Kalemba is about 46 km north of Nsanje, it is a Catholic community hospital and like Trinity it is better maintained than the government health centers although it does have some areas that do need some tender loving care.The wards are scattered about in the compound at some distance from each other. As a hospital however it does not provide many laboratory investigations other than malaria paracheck, hemoglobin and urinalysis. The ART lab does draw blood for viral load and this is then sent to Nsanje District Hospital. Viral load has just being made available in a few health care centers and Kalemba is one of the most active centers to take advantage of it.
The waiting area of the ART Clinic is in a narrow corridor and the clerk who checks them in uses an old bed for his desk, then they are sent to the nurse and medical officer. The nurse mainly sees patients who are asymptomatic and counsels them on medication adherence. This being a Catholic hospital there is no family planning but she could refer them to other facilities, however most women have to get their husbands’ approval.
A woman carrying a two-month-old baby on her back when asked if her husband had been tested for HIV, she replied that he was positive but that he left her (she was the second wife) when she was a month pregnant and three children and also his first wife and five children to have a third wife. Now she survived by tilling the land and selling what she grew. She related all this without much emotion. The nurse’s reaction was, “Men are cruel.”
On our way home the driver took a short detour in Bangula to look at the “wash-away “of the Shire River. The fast flowing Ruo River fed its water to the slow-flowing Shire, overwhelming it and creating a run-off from the Shire and destroying a bridge that took vehicles to the East Bank, at least that was what I was told. This has been a problem for sixteen years. A trip to the East Bank that used to take a couple of hours now necessitates a detour to Chikwawa and a five hour travel. Apparently the government has now started to rebuild a bridge. We talked to the engineer who told us that they hope to have the bridge done by December before the rain comes. They were filling up the river with rocks and earth at the narrowest part of the river from both sides of the banks before building the bridge. I just wonder if this would create a bottle neck for the swift water to flow and if so the bridge would be washed away again. This part of the river is called Mtaya Moyo (lose one’s life)
The currents are swift here, men with big muscles maneuvered wooden boats loaded to the hilt, the sterns were almost level with the water while passengers were busy bailing water out of the boats crossing this narrow section of the “wash-away”. If there was indeed a bridge, the boatmen would soon lose their livelihood perhaps until it would be washed away again.
