Geographical challenges in Ludewa District have been causing difficulties in delivering medicines and medical supplies to health centers as well as transporting patients especially when they receive referrals from peripheral centers to the District Hospital.

This situation is due to some villages being located on cliffs and others on the shores of Lake Nyasa where they are forced to travel by water for three to twelve hours.

This was stated by the Chief Medical Officer of Ludewa District, Dr. Stanley Mlay when he spoke to Mwananchi on November 19, 2023, adding that 80 percent of the supplies are ordered from the Medical Depot (MSD) and ensure that they reach the beneficiaries.

“In the delivery exercise, there have been several challenges we are facing, including some of the centers located on the shores of Lake Nyasa not having friendly infrastructure in terms of roads.

“The centers are located on rocks so there has been a challenge of the lack of official roads, which can be used to transport the relevant equipment,” he said.

He said that most of the time they have to transport by water using boats and later they are brought down to land and a procedure is made to find strong people to carry them up the mountains until they reach the villages.

Dr. Mlay said that the District has other challenges with some of the centers that are located in accessible areas but due to infrastructure damaged by rain, it has been difficult for cars and motorcycles to pass easily.

He said that this situation makes them use alternative routes to ensure that the medicines reach other areas that are 4 to 10 kilometers away.

However, Dr. Mlay says that due to the speed of construction of centers, some are being built in areas where there are no roads so they look at how to deliver medicines, medical equipment and reagents and quickly Most of them reach by foot or bicycle.

“But as the days go by, there are improvements in infrastructure, the challenges have been decreasing, so we ensure that the equipment arrives so that the services can continue to be provided.

“There are some areas due to the lack of roads, the patient has to be carried to a place where we have the infrastructure to transport him…

“Even when he is carried, we ensure that other procedures are carried out so that the patient reaches the hospital and our specialists have sufficient training and accompany the patient so that they can deal with emergencies that may arise,” said Dr. Mlay. He said that there are some areas with water infrastructure where they also ensure that they deliver services.

“There are at least 10 centers that border the shores of Lake Nyasa and others border Mbinga, there we have to transport by boat. Now you come to find those centers, the boats we use in some centers take no less than three to four hours to deliver the equipment, but we ensure that we deliver.”

He mentions some of the facilities such as the Nkwimbili, Masimavalahu, Lupingu, Ntumbati, Ndowa, Lubila, Nkanda and Makonde health center located on land but due to the infrastructure they are forced to carry them on their heads on motorbikes and bicycles.

He said MSD has been working hard to ensure that the basic products that are imported are available and they request that the needs be met in advance so that they have time to find imported products so that they are available on time. Even the price of the products they buy there is lower than that of the suppliers.

“MSD has now ensured that they have a procedure to deliver the products directly to the facilities in the past, they were delivered here to the facility and we as the District distributed them to the facilities now that had its own transportation challenges,” said Mlay.

Despite these inaccessible areas, the Government has facilitated the construction of a concrete road on the section that enters Lupingu village located on the lake which is used as a waterway to other villages that are not accessible on the shores of the lake.

The people of these areas have said that they are unable to move because they were born there, despite the existence of only one thriving crop, which is cassava.

"Our ancestors who came here, we were born and educated here, we cannot move. Although life is difficult in these areas, we are used to eating cassava and seafood or fish that we catch from Lake Nyasa," said Monica Kiswaga.

MSD Iringa Zone Manager, Robert Lugembe said they will continue to carry out their duties professionally and ensure that all health products reach the beneficiaries on time as requested.

He stressed that despite the infrastructure challenges, MSD has still been ensuring that it reaches all centers and dispensaries that are difficult to reach.

He added that MSD will continue to work closely with the leadership of the District Council to ensure that citizens receive quality health services, especially reliable access to medicines and medical equipment.