Young Indian launches campaign to help Malawian patients get access to appropriate care
My name is Parth Patel, I am 22 years old, and I am Indian, but I currently reside in Malawi, a country with a population of more than 18 million people, daunted by the raging epidemic of HIV and AIDS, as well as other diseases such as malaria and tuberculosis (TB) for the last two decades. With recent changes in lifestyle within the population, chronic non-communicable diseases (NCDs) have become increasingly significant causes of mortality among Malawian men.
Over the last decade, the disparity in the doctor-patient ratio in sub-Saharan Africa has become increasingly severe, despite efforts to boost the admission of medical students and creation of programs to train more clinical officers. This is due to the rapid and continued expansion of the population. As such, the health systems are fragile and inadequate to meet the rising health needs. Despite growing international attention, donors have been reluctant to undertake significant investments required to address the human resources problem, comprehensively, given the social and political sensitivities.
On a regular basis in Malawi, which is situated in southeastern Africa, at the diabetes and hypertension clinics, a doctor shows up only once a week and when that happens, you may see an endless line of patients waiting to meet them and address their health concerns. It is very common to meet patients at the end of the day who are extremely frustrated because they could not meet with the doctor, despite the fact that it was their third or fourth unsuccessful visit, with some having traveled from remote areas that are five or even six hours away. Some patients who were at the clinic and were severely ill lost their lives because they couldn’t access the needed health care. Being a medical student trained to assist people in any way I can, it is extremely painful to watch these scenes and to not have any power to intervene at all.
One time, when I was on a ward round, I vividly remember talking to my mentor about a patient with a severe form of stroke. He was told that he never had any health problems, considering that subclinical hypertension is not readily detected and no healthcare worker ever bothered to check his blood pressure. Unfortunately, the patient did not survive. This compelled me to think about why we are so neglectful of such silent conditions. I discussed it with my mentor, trying to understand not only how we could treat these people but also how we could prevent the progression of their diseases. He told me about the screening services that are in place in Western countries. I asked him why we didn’t have those services here in Malawi and his answer again was the shortage of staff.
There had to be a way to stop this epidemic from getting out of hand. We had to fight it, before it struck massively. There are approximately 500 doctors in Malawi and it is literally impossible for them to provide the entire population with these screening services. However, I realized that there were more than 2,000 medical students in Malawi that, if properly trained, could impact the nation’s health positively, but, again, I felt powerless about it.
A couple of months later, I was elected president of the Medical Students Association of Malawi. So this time, I had the authority and the support of the majority of the medical students within the country. This meant that we could initiate these screening services from time to time and try to mitigate the impact of the non-communicable diseases. I had brought up the concern with the students who seemed to be willing to support me. My mentor, shocked by the overwhelming support, agreed to get a group of doctors to train us. Training for screening, using vital signs, is actually now a part of the medical school curriculum and is taught from the first year.
We, as students, knew about the screening, but didn’t have the tools to provide it, considering that they are expensive and not everyone can afford them. In the beginning, we would borrow the equipment or rent it, taking money out of our own pockets. As expensive as it was, we decided to go ahead with it because it was for our people. Another issue we faced was the location: We couldn’t do these screenings at a random place. It had to be convenient for the people and not take up too much time. Therefore, I approached shopping mall owners and brought up the issue with them. Most were quick to understand and agreed to give us a space in their parking lots to conduct our campaigns.
Then we started the screening campaigns. We identified a good number of people who had subclinical forms of various non-communicable conditions. Unfortunately, the issue of long lines and huge waiting times still stood. How could we make sure that people who need urgent care are given priority? We discussed it with many doctors and concluded that the people who need urgent care should go straight to the emergency room. We also made sure to issue a reference note for them so that the attending doctors knew what the patient was coming in for.
Despite it being a good service, the students’ association realized it was becoming an unsustainable project, with the cost exceeding the association’s budget. We had to figure out another way to financially support the project. I suggested that an honorary fee be introduced to contribute to the program’s sustainability.
It has now been almost nine months since the start of our campaign. The donations collected at the screening campaigns are sufficient to sustain the project. Screening campaigns have also been initiated at corporate levels, whereby a small group of students visit a workplace, be it a bank, office, factory, or mill, and screen the employees of a particular organization. A 20-minute health talk on a chosen topic from the various topics related to the non-communicable conditions is also provided to a collective group of employees.
I admit that this idea-turned-campaign has not been able to cut down the long queues at the clinics. However, it has been able to identify individuals, from all walks of life, in need of help and has guided them to seek the right care. I am very optimistic that one day, with more resources, we shall be able to do more.