People in villages under Traditional Authority Khwethemule in Thyolo Thava constituency are paying a heavy price for the area's geographical placement as they cannot afford to access public hospitals which are located some 30 kilometres away.
Some of the people interviewed told Malawi News that the rough terrain of the remote area located on an innavigable road off the banana laden Thekerani area has become a hindrance for them to get medical care via the public purse.
A visit by Malawi News to the area this week discovered that most people have given up on getting treatment from public health units instead they are leaving patients to die in homes claiming they can't afford health units under Christian Health Association of Malawi (CHAM).
"The choice we have to make now is either carry our sick on a stretcher to an expensive private health facility which of course we cannot afford or else let the sick to die at home," said Sabina Matiyasi of Mangwalala village in the area.
Our further incursion into the area revealed that a strange disease to banana plants which is the main income generating activity of the area has greatly impoverished villagers who cannot afford medical bills at privately owned Malamulo and Molele mission hospitals.
Stella James of Vinanyanga village who claimed had to deliver her fourth child by the roadside due to long distance to the nearest Changata Health Centre said her life could have ended on the day.
"We could not afford transport to Thyolo which is pegged at K500 one way on top of other expenses. As such we were on foot and I delivered there by the road, with my mother acting the mid wife. Some private clinics charge as high as K14,000 a week for malaria treatment, failing which you are detained. As villagers we don't know where to take these problems," said James.
The developments are coming at a time when government is supposed to fulfill United Nations Millenium Development Goals by 2015 some of which targets combating HIV and Aids, malaria and other diseases, reducing child mortality rates and improving maternal health.
But Thyolo District Health Officer Andrew Likaka while acknowledging lack of proper health service delivery to the area in question said his office is working towards finding a solution to the problem.
"Generally the challenge is that geographically the southern part of the district is very hilly and difficult to access because of bad roads. But it should be known that although as government we do not have many health facilities we have struck a Service Level Agreement (SLA) with CHAM facilities.
"They are supposed to provide under five and maternity services for free. We have also agreed that villagers should get STI and malaria treatment on those terms as we pay them for the services," said Likaka.
But he said Thyolo District Hospital has plans to establish new health units in some areas including Khwethemule to complement outreach clinics that the hospital currently provides.
Likaka however expressed ignorance at claims that some private health facilities are overcharging and sometimes detaining patients because of failure to pay medical bills.
"We have no control over the billing system of our partners but we will conduct an investigation to establish the truth on the ground," he said.
Spokesperson for Ministry of Health Henry Chimbali said the ministry's policy regarding access to health care stipulates that people do not walk longer distances than 10 kilometres to get to health facility.
"Implementation of this policy has already started in other areas, so soon we will get to the areas as mentioned," he said.
However Executive Director for Malawi Health Equity Network (MHEN) Martha Kwataine bemoaned the health setbacks the community is facing.
"It is unfortunate that access to health care services in public hospitals is being denied to these people due to infrastructural challenges. As MHEN we are aware of this and it is not in Thyolo alone. Authorities should not give up but continue lobbying with the DHO on the need for a public health facility.
"The other challenge we need to address at the community level is poor health seeking behaviour. Most rural communities in particular wait until people are seriously ill before they think of going to seek health care services a practice which is very detrimental to one's health," said Kwataine.
She said the development should be factored in the long term plan such as the Public Sector Development plan.
"Once a mapping is done of how many health facilities-health centres, district hospitals and tertiary hospitals that the country needs, we can then begin to mobilize resources and develop strategies to construct them over a certain period of