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Dr Jane Bates: Acute-on-chronic Emergency

Published 29 Jan 2015

Many people here daily live life on the edge, so it doesn't take much to push it over into an emergency. As Malawi last week experienced its usual annual rainfall during just three days, we found ourselves experiencing a natural disaster. Early signs of the larger disaster came as three people came to our home in Blantyre over a twelve hour period to report that their houses had collapsed the previous night.

A few days later I walked around a township five minutes from our house to get an idea of how people had been affected. Almost every other house in the area had lost at least one wall, most were patched up with plastic nailed into remaining bricks, with bottle tops against the plastic to try to stop it tearing.

Acute-on-chronic emergency

As I guess is often the case during emergencies in marginal environments, the problems being experienced are 'acute on chronic'. As people generously respond to the acute situation, regular services risk being neglected. We may respond and react in a crisis, but why can't we plan to prevent one? Planning building more carefully, using fired bricks and moving away from flood plains would all help to prevent disaster.

Away from the flooding, there are different kinds of disaster. In Malawi's biggest hospital, where I work as a palliative care doctor, oral morphine supplies ran out last week. It's distressing that this is unlikely to get any attention or funding despite the fact that it is an 'emergency' for the many people suffering severe, chronic pain.

Reflecting on some of these questions has made me feel uncomfortable and at times disappointed as I recognise my own hard heart towards those in most need. Over recent days God seems to be teaching me that we are all more prone to responding to crises than carefully planning preventative measures. 


This is an excerpt from Dr Jane Bate's full article at the Christian Medical Fellowship blog. Jane works with the Palliative Care Support Trust, EMMS' partner in providing palliative care in Malawi. PCST are also delivering an emergency response following recent floods in Malawi.