Several Health Care Facilities in Malawi have their water run dry due to massive vandalism of water pumps and this has left most of these operating without running water, Owen Nyaka writes.
WaterAid Malawi is promoting water, sanitation and hygiene (WASH) in Health interventions through delivery of various projects such as the Deliver Life II which is funded by the Scottish Government, GIZ, Wimbledon and Armani Funded projects across selected districts in the country.
The projects aim to improve access to, and use of, sustainable water, sanitation and hygiene (WASH) services in marginalized communities and Health Facilities in the marginalized areas.
The Deliver Life II project is a shift from business as usual because it integrates WASH in health outcomes, especially for mothers and babies, with the aim to ensure a safe and clean delivery environment and reduce the risks of WASH-related illnesses.
However, series in theft of water pumps across the country poses a very big threat to; pregnant women, patients, guardians and health care workers. Unfortunately, Mpamantha HCF in Nkhotakota district is not one of the WaterAid invested health facility through Deliver Life II project.
Mpamantha has been operating without running water for seven months now after its solar pump was stolen. The facility has also registered five cases of cholera with one death.
“With these registered Cholera cases, lack of running water and a single bathroom, I am nervous that hygiene might be compromised and increase the risk of infections,” says a 25 year old Angela Mathias, from Nkhongo 3 village of Senior Chief Malengachanzi in Nkhotakota district.
Angela was one of the admitted pregnant women during the time of this interview at Mpamantha Health Care Facility (HCF). She also added that her guardian sometimes goes to Ndira – dambo wetland to fetch water because demand is high at a nearby borehole.
Mpamantha health facility has a catchment population of 22,082 but the facility also receives people from other catchment areas like lakeshore area, Nkhotakota Game Reserve, Sani and Chia lagoon, and with this extension, it is estimated that the facility serves a population of closer to 40,000 people.
With these statistics, it is pathetic to see that the facility has only one toilet for males and one for females according to Thokozani Tambulasi who is the Senior Medical Assistant and In-charge at Mpamantha, he echoed that they are worried with their situation of water and sanitation because both staff, patients and guardians use this single toilet as communal.
“The facility has a single toilet, no guardian shelter or waiting room and there is only one bath room. So issues of hygiene is worrisome although we are trying to manage to reduce the risks of WASH-related illnesses,” says Tambulasi.
Tambulasi said although government through Nkhotakota district council has employed three (3) women to do menial job of fetching water from a nearby private borehole and fill them into buckets, these buckets of water are not enough to use for mopping the entire facility including its sanitary facilities-toilet and bath, usage for drinking pills by patients, hand washing for both patients and staff; including usage at Maternity ward – the water is not enough to run the daily operations.
Most Health Care Facilities lack safe running water, supplies, and other basic hygiene facilities such as improved toilets and bath shelters. Where toilets are available they are often not designed to suit the needs of a pregnant woman.
Community Midwife Assistant at Mpamantha, Catherine Nyasulu says hospitals without running water and decent hygiene pose a big threat to public health.
Nyasulu says for over seven-months now after the water pump was stolen, the owner of the borehole has now started charging six thousand kwacha (MWK6, 000) for every user per month be it a staff or patient.
And most of the communities are in dire poverty that as such, not all patients can afford to pay. She said this is being seen as one way of reducing number of people accessing the borehole.
As a woman, Nyasulu say she makes sure that she has clean water at her home before coming to work. In her department, the maternity, water is required more than any other part of the facility. Having water at point of care is very important as there are a lot of activities that require water during childbirth.
Women needs water to clean themselves, their clothes and their surroundings. Therefore, lack of water means that women deliver in an unhealthy environment.
Utensils at labour ward also needs to be cleaned and sterilized and the water needs to be changed regularly.
During antenatal, pregnant women are also provided with medicine which they need to take instantly and all these activities requires water.
Mpamantha on average has a daily average of 70 people accessing antenatal services.
“We need to thoroughly wash our hands after serving each client. With no water, we cannot wash our hands. People are not even washing their hands when they enter the hospital due to lack of water.
“We are at great risk as health workers, not forgetting the patients we have to attend to. Instead of patients getting health services from facilities, they are at a risk of acquiring infections. Simply because we have no running water. Water is life. Without it, we are doomed,” says Nyasulu.
She, however says the water which is filled in buckets for the facility usage are not guaranteed to be safe because anyone can contaminate it since everyone goes with their utensils to fetch from it.
Water hiccups have rocked many public HCFs across Malawi and this hiccup is being man made by bandits who have been stealing water pumps which the facilities relied on to pump water and reticulate into main tanks to several pipes of the facilities.
For instance, recently water pumps theft has affected Mfera in Chikwawa, Likangala in Zomba, Chikowa and Makata in Blantyre, Kawinga in Machinga and Nyamithuthu, Tengani, Phokera, Makhanga, Osiyana and Masenjere in Nsanje.
Lilongwe has also not been spared. The affected facilities in the capital are Matapira, Nathenje, Mitundu, Chiunjiza, Katchale and Area 25 HCFs.
Almost 10 facilities in Mangochi district are operating without tapped water due to the same issue of theft. These are just few facilities that have faced vandalism of water pumps theft.
However, an investigation into how the pump was stolen at Mpamantha shows that there is negligence to the sub-contracted security guards.
Facts acquired from different sources, indicates that a guard on duty name withheld did not report for duties on the night of April 24 this year and this is the day where the lone water pump was stolen, making operations difficult.
Investigations also show that another person with the same surname of that of the guard on duty was implicated in a massive theft of new connection of meters of Central Region Water Boards installed in some facilities in Salima. The suspect is a plumber by profession.
Mpamantha Facility In charge Tambulasi said most of the time he starts work early, as such, he discovered one early the morning that the pipe was tampered with and that the pump was stolen. He informed his fellow staff and discovered that the guard on duty was at his home.
“It was us the staff who informed the guard on duty by calling and telling him about this theft at around 6am. He was later taken as suspect and arrested. Later, he was released on bail and that currently is working at the facility but up to now, we do not know the progress of the case since the police did not inform us if the people have been apprehended or not,” says Tambulasi.
The community at Mpamantha through Health Centre Management Committee (HCMC) Chairperson, Dalitso Kamanga and Secretary Zamuzamu Amadi said they are worried with the conduct of security guards saying after the pump was stolen – Nkhotakota DHO provided buckets as a short term relief but last week some of the buckets were also stolen when another guard on duty did not also report for work.
“There is need to replace the guards with new ones. It is strange that thieves always come when guards failed to report for work. We feel the guards are involved in these thefts and if this cannot be rectified, even if a new pump is be replaced, it will not be safe,” said Amadi.
Nkhotakota District Hospital Spokesperson, Garry Chilinga said days after the pump was stolen at Mpamantha facility, thieves also tried to steal at Mwansambo HCF but they were apprehended because the guard and communities were alert.
At Sankhulani HCF in Nsanje district and at Ming’ongo and Nthondo HCFs in Lilongwe there were also cases of attempted theft and the suspects were apprehended. Nsanje District’s Director of Health and Social Service (DHSS) Dr. Gilbert Chapweteka says at Sankhulani facility because the community were sensitized when the thieves came, the community was able to apprehend the suspected Thieves.
“Police, Health Centre Management Committee (HCMCs) and the community leaders were sensitized on the spate of theft so they were alert,” says Dr. Chapweteka.
Principal Health Services Administrator for Lilongwe District Hospital Mrs. Towera Chiona says when someone was caught at Ming’ongo and Nthondo facilities, they thought it was an opportunity to know who are doing this but unfortunately they did not get any information from the Police.
She said although they have replaced the pumps with assistance from Ministry of Health partners and in other facilities being helped by members of parliament for the areas – the problem with most of these facilities is that the pumps are placed far from the facility and there are few guards who only concentrate their efforts at the hospital.
At Nthondo facility in Lilongwe, on 19th September, this year a man named Jawadu Mali of Kalenga village, Traditional Authority Mbela in Balaka district attempted to steal a water pump. Nthondo Facility In charge, MacDonald Champopa said the incident happened around 10 during night.
The thieves failed to break due to a sound of an alarm from the system of the pump and that the guards were alerted after the alarm went off–they rushed looking where the pump is, and they found nobody.
Later, after 30 minutes unknown people entered into the solar pump system, aimed at breaking the alarm and Jawadu Mali was caught by a guard who was in the solar power installed facility.
“The community was not informed immediately for fear of mob justice. The guards kept the thief all night and alerted the community around 5 o’clock early in the morning, the police were called and they came to the scene 30 minutes later and took him to Namitete Police,” says Champopa adding that by the time Jawadu Mali was caught, he claimed he was coming from Chinsapo in Lilongwe, a location which is said to have many hardcore criminals.
Champopa who is working as Medical Assistant says the community has established a group of men, community policing to patrol around the facility and where the pumps are, to assist the guards.
Inside sources say Jawadu Mali was expected to appear in court on 26th October this year, for his attempted theft case which occurred on 19th September this year.
A Malawian in Nkhotakota who only identified himself as Nyengo Yakwana says people actually know who does this but choose to keep silent. He said, culprits if caught should be charged with homicide.
“Seriously innocent people’s lives should not be put to ransom because of few unpatriotic citizens. They should be dealt with once and for all,” he said adding that this matter should be handed over to village chiefs because they usually know people who do bad things in their society.
The costs of most of these water pumps are over MK6 million each and simple calculation of the facilities affected means that above MK200 million has been lost in only few districts of Nsanje, Chikwawa, Blantyre, Zomba, Machinga, Lilongwe, Mangochi and Nkhotakota that has been reported.
National Police Spokesperson Peter Kalaya could not respond the questionnaire on massive theft of water pumps despite several reminders for three weeks now.
At Kawinga and Chikwewo HCFs in Machinga district, Amref has installed water tanks and provided sanitary facilities with funding from WaterAid.
Even though the communities at Kawinga and Chikwewo survived on boiled mangoes during previous hunger situation, the communities have been sacrificing to make individual contributions of donating bag of maize per household and part of the money they have bought a water pump and hired electrician to make wire ring for their facility which has been running without electricity since its construction in 1979.
Amref Project Officer Charles Chirwa applauds the communities for reducing vandalism, stating that at Chikwewo facility for example, the pump was stolen twice, but thanks to community intervention, they hired a full-time guard who works twenty-four hours a day.
“This guard is being paid by the community through the revenues which they collect at the facility. A person is employed to keep the bicycle while they are getting services and in return they collect revenue,” says Chirwa. This is one initiative that the communities are being responsible in taking care of the property at the facility.
Access to WASH in health care facilities is a critical component of an essential health package and achieving universal health coverage in Malawi and water pumps theft is retrogressive which needs mindset change, influencers bringing security and community ownership in order to curb these water pump thefts.
Over 300 health facilities out of the country’s 600 facilities need urgent attention due to poor hygiene, water sanitation and waste management according to WaterAid Malawi Country Director Mercy Masoo.
WaterAid Head of Program, Peter Phiri said on the issue of vandalism under the Deliver Life Project, his organization is approaching it on two or more fronts.
He said on technical side, they are strengthening security through changing of infrastructure designs, a case in point is the housing chamber for submersible solar pumps which they are covering with massive reinforced concrete apart from anchoring the top part of the pump with steel bars.
On community engagement, Phiri, said they are working with community structures including local chiefs to sensitize and mobilize communities on dealing with this malpractice including community policing.
He said the third approach on working with Hospital Administration they are advocating and supporting facility managers in ensuring that they provide sufficient security personnel. He, however say they are still facing challenges on this aspect though, as budgetary limitations is key issue for the Health Facilities.