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A letter from Barbara Nagy in Malawi

April 2012

This is our first week of 2012 without rain, and we have a sense of tremendous relief—we’ve made it through another malaria season, with the help of God and the prayers and hard work of many people. The entire pediatrics ward staff as well as lab, outpatient department, and many others feel as if we’ve passed through the fiery furnace!  This year our pediatric ward census topped 270 patients per day (in 52 beds).  Over 1,600 children passed through the pediatrics ward in the month of January alone.  The nursing staff in particular was so stretched it was often challenging to get a trained person to the side of every emergency.  We were blessed to have visiting nurses and medical students who were willing to work many extra hours per day doing triage, lab tests, or whatever was needed in disaster style treatment pods and staff from other areas of the hospital helping, as able, to ease the crisis. 

Lunch became a coke guzzled in a few minutes of sitting down. Electricity seemed to go off just at the moment we had a whole new crop of very sick admissions, turning off lights, support equipment and oxygen, and ultimately burning out the hospital’s backup generator.  Political unrest resulted in many hospitals and health centers completely running out of medicines, and therefore many patients arrived after being seriously ill for days and were critical on admission. We counted ourselves extremely fortunate, thanks to support sent from the PC(USA) and other friends, not to have run out of funds to buy medicines and were thus able to provide basic medical services for close to 200,000 people, counting those served by our health centers.  The countrywide lack of fuel meant that many ambulances were unable to run.  A baby from a nearby health center was sent to us by bicycle taxi with a hemoglobin of 2 (normal is over 12).  It took her five hours to get to us, and she died just as the family arrived at the pediatrics ward—one of many uncounted deaths related to poor governance in Malawi. 

Although this sounds like hell on earth, there is much to be grateful for.  The extreme dedication of many hospital staff members, extraordinary support by hospital administration, and support of our overseas partners such as you kept the death rate at about one-fifth of what it is at other hospitals in Malawi and many parts of Africa.  Service Level Agreements, which enable children under 5 to get care subsidized by the Malawi government, have stretched our system to the max, yet prior to their inception many of these children would have been dying out in the villages because of lack of money to pay for their care.  We still have only half the population in our area eligible for subsidized care, which is a situation that needs much prayer and attention. 

We deeply appreciate those who have sponsored a pediatric bed for a year, as they have enabled us to care for some of those without government subsidy.  One new 4-year-old diabetic had to stay in the hospital for weeks so his family could learn to give insulin and care for his condition.  His mother collapsed when she heard the amount of his bill, which had already been reduced by half.  Fortunately there was a visiting doctor who brought a gift that covered the remaining portion, and I have had the pleasure of seeing this little guy return to the pediatrics clinic healthy and robust with well completed blood sugar logs, a feat that is seldom seen in the U.S.

Our most common cause of admission by far remains malaria, and many funds sent from donors go directly to emergency blood transfusions and quinine.  An indoor residual spraying program supported by the PC(USA) went to many of our communities and treated houses for mosquitoes, immediately decreasing malaria cases and deaths where spraying occurred.  A follow-up study after spraying showed that anemia in children was significantly reduced as well, giving those children a better chance at success in school.

Against all odds we have managed to increase services in outreach clinics, which extend basic health care to parts of our hospital’s catchment area that are too far away to get to the hospital.  I believe that we would have had far more admissions and deaths were it not for this. Expanding public health services is a high priority particularly because of unaddressed basic health needs of children in the communities.  I have been offered an opportunity to get a Master's in Public Health, which will support this. 

Major renovations of the pediatrics ward have begun with the support of a group of churches in Holland.  This will increase our number of beds and the capability to care for critically ill children.  Funds for a new generator capable of supplying the increasing power needs of the hospital have been received from Scotland.  Finally, Malawi recently experienced the death of its president, but we are thankful beyond words that the vice president was duly installed without the civil war or unrest that was predicted.  Funds for a new ambulance, approximately $60,000, will be needed to accomplish our goals of getting health care within walking distance of our population, a sort of "health center in a traveling box" concept, so please pray for and consider how you may support this need.

On a personal level, in a few short months there will be a new high school graduate in our family!  Thanks to all who have prayed for us and supported us.

Barbara Nagy for Melia, Anna, Happiness and all of the Nkhoma community

The 2012 Presbyterian Mission Yearbook for Prayer & Study, p. 106

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