Taiwans Medical Missions in Malawi Making Significant Impact Taiwan extends medical help to Africa
By Ma Kang-yao
Supplements Writer Photos Courtesy of DOH
"Politics should never override professionalism and there shouldnt be any boundaries in health-related issues," said Minister Hou Sheng-mou in an interview on Taiwans role in global health. He also noted that Taiwan shouldnt be excluded from the public health network and be left to fight on their own because diseases know no boundary. "The exclusion of Taiwan means the possibility of it becoming a loophole in disease control," he said.
Minister Hou also said that Taiwans achievement today is the result of international cooperation, adding "we are very grateful to those who have reached out to lend a hand in our times of need; now that we have the ability to help, we really hope we can reach out and do the same."
Taiwan has medical missions in Malawi, Burkina Faso, Chad as well as Sao Tome and Principe. The goal of these medical missions has been to help these countries improve their sanitation. The Bureau of International Cooperation under the Department of Health has made of Malawi the most prominent example of Taiwans achievement in this area in the last few years.
Malawis Mzuzu Central Hospital
Malawi has always been the focus of Taiwans medical delegation. The medical mission in Malawi is usually stationed at the Mzuzu Central Hospital. The hospital, which was built with monetary aid from Taiwan, is currently managed by the Pingtung Christian Hospital.
"We want this hospital to be the best one in Malawi," said Chen Shi-chan, Taiwans former ambassador to Malawi. Mzuzu was dubbed by Malawis first president as the "dead north."
"We want the Mzuzu Central Hospital to be the No. 1 hospital not only for its cleanliness but also for the quality of medical treatment," said Chen.
Taiwan has developed and introduced the Fingerprint Identification System (FPIS), enabling doctors to easily register and identify patients through their fingerprints. Bar codes are also used to key in patients drug use in order to keep track of drug dosage and distribution, as well as to facilitate data input and statistical analysis. "Malawi, a country where people are without identification cards, is where we have set up the fingerprint system," pointed out Dr. Chen Ho-chun, a member of the medical mission. "This managerial system can mean savings in the manpower and in the time of the medical personnel to efficiently keep and identify Malawians medical records.
Without a reliable management system, our donated medicines may end up being shipped to and sold in the black market." According to the findings of a survey conducted by the Mzuzu hospital, the average time spent to identify patients has decreased from 10 minutes to 3 minutes and the personnel needed to handle administrative tasks has decreased from nine to six.
The 300-bed Mzuzu hospital is one of the few advanced hospitals in the area. Many doctors from countries such as the Great Britain, Egypt, Canada and the United States come to the hospital to do their research.
"In the future, the hospital can be developed into a medical research center such as Tropical Diseases Center or Bio- tech Center," said Minister Hou.
Child patients, formerly given access to only three kinds of prescriptions available, had a recovery rate of more than 60 percent after Taiwanese doctors stationed at the hospital began to provide more options.
Rainbow Clinic
Malawi with 15% of those aged 15 to 49 infected has one of the highest HIV/AIDS prevalence rates in the world. The national prevalence rate is estimated at 9 %. To reduce HIV-related morbidity and mortality as well as to provide opportunity for a longer life expectancy or survival among HIV positive patients, the Anti-Retroviral Therapy (ARV) has been offered to HIV positive patients since 2001.
In 2002, the Pingtung Christian Hospital took over the management of the Mzuzu hospital. In July 2004, the hospital set up a modern ARV clinic, which is also known as the Rainbow Clinic. It is North Malawis first and only free AIDS treatment center, systematically providing medical care to patients.
The Rainbow Clinic effectively keeps track of the patients progresses. Taiwans Department of Health sponsored instruments for virus titer evolution to provide better clinical services in the clinic laboratory.
Since the opening of the clinic, more than 3,000 AIDS patients have received ARV regularly. The Rainbow Clinic also provides these patients vocational training program to enable them to be self-reliant.
Health of Mother and Child
The childrens death rate in Malawi is one of the highest in the world. About 24% of the newborn babies would die before reaching five years old. Due to the childrens high death rate, most families try to have more children to compensate for the death.
The poor sanitation in Malawi makes child delivery a high risk for mothers. Statistics show that for every 100,000 delivering mothers, about 1,000 would die. The death rate is about 1%.
"Maybe it is hard for us to imagine that Malawi women give birth by the roadside or inside the toilet, without giving importance to sanitation or sterilization," said Dr. Solomon C.C. Chen, director of International Medical Cooperation & Development Center at the Pingtung Christian Hospital.
A serious problem of Malawis medical system is the lack of doctors and medical personnel. There are only less than 50 Malawian doctors working in this African country after having been educated in developed countries. More than 100 Malawian doctors practice medicine in England.
"The medical personnel remained here are just midwives," said Dr. Solomon C.C. Chen, a Department of Health consultant. "According to WHO data, half of African newborns are delivered by midwives. The situation has made us decide to put emphasis on the training in midwifery. There is a need to teach them the correct way of assisting delivery."
However, Dr. Chen Hou- chuang, a member of the Malawi mission for two years, spoke of the risk. He explained: "This is a necessary but bold move. Training the traditional birth attendant (TBA) means we are operating a separate source for nursing staff other than the typical Nursing School. "In two years, the Taiwan Medical Mission has trained 50 midwives.
"We first work with the leaders of the villages to identify who are doing the job of midwives and we try to educate them," said Dr. Solomon C.C. Chen. "We next provide the facilities for delivery. In these two years, these 50 midwives have successfully delivered thousands of babies alive."
He went on: "Many people look down on the TBA as a low or even poor alternative. But I think this is the foremost step to solve the problem regarding the lack of medical personnel."
"During the training of midwives, we try to tell them many other aspects of sanitation, emphasizing that the quality of children is more important than the quantity and letting them learn how to improve their living environment and the way to avoid AIDS and venereal diseases," he said.
Sex-transmissible Diseases Blood Donation Program Malawian hospitals havent been able to built up a blood bank system, which leads to many unfortunate deaths. Car accidents, childbirths or even minor surgeries often call for blood transfusions. Such emergencies can result in an unsafe environment for blood transfusion. The last-minute blood donors may carry diseases such as AIDS and hepatitis, among other diseases which can be transmitted by blood."I have been told a sad story about a ranking official from Malawi having come to Taiwan for medical check-up. When he was diagnosed as HIV positive, he was shocked because he claimed to have never been promiscuous. We have reason to suspect the disease was transmitted by blood transfusion," said Dr. Solomon C.C. Chen.
The Lion Club International 300A1 donated one blood mobile to Malawi through the Taipei Blood Donation Center for use as blood donation stations or blood banks on the move. Two blood donation vehicles and professional personnel to run them will make a huge impact in improvingthe blood donation situation in Malawi," said Dr. Solomon C.C. Chen.