Visiting Masambuka – an exciting new initiative by St Andrew’s Clinics for Children

Since the commencement of the MalDent Project, I have been privileged to observe the work of many organisations, both Malawian and international, that are working to enhance healthcare facilities in Malawi. I wrote recently about the charity AMECA, with which the MalDent Project is now partnering, and during my current visit to Malawi I had a wonderful opportunity to see at first hand the ongoing work of another charity, St Andrew’s Clinics for Children (STACC).

STACC was set up by staff at the University of Glasgow in 1992. Its mission is to support clinics in the poorest areas of sub-Saharan Africa to deliver primary health care for children. STACC supports clinics in Ghana, Kenya, Nigeria, Sierra Leone, Tanzania and Uganda but until recently the organisation was not associated with any clinics in Malawi. That situation is now changing.

In April 2022, STACC agreed to provide support for a project that will deliver primary health care for children in Machinga District, a rural community in Southern Malawi.  The charity is providing some initial capital finance for the clinic in a village called Masambuka, and will make quarterly payments to cover treatments for children in the community for an initial period of five years.

Professor Paul Garside, a key player in the Scottish Government funded Blantyre-Blantyre Project, is also a Trustee on the Board of STACC. He had visited Masambuka in May 2022 before commencement of construction and had promised the Village Chief and visitors that he would return. That opportunity arose recently, when I was lucky enough to accompany him on his second visit, along with Professors Iain McInnes and Andy Waters, also from the University of Glasgow. The visit was facilitated by Dr Mwapatsa Mipando, well-known to readers of this blog as one of the prime movers in setting up the MalDent Project and an ongoing strong supporter. Another hat worn by Dr Mipando is Chair of STACC-Malawi, and he is playing a critical role as the Masambuka Clinic project is getting fully underway. He delivered an excellent on-line lecture to STACC supporters recently and you can listen to it here

Since Paul’s visit in May 2022, work has now started on the construction of both an accommodation block for the paramedics and the clinic itself. Mwapatsa picked Paul, Iain, Andy and myself up early in Blantyre on 11th February and we set out on the three hour drive to Machinga.

Before tackling the last few kilometres of the journey, we met the local Health Surveillance Assistant, Mcpherson Mailosi, who showed us around the Ntaja Health Centre, where he is based. The Masambuka Clinic will be his health post and he currently visits three times per week if possible.

We then all returned to the car and drove the 10 km along a single, track un-metalled road to Masambuka. As we arrived at the village we were serenaded with singing from a group of ladies who had been awaiting our arrival. After leaving the car we were directed to seats outdoors where formal introductions and some speeches were delivered, courtesy of translation by Mcpherson. We received a very enthusiastic and warm welcome and the villagers were clearly delighted that Paul had kept his promise to return. The Village Chief has formed a Building Committee which liaises with the contractors and health authority. 

The Government health officers are very supportive of the STACC project as is the local Village Chief and the community. The Village Chief himself has donated land and the village members have already produced 140,000 bricks to support the project.

After the initial speeches we were shown the existing healthcare building and it was clear why a new facility is needed urgently:

Next we were shown some additional features of the village where further discussions took place around issues such as sanitation and hygiene.

Infections remain a huge problem. The village has an extremely high prevalence of malaria and has been hit hard during the recent cholera outbreak. Mother and child pre- and ante-natal care remain a challenge in this remote area and the women told us stories of mothers giving birth on the road as they currently have to walk to the clinic at Ntaja. Mcpherson also noted how difficult it will be to deliver the four doses required of the new malaria vaccines. The STACC clinic will go a long way to alleviating these problems for the approximately 2,000 people around the larger village and the 15,000 in the broader catchment area.

The contractors have delivered building materials and equipment which is stored securely in a shipping container. They have based a three man team close to the village, led by a foreman who speaks the local yao language as well as chichewa.

Our first stop in relation to the building work that has commenced was to view the foundations for the accommodation block that is being built for healthcare workers delivering service in the clinic:

Currently, staff have to cycle 15 miles along poor quality tracks to attend the clinic, and frequently they can only manage to attend for two or three days a week. The accommodation block will enable them to stay overnight and provide daily services in the clinic. 

After seeing the progress being made with the accommodation block we started walking towards the site of the clinic itself. Spontaneously the ladies from the village burst into song:

En route to the clinic we passed the area where concrete blocks are being produced:  

Soon we were viewing the site of the future clinic, the various rooms outlined by the foundations and first courses of bricks. It is an extremely exciting prospect.

As the viewing of the site was nearing an end, it began to rain (a welcome occurrence for the villagers in light of the very dry rainy season to date) and we returned to the shelter of the existing healthcare building for further discussion and speeches.

Among those who spoke was Mwapatsa Mipando:

At the end of the speeches, the ladies in the village again burst into song and began dancing. You will notice in the video that one of the village spokesmen is joining the ladies in the celebratory dancing. This is apparently very unusual and was a huge honour for us. It was an exceptionally emotional occasion.

This had been an unforgettable experience. Seeing the delight of the villagers at the prospect of having a fit-for-purpose local child healthcare facility was a reminder of how much we sometimes take for granted in the UK. The strapline for STACC is ‘Supporting better health for African Children’ – it will certainly be achieving its mission at Masambuka once the clinic is up and running.