Bwaila Hospital (formerly Bottom Hospital)
A Tier One Hospital
In 2005 Jack McConnell the First Minister from Scotland toured Bottom Hospital in Lilongwe, Malawi. Bottom Hospital, recently changing its name to Bwaila (River) Hospital, is one of the top tier hospitals in the government medical system. The description of the hospital at the time of his visit was reported in The Scotsman on May 25, 2005.
“The windows are broken and the stench of urine and sewage seeps through the corridors. There is only one working incubator and if that is in use when a sick baby is born, the unlucky infant is handed back to its mother to die. Bottom Hospital near Lilongwe has one of the worst rates of maternal and infant death in the world. Doctors describe conditions there as “medieval” as they struggle to cope with almost no staff and none of the equipment patients in the West take for granted.”
Graeme Walker, a doctor working for the Edinburgh Royal Infirmary reported concerning Bottom Hospital, “Here, a mother dies every six days. I have been working at the ERI for eight years to witness that.” The news article refers to it as being “Born into a hospital from hell.”
Another vivid description of the conditions in the urban facility was reported by Sean O’Toole in a report “Malawi 2003: Tuberculosis and guardian care” 27 October - 26 November 2004.
“Lilongwe’s Bottom Hospital … is a ramshackle collection of single-story buildings. Long queues of people, mostly women, many adorned in traditional cloth, stand patiently in line waiting for medicine or a chance to consult with a doctor. Old hospital beds lie outside, rusting in the mid-summer rain. The hospital has a distinctive smell, thick and wooded, damp and generally pungent. One could rudely assert that it is the smell of ill health, that it is a smell that is only vaguely medicinal, and that it is particularly prevalent in the wards but in truth the smell is less threatening than it is unfamiliar. There is a hint of burnt porridge to the odor too, probably due to the fact that many guardians and visitors are allowed to cook food on the hospital premises.”
Another view of the hospital is experienced through the words of Deborah Landis Lewis a fourth-year student from the University of Pittsburgh School of Medicine (2005-2006) who worked at Bottom Hospital. “Bottom Maternity Hospital serves as the referral hospital for the central region of Malawi. With more than 12,000 deliveries per year and 3-ruptured uteruses a week, it is one of the busiest maternity hospitals in southern Africa. That’s 12,000 deliveries, with only 2 consultant obstetrician/gynecologists, and they have to cover gynecology at another hospital as well. That in a country whose maternal mortality rate is third in the world and rising: 800 maternal deaths per 100,000 live births. Europe hasn’t seen those numbers since the 16th century. The rate in Scotland today is 5. A little history on the name: Back when the British ruled Malawi, there was Top Hospital and Bottom Hospital. Top Hospital was for the whites, Bottom for the blacks.”
Smith Chibaka, a Malawi doctor practicing in the capital city of Lilongwe reports the following information, “The name Bottom is reported to have originated from the identification of the two hospitals that existed in Lilongwe then. There was a Whites only hospital, which was in Area 3 of Lilongwe. That one was a Top Hospital. And the other one for Blacks is one, which is now called Bottom. Recently, it has been re-named Bwaila Hospital. The bed capacity at Bottom is 220. I am told there are only 2 Obstetricians. Currently, there are 39 nurse midwives and only 3 midwives. Statistics for 2006 show total births of 11,083. In that same year 2006, there were 300 neonatal deaths (dying before 28 days of births). There were 313 stillbirths - (those born dead). Maternal deaths numbered 25.”
Discussions were held in mid-2006 with the now deceased First Lady of Malawi and a decision was reached for the Malawi Project and World Emergency Relief to send at least two large 40-foot trailers filled with medical supplies and equipment to the Ethel Zvauya Mutharika Foundation in order to help to refurbish Bottom Hospital. Additional plans were put into place to schedule teams from America to assist in cleaning and painting portions of the hospital and to help in the repair and refurbishing of equipment and machines in the hospital.
