October 2007
Dear Friends,
The hospital has been passing through what is traditionally the quieter part of the year. Mosquitoes are fewer during the dry season, and the two successive years of good harvests mean there are fewer kids with severe malnutrition. When one is admitted, we are often sure right from the start that the child has either TB or HIV, which vastly simplifies and speeds up the evaluation and treatment, perhaps saving the patient's life.
New housing has enabled the hospital to hire desperately needed nurses and send some of our more experienced staff nurses for diploma nursing courses, so in a few months we will have diploma nurses in charge of all areas of the hospital, as well as the community health program. This is a step forward that will greatly improve care, reduce costs, and provide much better education for the nursing students in their clinical rotations.
Thanks to work teams from several countries, much of our outpatient area has been renovated. This has significantly improved the care we can give our patients, especially children. There has been a gift of computers and a grant approved to provide Internet access to our hospital, so all those emails people send me should have a higher chance of getting through!
Our huge pharmacy, which supports a network of health centers all over central Malawi, will now be computerized instead of being run with paper and pencil, a jumble of files that no one had organized. This will enable us to access current information on a wide variety of patient care problems and allow us to order drugs and communicate about important hospital business without driving into Lilongwe, an hour and about 50 dollars worth of fuel away.
We have also recently heard that a grant written two years ago to build a new maternity ward was mostly approved. Since the hospital entered into a service agreement with the Malawi government about a year ago—to provide all pregnant women in our area with free care—our maternity census has gone up by about 50 percent already, and the new maternity facility is badly needed. We hope and pray that this will be an important step to addressing the maternal mortality in Malawi, which is over 100 times what it is in the United States.
We continue to refine neonatal protocols and disseminate them to other hospitals, and we also teach neonatal resuscitation courses. Both these interventions have been successful in sending more healthy babies home, so we are hoping to duplicate these results in other hospitals.
Many people in Malawi have been working for the last few years to increase the number of children on HIV therapy, as almost none of the hundreds of thousands of children with HIV were getting any treatment. Their efforts have been successful at making a good beginning. We look forward to many more children getting treatment. It is now possible to get a child tested almost from birth, and the outcomes for children with HIV are improving steadily.
We have passed through a very tough year financially, often relying on the help of Presbyterian Women of North Carolina. At the beginning of this year, the hospital was 150,000 dollars in debt, which accrued over the past ten years due to accounting difficulties and the inability of most patients to pay for their care. We were at the crisis point, unable to get any more medications since our suppliers wouldn’t extend any more credit. After huge amounts of work, prayer, tough financial controls, and help from several sources, we are on much firmer footing. We realize that most of our patients will need subsidized care for a long time, but we have a better idea what that care will cost and can act proactively and more economically to provide it. Currently there is less than 60,000 dollars of debt remaining, and much of this is where one hospital department owes another.
The hospital now spends about 600 dollars a day for medications. It would be fantastic if a anyone wanted to give a super Christmas present: a day’s worth of medications. Maybe in honor of that extra special doctor, nurse, or other medical professional in their lives! Malaria admission for a child costs about 12 dollars, 16 dollars if there is a blood transfusion. A routine vaginal delivery costs about 10 dollars; medicine to prevent transmission of HIV to babies of mothers with HIV is about 2 dollars. An outpatient visit costs about 5 dollars including evaluation, laboratory tests, x-rays and medicines. One day of oxygen for a patient runs about 60 dollars, if one depreciates the machines and pays for electricity. These are actual costs, not including staff salaries—not what the patient pays, since care is heavily subsidized in most cases. Thanks so much for thinking about Nkhoma Hospital as you think about how to gift and honor ones you love this Christmas.
My phone lines are again dead, so I once again have great difficulties sending and receiving email. I love getting mail, but please do not send pictures, singing or moving messages, colored print, large attachments, or anything larger than 200 kilobytes. Sometimes people add my email to a group mailing, then my address gets picked up by people who don’t understand my email limitations. Just now I am unable to receive any email because someone somewhere sent me a two megabyte message. I will again have to drive into town (at a cost of around 50 dollars for gas) to delete it before I can receive any more messages. This is a very significant problem. Please let folks know about this!
Happy’s adoption
We are stuck in a terminal holding pattern again. No one has been out to do a new home assessment, and we have missed multiple court dates. Since I have a plane reservation for all of us to be in Kenya in November with Happy's name on her ticket with her new adopted name, it occurs to me that we'd better get some action or we may have trashed a plane ticket. Please keep praying!
As we look at what has happened in the past few years, we are full of gratitude to God who has privileged us to participate in this ministry and with thankfulness to you who continue to think of us, pray for us, and support us in many ways. May the living Christ dwell in your hearts richly!
Barbara
The 2007 Mission Yearbook for Prayer & Study, p. 337 |
