Strategic vision MMWT

Strategic Vision

Providing assistance to distant neighbors in Malawi from a Christian perspective. This aid is realized through a multi-year commitment to a project aimed at improving local living conditions, particularly in the field of healthcare.

Introduction

After a long-standing relationship with Nkhoma Hospital (2006-2016), MMWT has been committed to Embangweni Mission Hospital (EMH) since 2016, to once again improve medical care locally. EMH is a rural hospital providing medical care for a large area. The nearest hospital is located 60 km away. Maternal and child mortality rates are high, and facilities are limited. There is a significant shortage of facilities, medical equipment, medication, staff, and expertise.

Objective

The primary goal of the collaboration between MMWT and EMH is to significantly reduce maternal and child mortality in the region. MMWT, together with the hospital management team, has developed a multi-year plan focusing on Quality Building (improving and maintaining facilities such as buildings, departments, staff housing, and providing equipment and medications) and Capacity Building (improving staffing levels and expertise in medical, nursing, management, financial, administrative, and logistical areas, and providing medical equipment).

Approach

MMWT’s approach involves giving EMH its own responsibility and leadership in implementation, with the following conditions:

  • Continuous involvement of MMWT in the projects, with 24/7 presence of a limited number of experienced volunteers on-site to coordinate daily activities and periodically report progress to MMWT.
  • Intensive knowledge exchange through visits by experts and MMWT board members to evaluate and optimize projects with all stakeholders on-site.
  • Transparent fundraising and accountability towards individuals, foundations, and collaborating organizations.

With this approach, MMWT aims to ensure that funds are spent properly and fully benefit the intended project. MMWT has ANBI status and closely collaborates with Wilde Ganzen and MissionInvest. MMWT’s approach is a proven concept.

Completed Projects

In 2017-2018, the “construction/renovation of staff housing” and the “renovation/reorganization of the pharmacy” projects were completed. The construction/renovation of staff housing, including 4 residential units, was necessary to create housing conditions for hospital staff. The renovation/reorganization of the pharmacy was necessary to immediately improve the quality of medical care.

In 2018-2019, the “construction/renovation of the pediatric ward” project was completed. The construction/renovation of the pediatric ward was given high priority due to EMH’s large influx of young patients and the poor condition of the existing pediatric ward. With the new and fully equipped pediatric ward, which was completed and put into use by late 2019/early 2020, a significant improvement was made in medical care, particularly for this target group of children.

In 2020-2022, the “construction of a new operating room facility” project was completed. The hospital’s operating room was in a completely dilapidated condition, severely limiting adequate medical care, such as performing (emergency) cesarean sections on pregnant women. This project has been completed, delivering an operating room complex with 3 operating rooms and a laboratory space. As part of this project, covered corridors were built to connect the various departments, and a building with washing facilities and sanitation was constructed to improve hygiene conditions. The entire complex was officially handed over to EMH in October 2022. During this project period, training was initiated in Malawi with the assistance of Dutch trainers for clinical officers, nurses, and midwives. Additionally, 2 clinical officers participated in the Utrecht Summer School program in the field of pregnancy care and obstetrics in the Netherlands.

Project Plan 2023-2025

In the period 2017-2022, the focus of activities at EMH was primarily on Quality Building. Part of the hospital (including staff housing, pharmacy, pediatric ward, operating room complex) has now been completely rebuilt and is fully operational. The second pillar of MMWT activities (Capacity Building) has also received attention (training of 2 clinical officers in the Netherlands, training of 6 midwives in Malawi), but needs to be further developed.

During the last visitation in October 2022, EMH management rightly indicated that adequate buildings are crucial for good healthcare, but that these facilities only contribute to the reduction of maternal and child mortality if the equipment, materials, and expertise are also present. The operating room is not yet fully equipped. For the foreseeable future, Capacity Building appears to be more important than Quality Building.

During the visitation in October 2022, contact was made with Engineering Mission Industries (EMI) in South Africa. This organization conducted a Sustainability Assessment of several hospitals in Malawi, including EMH. The conclusion of this assessment fully aligned with the above observations of MMWT that the construction infrastructure, with a few exceptions, is reasonably good, but there is a strong need for investment in strategic planning and leadership development, with a significant focus on staff/management training.

During the aforementioned visitation, contact was also made with Dr. Douglas Lungu, a surgeon in Mzuzu, who is the local representative of the Medical Benevolence Foundation (MBF), based in Houston, USA. This organization supports medical development work in low-income countries such as Malawi. Dr. Lungu is currently establishing a training program for local surgeons throughout Malawi. MBF considers the new operating room complex at EMH highly suitable as one of the training centers for surgeons in Malawi. This would mean that surgeons, under the leadership of Dr. Lungu, can perform operations at EMH for several days per month. Thus far, only clinical officers capable of performing small-scale surgical procedures and cesarean sections have been present at EMH. Participation in the MBF surgical training program is expected to have a significant impact on healthcare capabilities at EMH. Therefore, MMWT sees MBF as an important partner to collaborate with. Additionally, MMWT is currently exploring the possibility of stationing a Dutch tropical doctor as a volunteer at EMH for several years, to work towards continuous improvement of quality, organization, and leadership, in line with the recommendations of EMI in South Africa. This would ensure the transformation of the completed operating rooms into a surgical training facility.

Of course, adequate equipment in the operating rooms is an absolute requirement to realize these ambitions. An extensive inventory of the necessary medical equipment has been conducted in consultation with EMH and MBF. It has been agreed that MMWT and MBF jointly commit to acquiring the necessary medical equipment for the setup of 2 operating rooms. This will create an up-to-date surgical operating and training center that can significantly improve medical care at EMH, greatly enhance the hospital’s impact, and contribute to the training of surgeons for the whole of Malawi.

In summary, the “Capacity Building Operating and Training Center” project aims to:

  • Purchase medical equipment for OR 1 by MMWT
  • Purchase medical equipment for OR 2 by MBF-USA
  • Initiate and implement a surgical training program for Malawian physicians at EMH by MBF under the leadership of Dr. Lungu
  • Station a volunteer couple (tropical doctor and IPH expertise) by MMWT at EMH for a period of 2-3 years (starting from October 1, 2023)
  • Send a volunteer couple (construction and nursing expertise) by MMWT to EMH for a period of 3-6 months (starting from June 1, 2023) for small-scale construction/renovation/maintenance work and to provide a nurse training program.

Budget Project Plan 2023-2025

 

Costs x 1000 Euro
2023 2024 2025 Totaal
Training 10 10 10 30
Medical Equipment 100 100
Volunteer couple (doctor and IPH) 45 45 45 135
Volunteer couple (construction/nurse) 20 20 20 60
Materials 50 50 50 150
Total (x 1000 Euro) 225 125 125 475

 

Limitation

MMWT is limited in terms of capabilities and financial resources; plans can only be realized with financial support from third parties.