Malawi: Sister Beatrice faces the AIDS epidemic
Sister Beatrice Mkandawire is the Senior Registered Nurse at Kamuzu Central Hospital in Malawi. The hospital lacks vital equipment, and working conditions are incredibly difficult. Better training, equipment and higher salaries and committed nurses like Sister Beatrice could do so much more.
Its 831 beds are often expected to cope with more than 1200 patients. Despite being the second largest hospital in Malawi, it has less than two thirds of the nurses needed.
This means overcrowded corridors and wards, people sleeping on the concrete floors, waiting long hours, and overworked nurses like Sister Beatrice struggling to help everyone. In her own words, “a lot of patients are sick and the number of patients we have - it's just too much. The nurse to patient ratio, the gap we have, it's too big.”
The impact of HIV and AIDS on staff at public hospitals like the one where Sister Beatrice works is devastating. In Malawi, almost one million people between the ages of 15 and 49 are living with HIV. Up to 170,000 people need vital Anti-retroviral medicines that can improve and prolong their lives.
The AIDS epidemic has increased the workload for health workers in Malawi, and some health workers leave their jobs because they are scared of exposure to HIV ”“ especially where there are shortages of vital equipment such as gloves.
Beatrice knows clearly what could make her job better and change the lives of more people in Malawi. The hospital lacks vital equipment, and working conditions are incredibly difficult. It is hot and overcrowded, but there are no fans.
And salaries in the public sector are low. “The private sector, NGOs, they're all getting more money” [But] even if you can't give nurses more money, at least you can stimulate them by giving them more training.”
In 2003, the Malawian government recognized that something needed to be done about the shortage of nurses and doctors and they introduced a 'top-up' allowance that did improve salaries for some. This top-up has made some difference but not enough. “A nurse with three or four years' training can be getting less than someone with just a primary education who's doing some small business,” says Dr. Charles Mwansambo, a pediatrician at the hospital.
Sister Beatrice has four children at home. In order to save money for their education and other needs, she doesn't have lunch at work, eating just a small snack to get her through the day. Because of her qualifications she was offered a better paid job outside the public sector, but she refused, deciding to stay in the public hospital to help the many families and children who really need it.
“We're giving all we have to the government, all the knowledge, all the skills we have. Yes, the morale of the nurses is quite low. But in spite of everything, I still love my job,” she adds.
Basic health care is the fundamental right of every person. The number of HIV and AIDS patients at the Kamuzu Central Hospital has more than doubled. There is an urgent need for more doctors and nurses to fight HIV and AIDS. And with better training, equipment and higher salaries, committed nurses like Sister Beatrice could do so much more.
