Mpongwe Mission Hospital, Zambia

Our work with the Mpongwe Mission Hospital in Zambia began even before our registration as a charity.  On a Friday afternoon in August 1997, as Ron Prosser was preparing to leave the village, he was approached by the hospital administrator and the local Baptist pastor who announced that Ron was the answer to their prayers and would he find a doctor for the hospital. Despite serving 30,000 people, the hospital had been without a doctor for some time.  So started a chain of events which resulted in the arrival, in December 1998, of two Dutch doctors. In preparation for their departure, HHI is currently helping to fund the seven year training of a young Zambian as a doctor to eventually work in the hospital. We also supply medical equipment and drugs.

(John Phiri, who has been studying at the University of Zambia, reports his studies being disturbed by street riots over study fees; he has now passed his exams)

With the departure of Dr. Wim from Mpongwe Mission Hospital at the end of a long and effective tour of duty, Dr. Marieke is now running the hospital on her own until December 2001, when her own contract expires. She has indicated that she is willing to stay on for another few months while replacement is found, but we cannot expect her to stay for ever, and a job has come up in her home country, so we can expect staffing problems in the short-term.

She writes....

"It was a clear and chilly morning in May. I was seated outside the Mother and Child Health department, warming myself in the sun and watching the Primary Health Care Team loading the vehicle for today’s outreach. Our destination was Intanda, 80 kilometres from Mpongwe Mission Hospital in a far to reach corner of Mpongwe District. Although the place is not within our direct catchment area, we granted the request from the community to conduct outreach activities in their area. The reasons being that they are well organised and always ensure a good turn up of people.

Primary Health Care is part of the health care package Mpongwe Mission Hospital delivers to the people of Mpongwe District. Until July 2000 this was mainly done within the walls of the hospital: mother and child health clinic, family planning clinic, health education on the wards and HIV-counselling. To reach more people and increase the vaccination coverage, these activities should be brought to the community.

Officially, outreach activities are supposed to be funded by the Zambian Government. In the past three years the money was never enough to cover all expenses and after a short period in 1999 further outreach activities were suspended by the hospital. Luckily, my former secondary school in the Netherlands raised a considerable amount of money that enabled us to restart the outreach activities for a period of two years. Since July 2000 the PHC team, consisting of a midwife, the nutritionist, a clinical officer, the environmental health technician and a driver makes weekly visits to one of the five health posts in the area. This had turned out a success.

I had been along with the team two times, but they really wanted me to visit Intanda. Today would be the first visit after four months. Throughout the rainy season the area was not accessible for the vehicle because of flooding.

Just before we arrived at Intanda, a lady emerging from the bush stopped the car. Her grandmother was sick and not able to walk to the health post. I picked my stethoscope and accompanied by Gertrude Chanda, the environmental health technician, followed the woman to a cluster of small huts. Outside, an old woman was lying on a mat in the sun. After greeting her and introducing ourselves, she told me she suffered from abdominal pains for more than a week now. I asked her some questions and after that she was taken to one of the huts where I could examine her. She did not look very sick, but on palpating her abdomen I felt a mass. I could not tell her what this mass was and advised her to come to the hospital for further investigations. The family would discuss this and find ways of raising some money for transport and hospital admission. For now, I could only give her something to relieve the pain.

On reaching Intanda we were warmly welcomed by the community health worker. No people had arrived yet, but they would be coming now they had heard the car, he assured us. 'Our clinic' consisted of a group of huts, which looked abandoned and in need of renovation. The place was used for the Chief when he came on his annual tour.

Before I could start work, the community health worker took me down to the river to have a look. It is the only source of water in the area and the quality is not very good according to recent analysis of a sample that was taken to Lusaka by the environmental health technician. Intanda is really remote and only accessible by dustroads, which deteriorate rapidly in the rainy season. There is no electricity, no school and no clinic. People mostly grow millet, because there is no hammermill nearby to grind maize. A lot of Tonga’s from Southern Province have settled in the area because of good grazing ground for their cattle.

Mrs Mwenda, the nutritionist was preparing for a cooking demonstration. Meanwhile, I accompanied Sister Zaza to one of the patients on the home based care programme. Since the hospital receives funding for the HIV/AIDS care and prevention programme, twelve community based home care volunteers have been trained. They visit the chronically ill patients in their area and are monthly supervised by the hospital.

A young woman was seated outside taking her lunch. She looked wasted and was not able to walk unescorted due to an abscess on her thigh. However, she assured us she was much better compared to two weeks ago. Her family was taking good care of her.

On returning to the health post, Mrs. Mwenda was just through with demonstrating how to make soya fritters. A large group of women and children was listening to a health talk about the prevention and treatment of diarrhoea. After that, everyone queued up for weighing of the children and vaccinations. I took my place in the shade of some trees and started attending to patients. Surprisingly, mostly men sought my opinion about their longstanding problems. And of course, a lot of children with fever, diarrhoea, sore eyes and cough. The only drugs available are chlorquine, paracetamol, aspirin and eye ointment.

A proposal to let the community contribute financially for a medical consultation (just as in the hospital) has not been received enthusiastically. That is understandable, but on the other hand if they want proper treatment for their conditions they have to contribute.

Sister Ruth Ntebeka was winding up her antenatal and family planning clinic and around 17 hours we had seen about 80 people. We could sit down and enjoy a meal of nshima, chicken and kapenta, prepared by some women from the community. We reached home around 19 hours. It had been rewarding and enjoyable day for me."