Malawi
Malawi is a beautiful but small country in southern Africa, surrounded by Zambia, Tanzania and Mozambique. It has the third largest lake in the whole of Africa, Lake Malawi, which covers a fifth of the country. Malawi is called 'the warm heart of Africa' after its friendly and gentle people. Despite its beauty, Malawi is a very poor country and its economy relies on foreign aid and agriculture, particularly tobacco. Most of the population live on less than two dollars a day.
The Need In Malawi
Most people in Malawi will never see a doctor. That’s because in Malawi, there are only about 350 doctors in total. That’s roughly 1 doctor for every 50,000 people. In the UK, we have over 100,000 doctors – or 1 for every 500 people. There are even fewer specialist doctors in Malawi – for example, there is one neurosurgeon for the entire country. Only 8% of paediatrician and 9% of obstetrician posts are filled. But it’s not just doctors. In the whole of Malawi, 33% of nurses’ posts are vacant and prior to the development of the physiotherapy course at the College of Medicine, only 27 physiotherapists for the entire country.
This chronic shortage of health workers has led to Malawi having some of the worst health outcomes in the world. It is one of the most dangerous places in the world for a woman to give birth: one woman will die from childbirth for every 196 births. In the UK, 1 woman will die for every 8333 births. The lifetime risk of childbirth, which is the cumulative loss of life due to childbearing over the course of a woman’s life, was 1 in 36 for a Malawian woman in 2008. In the UK, it was 1 in 4,700. It is the same for children’s health: for every 1000 children born, 110 will die before they turned five. Women and children will particularly benefit from more health workers. This is why Medic to Medic is supporting trainee health workers in Malawi, to help change these shocking statistics.
Where We Work In Malawi
Kamuzu University of Health Sciences (KuHES), formally the College of Medicine (COM), offers degrees in medicine, pharmacy, medical laboratory science, physiotherapy as well as a range of other upgrading and Masters courses. It is based in Blantyre, the largest city in Malawi and the commercial centre. Initially, the university could only offer the clinical phase of training, and students were sent to the UK in order to do their preclinical years. Now all five years of the medical course are completed in Malawi, with clinical attachments at the Queen Elizabeth teaching hospital in Blantyre, Kamuzu Central Hospital in Lilongwe and the rural campus in Mangochi. An additional premedical or foundation year is offered for those students who don’t have science to A-level standard (A-levels tend to be offered only in private schools in Malawi).
In 2021 Kamuzu College of Nursing (KCN) merged with Kamuzu University of Health Sciences (KuHES). KCN was founded in 1979 with it's mission to deliver high quality and cost effective nursing and midwifery education and other health related programs to students and other stakeholders through teaching, research, consultancy and outreach, advance professional growth and promote the health of the people of Malawi. If is the biggest nursing and midwifery college in the Southern African Development Community (SADC) offering both undergraduate and postgraduate qualifications.
Mzuzu University (MU) was initially a teacher training college set in the town of Mzuzu in the northern region of Malawi. It expanded during the 1990’s and 2000’s to incorporate other faculties. The nursing faculty opened in 2006. Students at Mzuzu undertake clinical placements in the northern region of Malawi, which tends to be more rural compared to other regions and their training is centered on the rural health needs of the local population. MU also hosts the only degree programme of optometry. Optometry students are involved in service provision by undertaking outreach work in rural areas during their training. Students from the northern regions of Malawi are often underrepresented in tertiary education and our partnership with MU is an exciting opportunity to help disadvantaged students from the northern region.
Saint John of God College (SJOG) located in Mzuzu in the northern region of Malawi. It was set up following discussions with the Brothers of Saint John of God Ireland in 1993. Today SJOG provides education and training in mental health for clinical officers and nurses specialising in the field, as well as providing social services (including counselling and vocational training) to people in the region. The college is a private institution and was set up as an alternative to the public universities. They have the capacity to train more students than are currently enrolled and many students still struggle with the cost of tuition fees. Mental health in Malawi is severely underfunded and the partnership with SJOG offers Medic to Medic an opportunity to ensure students wishing to specialise in mental health are also given an opportunity to qualify and go on to serve Malawians with mental health problems.
Ekwendeni College of Health Sciences is affiliated to the University of Livingstonia in the northern region of Malawi. In 2014 the clinical officer training programme started with just 12 students. In 2016 the course had expanded to 68 enrolled students. A clinical officer is a health professional qualified to perform medial duties such as diagnosis and treatment of disease and injury, including ordering investigations, performing procedures and referring patients to tertiary facilities when patient need dictates. In rural areas clinical officers manage and run missionary and district hospitals where there are no doctors and often hold similar responsibilities to their senior counterparts. Clinical officer training is generally shorter (minimum of three years compared to six years for a doctor) and they subsequently undergo a one year internship. Following qualification they can specialise in a department (such as medicine, surgery, paediatrics, obstetrics and gynaecology, psychiatry), following further postgraduate study. This qualification is often not recognised in developed countries. Clinical officers are seen as an investment in the health workforce since they often do not leave the country after qualification.
African Bible Colleges (ABC) was established in Liberia in 1976 and then in Malawi in 1987. The Malawi campus initially offered a 4 year degree in Biblical studies, then Mass Communication and also Education. In 2012, audiology subjects were offered to ABC students in response to the lack of Malawian audiologists. This training was developed in to a degree program, approved and accredited by the Medical Council of Malawi in 2016 and the National Council for Higher Education in 2021. The first students graduated with a degree in Audiology in 2021. There is an overwhelming need to assist those with hearing loss in Malawi. Having a hearing loss effects speech and language development, family relationships, schooling and work prospects. Given poor primary health services, the amount of preventable hearing loss in Malawi is significant. Graduates have the potential to change the lives of so many in their own country.
Mulanje Mission College of Nursing and Midwifery is owned by the Church of Central African Presbyterian - Blantyre Synod. It was established in 1930 by Scottish Missionaries. It offers the following courses, diploma in nursing and midwifery technician, diploma in public health, diploma in nutrition and community midwifery assistant certificate. Many students from poor social economic backgrounds struggle to pay fees. Nurse midwife technicians (NMT) comprise one of the largest numbers of health workers in Malawi.
Trinity College of Health Sciences is a Christian Health Association of Malawi (CHAM) training facility. The college was opened in 1964 by the sisters of Divine Providence under the proprietorship of the Chikwawa Diocese. It is found in the southern region of Malawi, the northern part of Nsanje district. Currently the college offers three programs; a diploma in nursing and midwifery (NMT), diploma in public health and diploma in nutrition and food science. Clinical allocations are provided at Trinity hospital, Mwanza, Thyolo district, Machinga, Chiradzulu, Nsanje, Balaka and Queen Elizabeth Central hospital. Our partnership with Trinity started in 2021. We have also developed elective partnerships with this institution, to enable international medical students an opportunity to gain exposure and experience of health priorities in rural Malawi.
Malawi College of Health Sciences (MCHS) was established by ministerial order in 1996 under the Ministry of Education, but operationally it operates under Ministry of health as a line ministry. The college has three campuses, namely; Lilongwe, Zomba and Blantyre.
The college is mandated to train middle level health workers (diploma) in various medical fields such as: clinical medicine, radiography, pharmacy, environmental health, nursing and midwifery, clinical ophthalmology, intensive care medicine (anaesthesia), orthopedics, dental, optometry, biomedical sciences, ear, nose & throat (ENT), community health nursing. Graduates of the college work in central/district hospitals, health centers, private hospitals/clinics and non-governmental organizations (NGOs). Malawi College of Health Sciences is often referred to as the hub of health training and practice in Malawi.
Students at the college do not have an opportunity to obtain a government loan for their tuition fees or living expenses. Government loans are only offered to degree level students. Costs of living in Lilongwe and Blantyre are particularly high. The result is that many students struggle with their course costs.
The Malawi University of Science and Technology (MUST) is an institution located in Thyolo, Malawi. Established in 2012, MUST was formed through an Act of Parliament with the aim of promoting scientific and technological advancements in the country. The university offers a wide range of undergraduate and postgraduate programs in various fields including engineering, humanities, health sciences, and information technology. With growing facilities and a commitment to excellence in research and innovation, MUST has quickly gained recognition as a leading institution of higher learning in Malawi. It strives to foster academic excellence, entrepreneurial skills, and social responsibility among its students, contributing to the overall development of the nation.
St John’s Institute for Health (formerly called St John’s College of Nursing Midwifery) is a Christian Health Association of Malawi (CHAM) member training college operating within Malawi. The college was opened in 1963 by the medical missionary of Mary sisters (MMM) and is under the proprietorship of the Catholic Diocese of Mzuzu. The college was initially designed to train nurses for St John’s hospital. In the years 1963 – 1970, the institution was offering a two-year Training program of enrolled nurses (EN) and 1-year enrolled midwifery at a certificate level up to the year 2000. However, with the increase in the Malawian population, the demand for nurses and midwives increased and the situation necessitated the college to open its doors to enable the training of nurses that would render health services in all health facilities in Malawi. Between 2000 and 2004, the college, like many other CHAM colleges, offered and implemented a two-year nursing technician program owing to the acute shortage of nurses in the health system. Since 2004, the college has implemented a three-year nursing and midwifery technician (NMT) program. In October 2018 the college introduced a certificate in pharmacy. This introduction necessitated the change of name from “St John’s College of Nursing” to “St John’s Institute for Health.” In addition to the existing programs, the institute introduced a certificate in clinical medicine (CCM) and university diploma in nursing (RNM). Students at St John’s undertake clinical placement mainly in the northern region of
Malawi.