The advent of Obamacare and the discussion of insurance policies in America has politicized the field of healthcare. The same trend is true in the Malawian healthcare system, albeit in a different way. Politics rules the healthcare system in Malawi at nearly every level. This isn’t always a bad thing–usually it means that the government is genuinely interested and involved in bettering health policy. However, it can sometimes result in the inefficient delivery of healthcare to the people at the end of the chain.

One example of the intersection of politics and healthcare is found in the story of Chatinkha Nursery, where Karen and I have spent numerous hours over the past two months. Gogo Chatinkha, for whom the nursery is named, was former president Kamuzu Banda’s grandmother. While Banda was in power, the nursery was extremely well taken care of. However, when he lost power in 1994, funding and care for the nursery declined significantly. After years of relative neglect, Chatinkha is now being renovated and expanded, allowing it to return to its prime. In Queens, entire wards are donated or sponsored by various donors including corporate sponsors like Sobo (a soda company that financed the Paediatric Oncology ward) or charitable organizations like the Lions Club of Blantyre (a group that helped build the Delivery Suite).

Politics also pervades the system at lower levels than the government. For example, since QECH is a government hospital, it should be run by Ministry of Health doctors and officials. However, since the College of Medicine also uses it as a teaching hospital, they claim some of the leadership responsibilities as well. In effect, every department at Queens has two chairs now: a clinical head and an academic head. This makes the chain of command more complicated and inefficient, but it also allows brilliant Malawian doctors to rise in the ranks and lead departments at the biggest government hospital int he country.

Politics and healthcare coexist in an uneasy but inextricable relationship. The goals of doctors and nurses can often clash with the plans of health policy makers at the top. However, when the clinical and political sides work together, health projects can take on a bigger scope and reach a broader base of customers and patients.