the midwives are cruel and unkind.

"I have helped a lot of mothers deliver because our doctors are either out drinking at the trading centre or merely interacting with their friends whilst expectant mothers are battling it alone. When you ring/call them, all you get at insults and calling of your names," she explained.

She added: "And when you deliver in their absence, you are fined MK5, 000. We don't know how to handle the situation because it is not by choice that women deliver in their absence. We feel the penalties are unfair and unjustified, yet we don't have anywhere to lodge our complaint."

A fear-laded Banda told Nyasa Times that that her family could soon be penalised for giving the media an interview on misconduct and malpractices by the health workers.

A female health worker, who did not provide her names, confirmed collection of fines from mothers who delivered in their absence.

"We use the money collected to buy small items such as mats and plastic pails for the use at the guardian shelter," she said.

A nurse-midwife Zince Chilenje said the fine is designed to deter women from delivering with the assistance of a midwife.

"It's for a good cause that we charge those fines. We are not after their money, but to encourage them to always seek professional midwife to deliver them," Chilenje.

But Banda dismissed the assertion, saying the money is shared between health workers and members of Health Centre Management Committee formerly known as Health Advisory Committee (HAC).

"The Health Centre Management Committee is our other biggest problem at this clinic. The committee members connive with the health workers into collected unwarranted fines from expectant mothers, which they share for their personal use," she said.

Banda also wondered how such hefty fines could encourage poor mothers to visit the clinic again.

"We are living in the village where access to income is very limited. So, how can such a fine encourage us to come to a hospital where midwives are hardly accessible to deliver pregnant women? Are they not contradicting themselves?" she asked.

Mbingwa Health Centre media assistant, Reuben Banda, feigned ignorance on both issues.

"I didn't also know that we have mothers in detention because they failed to pay fines. Honestly, you would be right to say I am not in control because I am not aware of these issues," said Reuben Banda.

The Malawi Health Equity Network (MHEN) executive director George Jobe asked government to investigate the matter and bring the culprits to book.

Jobe said what is happening at Mbingwa Health Centre has potential to discourage expectant mothers from seeking help from the clinic.

"It's a pity that this is happening at a time when we are discouraging mothers from delivering in the villages. Government must seriously look into this as a matter of urgency. Those found in the wrong must be disciplined," he said.

The Ministry of Health spokesperson Joshua Malango could not immediately comment .

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