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SETTING THE STAGE – Nkhoma Hospital, Malawi, Africa

With a population approaching 17 million, landlocked Malawi in southeast Africa is an island of poverty. One of the world’s most densely populated and least developed countries, its economy is predominately agricultural. Most people live in rural areas, many in abject poverty.

Malawi became an independent nation in 1964. Currently, it receives a modicum of economic assistance from other countries and multi-nation organizations, but decades of rampant, sub-standard living conditions have had dire health consequences. Infant mortality rates are extremely high. Life expectancy is only about 50.

Although economically disadvantaged, Malawians possess a rich culture and pursue age-old traditions such as music and dance. Artistic endeavors abound. Baskets, masks, wood carvings and oil paintings are used in ceremonies and sold to tourists in urban centers.

Known as “The Warm Heart of Africa,” Malawi is approximately 68% Christian and 25% Muslim. English is the official language, but many people in the area surrounding Nkhoma and throughout southern Africa speak Chichewa.

Malawi’s colorful flag reflects its history of perseverance and its hope for a brighter future. The black stripe represents the African people; red honors the blood of martyrs who fought for freedom from colonization; green symbolizes Malawi’s agricultural roots. In 2010, the white sun was added as a symbol of Malawi’s economic progress.

Along with this progress has come better access to education. However, the change is very gradual, gender-based and low by standards of the developed world.

Nkhoma Hospital Catchment Area

Nkhoma Village, Mission Community and Hospital are located 60 kilometers – about 37 miles – south of Malawi’s capital city of Lilongwe and more than 10,000 miles from HNC headquarters in Carlsbad, California. Nkhoma Hospital’s primary catchment area is the surrounding rural community. However, it serves a population of more than 75,000, including patients from around Malawi and the neighboring country of Mozambique.

The facility annually provides 17,000 on-site inpatient visits, 46,000 outpatient visits and 3,000 deliveries. The hospital conducts mobile clinics throughout the expansive catchment area – critical in this region where many people lack private or public transportation options. It does it all with a small but highly dedicated professional staff at the original mission site, where many buildings date back more than one century.

Nkhoma Hospital, which was established in 1915 with one missionary tropical medicine physician, is now a reasonably well-equipped 220-bed facility that has grown in staff and services. Agreements with the Malawi government have made care more affordable and accessible. The facility’s comprehensive website proudly displays a skilled team serving in major departments, from basic clinical, pediatrics and maternity to surgery, lab, X-ray, pharmacy, ophthalmology and more. A special unit is devoted to HIV/AIDS care.

Palliative Care is a Critical Need

According to the Status of Palliative Care [insert link to pdf when it’s on the website] produced by the Malawi Ministry of Health in June 2015, one percent of the population needs palliative care at any given time, primarily due to AIDS and cancer. The goal “is to improve quality of life of both adults and children faced with advanced and incurable disease through relieving pain and reducing suffering.”

Sadly, children comprise a large number of the 170,000 patients requiring palliative care. Nearly 12 of every 100 patients with life-limiting conditions are children. These and other statistics are merely numbers that tell part of the story; the real cost lies in human health and welfare.

Although the Ministry of Health recognizes the need for palliative care, it acknowledges that a major obstacle is the lack of professionals who are experts in the field. Since the turn of this century, the number of patients accessing palliative care from trained providers and volunteers from established sites has steadily risen, but many thousands of people, especially in far outlying areas, are left at the mercy of their disease with family members – including young children – doing their best, sans medication and knowledge, to care for them in what are dismally painful and frightening final days.

Addressing the Challenge

Here in America, the National Hospice and Palliative Care Organization has created Global Partnerships to address this critical healthcare need throughout the world. Among the multi-pronged efforts promulgated are scholarships that train professionals. This effort and others are now being conducted by Hospice of the North Coast, which entered into a Global Partnership with Nkhoma Hospital in January 2016.

For more information on becoming a part of this effort, click here.