Fran's Blog 3rd May

Well as you can see we have all been so busy on this GSE exchange! There is so much to absorb and to remember and I find it so interesting to learn not only about rural health issues in Africa but also about the areas of expertise of the other GSE team members.

In Malawi there is an organization called the Christian Health Association of Malawi (CHAM – like Australia, there are also many acronyms in health here). Briefly, they consist of a network of health facilities that operate in parallel with the public system (Ministry of Health). The facilities drill down to a rural village level where there may be two health professionals working at the equivalent of an enrolled nurse and diploma in health level. The distribution is quite vast across the country however there are problems with local communities being able to afford the health services. Like Australia, there may be transport problems with large amounts of time to travel to a health facility for more complicated needs however here there is only feet and bikes as the main mode of transport. Or you could wait for a mini-bus to come once a week (or month) past a rural village.

Retention of health professionals in the country is difficult with the absence of electricity, water, telecommunications, and education for doctors children combined with the attraction of overseas salary that pulls health professionals away from the country as well as away from rural villages. problems with professional isolation and no communication is also an issue here.

The basic issues in rural health workforce retention and attraction are similar to Australia but the issues to be overcome are much more exaggerated than Oz. Such as poverty, lack of electricity and clean running water, and lack of communication at the basic level. There is a long road to walk but there are many organizations here (NGO’s) that provide help at different levels.

Like Australia, politics and lack of research into the reality of the situation hinder the effective provision of quality health care to rural communities. It is too much to explain here but red tape, human resource turnover at the Ministry level, lack of communication between all players in the system etc all play a part. There are overlaps of serves provided as well as gaps elsewhere.

There are very heartwarming stories though and some excellent roads that are starting to build. Jodie’s blog will explain some of this and you can read about some of our activities in the other entries, I don’t want to double up!

I am having a fabulous time and learning a lot and I can’t believe we are halfway already!!

I will be back with more at the next chance I get!

Fran