Dr Arie, please tell us, in a few sentences, about you, your family and what do at Mulanje Mission Hospital (MMH) in Malawi.
I am a junior doctor, originally from the Netherlands, with training in tropical medicine which included two years hospital work in the Netherlands. I came to Mulanje in 2017 with my wife Lisanne, also a doctor at the hospital, and with our two young kids.
I work as a general medical officer, seeing in-patients and out-patients, maternity cases and occasionally I carry out surgery. I share the on-call rota and I am very involved in the day-to-day running of the hospital, including teaching, rostering staff, supervising the care of very sick patients and so on. Apart from that, I am involved in quality improvement projects such as development of protocols and expanding our care to new areas where there is a need.
What attracted you to MMH and what was your first impression of the hospital?
I was attracted to MMH because of its commitment to quality services for a very poor population. I liked the emphasis that MMH puts on prevention, rather than just cure. Moreover, Mulanje is next to a beautiful mountain which also attracted us as we are keen hikers! The hospital is the right size for me - big enough to be challenged and to create new opportunities, but still manageable by a small group of professionals.
What are the main needs and challenges at MMH?
Malawi is a country with big problems, of all which play out on the ground every day. As the population grows rapidly, there is an ever-pressing need for financial resources to sustain our care, as well as to buy medicines, materials and equipment. The hospital has a motivated and skilled workforce, but the need for more training and higher quality teaching programmes to create well-educated professional health workers is a real priority.
One of our challenges is that we sometimes take care of people who live in extreme poverty who may not be able to pay even the modest sum MMH asks from them. There is also constant pressure on resources at the large, central specialist hospitals, making referrals less than straightforward at times. MMH relies on the constant support of dedicated partners to fulfill its mission in our area. This support is vital for capacity building, for buying drugs and equipment and for expansion projects such as building new clinics.
How is Chifundo project and the UK Aid match funding that EMMS secured making a difference?
Chifundo helps us in many areas. It keeps our Palliative Care department skilled and motivated. Through the Chifundo project we support other healthcare centres in setting up palliative care services. UK Aid makes this possible. This funding means that we can support our palliative patients with drugs and help them cover hospital bills. There is support for the training of staff and development of the service we run at MMH. I would say that the UK Aid funded project is a comprehensive and well-thought through programme.
What would be your hope for the future of MMH, Mulanje as a place and for healthcare in Malawi in the future?
I would hope that MMH will continue to be a place where all employees, from ground workers to those in leadership, are proud to work. This means we are always focused on 'doing the right thing'. This translates into providing high quality healthcare to the best of our ability and keeping focused on preventive medicine, because I know that this makes all the difference in the context we work in.
I hope our doctors and clinicians will continue to grow in skills and professionalism. I hope teamwork will be ever more part of our culture, both within the clinical team and beyond. I hope individuals with good ideas will feel heard and will feel the opportunity to develop and try their ideas and feel supported by management.
I hope Mulanje will realise there is a great need to care for our environment, that sustainable land-use practices will get more and more engrained and understood by local farmers. I hope girls and women will get the role in society they deserve. For Malawi's healthcare, my hope lies with auxiliary staff, nurses and clinicians who do the day-to-day duties in all of Malawi’s health facilities. It is my sincere hope that they will get the quality education they need and that, once qualified, they will feel respected and get the opportunity to do what they need for the sick and needy.
For more information on UK Aid, please visit https://www.ukaidmatch.org/ To find out more about Mulanje Mission Hospital, go to http://www.mmh.mw/ To contact EMMS International, based in Edinburgh, Scotland, visit www.emms.org