Alleviating the plight of people with NCDs through PEN

Neno, October 07, Mana: In the heart of Malawi’s Neno district, 71-year-old Richard Mabvuto clung to life, a frail yet resilient figure in the face of adversity. His battle with hypertension took a devastating turn one fateful day when his body betrayed him, leaving him paralyzed. Yet, against all odds, Mabvuto’s story didn’t end in tragedy. While he continues to grapple with the aftermath, his journey is far from over.

From his hospital bed, Mabvuto recalls the day that changed everything. His voice trembles as his eyes fill with tears.

“I remember my legs giving in, I couldn’t move or stand. I thought it was the end,” he says. “But people found me, rushed me to the hospital, and here I am today, alive to tell the story.”

Mabvuto’s experience is just one of many faced by those living with non-communicable diseases (NCDs).

According to the World Health Organization (WHO), NCDs such as hypertension, stroke, cancer, asthma and diabetes account for 70% of global deaths in low and middle-income countries like Malawi and the burden is even heavier with 82% of premature deaths due to NCDs occurring in these economies.

In a bid to address the growing NCD crisis in Malawi, Partners in Health (PIH) known locally as Abwenzi Pa Za Umoyo (APZU) launched the Package of Essential NCDs (PEN-Plus) project in September, 2023.

The initiative, expected to run through August 2027 is designed to reduce the morbidity and mortality rates of NCDs by providing critical care and resources to vulnerable populations.

PIH has been operating in Neno since 2012 reaching over 5,000 people with NCD care. The PEN project offers lifesaving services such as treatment for diabetes and hypertension, post-acute health system recovery and ongoing care management.

Mabvuto is one of the beneficiaries of the PEN-Plus project. His wife, a pillar of support during his recovery beams with hope as her husband slowly regains his independence.

“My husband was so close to death,” she recalls. “But now, he’s improving every day. He can even do small tasks by himself. It’s like we’ve been given a second chance at happiness. Truly, there is always hope, even when things seem impossible.”

Another life transformed by the PEN-Plus project is that of 60-year-old Flora Livison, whose leg was amputated due to diabetes.

“I was on the verge of death,” she says. “But with support from health workers, I’ve stabilized. I’m on treatment now. It is possible to live with diabetes.”

In collaboration with the Ministry of Health, PIH continues to deliver high-quality healthcare to underserved communities.

From building infrastructure like Neno District Hospital and introducing advanced NCD clinics to renovating facilities in response to COVID-19 and Cyclone Idai, PIH has left an indelible mark on the district’s healthcare landscape.

PIH Medical Director, Dr. Christopher Banda said the organization together with the Malawi Government spends about US$ 175,000 per month to achieve their mission of helping government in advocating, designing and implementing a universal health system centred in community empowerment, equity and social justice.

“We believe in what we call the theory of change which basically looks at delivering high-quality health services while we accompany the government,” Banda says.

Banda says they support their clients by providing them with food and transport money to come to the hospital and get medication as medicine alone can't work, adding that resources are not adequate and they are looking for more partners to help in the delivery of safe health care.

In 2007, PIH constructed Neno District Hospital which was opened in 2009 including its fence, oxygen generating plant and planted a high-capacity generator, a variety of hospital equipment, paved ‘Dr. Keith Road’ from Lisungwi to Neno Boma to shorten the distance between the hospitals by 68 kilometers.

Banda adds that PIH also constructed integrated chronic care clinic at Neno District Hospital and a maternity wing at Ligowe Health Centre. Beginning in 2018, Neno District became the first district in Malawi to introduce Advanced NCD clinics.

PIH also constructed houses for 23 families in Neno who were affected by Cyclone Idai, renovated isolation centre, screening shelters and water systems in response to COVID-19 and constructed a High Dependency Unit at Neno District Hospital.

Despite the tremendous progress made, challenges remain. Neno Director of Health and Social Services, Haules Zaniku notes that extreme poverty limits many patients’ ability to follow prescribed treatment plans especially when special diets are required.

“Some clients need specific food that they simply can’t afford. It’s a real challenge,” Zaniku explains.

With a US$2.8 million grant from the World Diabetes Foundation (WDF), PIH is expanding its reach. While PEN services are available in all districts, full PEN-Plus services are currently limited to Neno, Salima and Karonga.

Through training healthcare workers, decentralizing NCD clinics and scaling up public awareness, PIH aims to improve the quality of care and health outcomes for patients across Malawi.

The story of PIH’s work in Neno is not just one of medical care - it’s a testament to the resilience of human life and the power of community. People like Mabvuto and Flora who once faced the grim prospect of death are now living testimony that with the right care, support and determination, even the bleakest diagnoses can be transformed into stories of survival.

Their journeys remind us that hope, in its most powerful form, is not just a feeling but a lifeline and in Neno, that lifeline is being woven, one patient at a time.