Earlier in the week, I saw another young mother sitting on the steps at the Embangweni Mission Hospital, a hundred miles to the south. Although I have no child of my own, I sensed the woman’s despair as she clutched her listless infant close to her breast, his dry, crusty mouth opening and shutting like a baby bird. Despite the deep creases in his tiny brow, he seemed to lack the energy to cry. All I heard was a faint, lingering whimper.

Muchini
BY Toccoa Switzer

The child could have been suffering from malaria or malnutrition, the two leading causes of death here for children under five. But dysentery and other water-borne infections are also prevalent. According to the International Institute for Environment and Development (IIED), over half the population — roughly seven million people — lack access to wash basins and flush toilets. It is a battle Jim and the engineers fight every day.

The hospital administrator at Embangweni, a bubbly woman with a broad smile, led our group on a tour of the 130-bed facility. On the outside, it resembled any other one-story brick complex but third world realities appeared around every corner. An old, mud-splattered pick-up truck sat near the front entrance. Over the back, a detachable cab covered the truck bed. Bright red letters on the side spelled “Ambulance.” In the main courtyard, wet latex gloves dried on a bush outside the operating room, dangling like ornaments on a Christmas tree. Nearby, a frail, elderly woman pumped a well lever. She stood on top of an elevated concrete disk, designed to protect against contamination. Clear, sparkling water gushed from the tap, a contrast to the stagnant, milk-colored liquid found in many hand-dug pits.

Muchini
BY Toccoa Switzer

Evidently, the older woman was a guardian. According to the administrator, guardians were family members or close friends who cared and cooked for patients while they were in the hospital. The administrator led us to the dark doorway of the guardians’ cookhouse. Inside, several women stirred pots over open fires — the aroma of onions and mustard greens spicing the smoky haze. Adjacent to the cookhouse, dozens of multi-colored blankets dotted a large field, the place where many guardians had slept the night before.

Later, we met the Deputy in Charge of Nursing. Like most nurses in Malawi, she wore a traditional fitted uniform, similar to the stiff, starchy ones that nurses in the States wore back in the 1960s. Outside a medical ward, one of my colleagues accidently splattered mud on her hem. “I’m sorry,” he apologized. “I got mud on your dress.” But her concern wasn’t with the mud. She smiled as she politely corrected him. “This is not my dress. This is my uniform.”

Although nursing is one of the most coveted and respected professions in Malawi, it is in the midst of a crisis. Close to two-thirds of the nursing positions throughout the country remain unfilled due to the attraction of higher paying wages offered by non-governmental organizations (NGOs) and wealthy health foundations. In addition, Malawi loses more and more health professionals each year to developed countries such as Great Britain and the United States. The Southern Africa Documentation and Cooperation Center cites that 52% of health administrators, 64% of nurses and 85% of physicians have left the country in recent years.

This trend is especially troublesome for rural hospitals such as the one in Embangweni. It is now clear why the new nursing quarters, which our church funded, was so critical. It houses eight nurses.