Over almost 100 years, the hospital has developed from a single missionary doctor equipped only with a qualification in tropical medicine, into a reasonably well-equipped 220-bed facility, with all major departments and a busy eye department. The hospital and Nkhoma synod mission premises are still located at the original mission site with many buildings dating back to 1912, when the mission was founded.

The Hospital's primary catchment area is the surrounding rural 32,000-strong community, but it serves patients from all over Malawi as well as from neighbouring Mozambique. It offers inpatient and outpatient care on site and conducts mobile clinics within its catchment area.

Pictures of Nkhoma Hospital

Inpatients

Inpatients are cared for on general medical wards (male, female and private), surgical wards, maternity, paediatric, burns, isolation and TB wards. With a labour and delivery room, 2 general surgical theatres and an ophthalmology department with its own ophthalmic theatre, it caters for a wide-range of patients.   Main ward rounds are carried out three mornings a week, with daily rounds for the severely ill patients. Elective surgery takes place on two days a week, Tuesdays and Thursdays, with surgeons and clinical officers on-call round the clock for emergency procedures. The doctors at Nkhoma Hospital have a special interest in repairing vesico-vaginal fistulas, and are an important regional centre for the repair of VVFs and and follow-up of the women affected.

The ophthalmology unit specialises in cataract removal and lens implantation.

Outpatients services

Ambulatory patients visit the hospital's outpatient department every weekday between 9am and 4pm.   Other outpatient services include a family planning clinic, an HIV clinic providing voluntary counselling, testing, and antiretroviral drugs, antenatal clinics providing antenatal care and education, an outpatient eye clinic, a casualty room for outpatient treatment, dressings and plaster of Paris, and outreach community clinics for the under-fives providing free immunisations and malnutrition treatment.

Other hospital services

Supportive departments include physiotherapy, a pharmacy, laboratory, 2 ultrasound scanners and an x-ray machine.

Patient Load

Yearly, 16,000 outpatients are seen, 10,000 patients are admitted, 1,500 operations are performed in general theatres, 4,500 ophthalmic operations are performed, and 1,800 deliveries are conducted.

The provision of these services significantly lightens the load of the nearest referral hospitals, the government-run Kamuzu Central Hospital and Bottom Hospital.

Subsidised care

The following treatments are provided free of charge to patients:

• Malnutrition treatment programme
• TB treatment
• Sexually Transmitted Infections treatment
• Antiretroviral treatment
• All family planning measures, including voluntary female sterilisation by tubal ligation to limit birth rate and childbirth complications
• Vesico-vaginal fistula repairs
• Patients referred from 5 government health centres for obstetric complications are treated free of charge through an agreement with the government.

Generally, the fees patients are paying is highly subsidised. An example is the cost for a caesarean section: patients pay 1400 Kwatcha (= 11 US$), which is not even near to the real costs.

Costs are kept low, because the local community would not be able to pay actual costs. This is possible through higher payments from private patients and donations from various individuals and organizations.

The hospital provides other treatment programmes free of charge

• Voluntary female sterilisation by tubal ligation to limit birth rate and childbirth complications
• Vesico-vaginal fistula repairs
• Epilepsy treatment
• Long stay burns treatment