Malawi is a country of 18 million people. The median age is 17yrs. 83% of Malawians are living in rural areas and rely on subsidence farming for survival. Many rural areas are still without electricity and water is provided from either a borehole or near by river/lake. Based on these understandings, most people rely on their own man power to survive. Plowing the field, scouring for firewood, carrying buckets of water from distances. All these activities are highly time consuming while creating a large strain on the physical body.
Nkhata Bay is known as the district but also the main town within the district. The district itself is 263,000 people while the town center is a population of 56,000. Within Nkhata Bay district, there are 12 regions with 20 health facilities. These are sourced with an average of 2 nursing staff to provide basic treatment and medication. Near the town center lies the regional hospital which is staffed with 5 doctors, 32 nurses and a range of health officers (basic trained medical staff to fill the demand). The hospital consists of a dental unit, optometry, X-ray, general surgery and a blood lab. A group of hearing technicians visit quarterly to provide service. There is no physiotherapist allocated to the district, although, you may hear otherwise. I am standing as the acting physiotherapist offering one day per week for out and in patients.
Nkhata Bay region is 4,200 square km’s and known as the most inaccessible region in Malawi (due to mountain and lake access). Many patients are traveling an average of 40km’s to reach the hospital. Relying on boat or local taxi’s, this can be from 3-10hr process. Those within a 10-15km radius often arrive on foot.
Lisale is our start up pilot community. An area of 5,300 people and 10 villages within. Each village is overseen by a local chief. There are 475 recorded households which creates an average of 11 people living per home. Lisale is 7km’s on foot from Nkhata Bay town with another 8km distance to the hospital. To travel by boat is affordable yet limited in capacity and time constraints. Travel by taxi is a private request and extremely costly. Majority travel by foot which is a 2hr distance to Nkhata Bay town. Within Lisale is 1 health service assistant (HSA). This is a basic trained community health worker. On average, the government is to provide one HSA/1000 people. Lisale is understaffed x5. With a population of 1,400 under the age of 5yrs, the HSA is running a supporting under 5yrs clinic 2 days per week. Lisale is a community with no electricity, 4 boreholes for water sourcing and no network for communication.
*all statistics are provided by the ministry of environmental health of Malawi