PRIMARY HEALTH CARE With reference to Mulanje Mission Hospital, Malawi
PRIMARY HEALTH CARE PHC is an attempt by the World Health Organisation (WHO) to promote basic health care for all, using a low cost, low technology approach, rather than a sophisticated health care for just a few. The aim is to tackle common illnesses, advise on simple preventative care and health education, using trained local people.
MULANJE MISSION HOSPITAL - MMH • The hospital is one of 2 in Mulanje district and was founded in the 1870’s. • It has 192 beds and over 6,700 admissions per year. • They have 3 doctors, 6 junior doctors and 45 nurses. • Their Primary Health Care department runs programmes in 71 villages which covers 66,000 people. • Main intervention areas are environmental health, mother and child health, nutrition and HIV/AIDS
FOOD AND NUTRITION • MMH has a number of schemes operating in this area. • Community garden in Zipangani village. It serves 5 villages and targets the most destitute mainly families and people affected by HIV/AIDS, orphans, female headed households and the elderly. So far the garden has benefited 45 people and has trained 260 people. More funds are needed to buy seeds and tools in order to extend the project to other villages in the area. The home gardening project encourages the use of locally available resources in the area to grow fruit and veg. These initiatives use less labour and therefore more user friendly
FOOD AND NUTRITION • Nutrition Rehabilitation Unit malnourished children and their mothers are admitted for 2 weeks. They receive food supplements but also education on safe water, dietary advice and home gardening etc. They are then monitored for 2 years on leaving the clinic. • People Living With Aids This is a nutritional programme for HIV infected people. In February 2006 over 700 people attended this clinic every fortnight! They receive a check up, a meal and the most malnourished get food supplements to take home. They get 5kg of “Likuni Phala” which is maize flour fortified with Soy. 420 of these 700 get food support.
FOOD AND NUTRITION • Charities like Oxfam have implemented Goat Loan Schemes. • They also work on farming projects to set up seed banks, and soil erosion prevention projects • They will also provide micro loans to help people set up businesses eg. Banana salesman.
HEALTH EDUCATION • Hygiene and health promotion are often taught through song (due to illiteracy and expense of paper and printing).
HEALTH EDUCATION • Information about HIV Aids painted onto wall of one of the classrooms at Mulanje Mission CDSS
HEALTH EDUCATION • Entertainment at local football match. • Singer is singing songs about how to protect yourself against HIV Aids.
HEALTH EDUCATION • Roadside posters are also used to spread the word!
MATERNAL AND CHILD HEALTH and TRADITIONAL MEDICINE • In Malawi they have built ‘Chipatalas’ which are small 2 ‘bed’ huts – cloths on the floor – where women can give birth. A villager is trained to help at the birth. Mobile clinics from MMH weigh the babies and at their clinics breast feeding is promoted • Kangaroo Mother Care at MMH– if the birthweight is under 2500g babies and their mothers are eligible for this. They don’t use incubators but instead they put the babies skin to skin in between the mother’s breasts. The heartbeat reminds the babies to breath. This has significantly reduced the IMR.
DISEASE CONTROL • Mobile immunization clinics from the hospital visit the surrounding villages and immunize against diseases like polio and measles. This has resulted in a reduction in the under 5 mortality rate (although it is still high!)
WATER SUPPLY AND SANITATION • Wateraid is involved in improving both water supply and sanitation. They have built deeper lined wells and pit latrines. They use appropriate and sustainable technology and believe in local participation.
CURATIVE CARE and ESSENTIAL DRUGS • MMH supplies ARV’s (Anti-retro Virals) to all HIV Aids patients. Funding for these comes from the Global Fund. They are now ‘free’ to all who need them in Malawi. • Diarrhoea is easily treated with ORT (Oral rehydration therapy) Pressure being put on Pharmaceutical companies to allow the manufacture of generic drugs in LEDC’s eg India which will make drugs cheaper . • which is an inexpensive mixture of salt, sugar and CLEAN water! • Village healthworkers visiting clinics in the villages around Mulanje can be trained to identify and then treat diseases such as scabies.