Dr Arie Glas, Medical Director at Mulanje Mission Hospital, was out of Malawi when travel restrictions came into effect. He’s been leading his team remotely during this pandemic, and here he reflects on their experiences of dealing with coronavirus on the frontline in Malawi.
What does your job typically involve? How is this changing during the pandemic?
I work as the Medical Director of Mulanje Mission Hospital in Malawi. I am a doctor with training in tropical medicine. When I started at MMH, my work was purely clinical: reviewing patients, running wards, improvement projects and performing routine surgery. Lately, more extensive projects such as the installation of a new X-ray machine have been part of my work. Since becoming the medical director about a year ago, overseeing the entire hospital and primary care programmes are now my responsibility also. Due to personal circumstances, I had to be abroad in the Netherlands for a short while, and now travel restrictions during the pandemic mean that I am unable to return to Malawi. Hopefully, we can return soon.
In what ways is your hospital ready for the escalation of COVID-19?
MMH has prepared itself by training staff in the management of patients with suspected or confirmed COVID-19. We also ran a community education campaign to ensure folks understand the basics of viral transmission and prevention. We ran an appeal, still ongoing, which enabled us to upgrade our critical care facilities with four new oxygen concentrators and provision of essential drugs and materials in case we see a surge of very sick patients. Traffic at the hospital is being managed by reducing entrance to one gate only, screening everyone who wishes to enter, and treating those with COVID-like symptoms separately, and allowing a small number of visitors only.
How is COVID-19 impacting your region?
The economic impact of COVID-19 is significant and is especially visible in the high cost of maize. Food prices were already a challenge due to a relatively small harvest, but the increased cost of travel and imports has made the situation worse. Many non-governmental organizations have retracted their staff from Malawi, leaving processes and projects unfinished or stalled. The central hospitals are less inclined to accept referral cases. The price of drugs and medical supplies has increased, though MMH bought a large consignment early March, which mitigated this partly.
What are the most urgent needs in your local communities?
Communities need reliable information about COVID-19 and should be enabled to access good quality, safe healthcare. We do not wish to see barriers to accessing any healthcare, with or without COVID-19. They also deserve a realistic and sensible governmental response, seeking to end rural poverty and investing in education as we recover from this pandemic.
What are you doing to help the most vulnerable?
We have provided infection prevention supplies to those incarcerated at Mulanje Prison. We have communicated through village leaders that essential care is always available at MMH and that it is safe to come and access it. We have made certain essential drugs are present and are investing in strengthening food security through our sustainable livelihoods programme.
What immediate challenges do you and the team face?
There are fears among the staff of becoming infected with COVID-19, though these are being mitigated with appropriate training. We face the challenge of working from a distance so that we are not as efficient as some other times. Many of our activities still depend on external funding, which means we deal with uncertainty as this funding may reduce.
What has encouraged you during these long, hard days?
The way that MMH staff and management have taken responsibility during this time of uncertainty. Some have stepped up to take the lead in preparing the hospital and keeping the routine care going – which is difficult enough already!
What do you worry about?
A global climate where polarization and political manipulation takes centre stage – instead of working together from differing backgrounds and angles to overcome inequality and poverty.
What keeps you going in the face of a crisis?
I’m encouraged by the courage and dedication of nurses, clinicians, management members and all other staff at MMH, who have come through many crises and take pride in providing quality healthcare and primary care.
I have been encouraged by Philippians 4:4-7, and it has helped stem the unrest we feel by not being where we wish we could be now:
Rejoice in the Lord always. I will say it again: Rejoice! Let your gentleness be evident to all. The Lord is near. Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.
You can support Mulanje Mission Hospital in its response to coronavirus through the emergency appeal.