When the heart fails: Tales of living on oxygen machines

FACED A SIMILAR MONTHLY LIMBO— Phiri By Imam Wali: Caloreen Alick, 19, from Mwaiza 2 Village, Traditional Authority (TA) Kachindamoto, in Dedza District died on January 14, 2026. She had battled interstitial lung disease since giving birth in September 2024. She left behind a 15-month-old child, now cared for by her grieving grandmother, Aisha Alick. Aisha said her daughter (Caloreen) was repeatedly referred to public institutions, including Dedza District Hospital and Kamuzu Central Hospital (KCH) in Lilongwe, for oxygen therapy. "We suffered a lot. For a year, we moved from one hospital to another and my child lost her life because all the public hospitals discharged us. They did not have medical oxygen to keep her on it long term, even though she had become entirely oxygen-dependent," Aisha said Public facilities were overwhelmed and lacked medical oxygen concentrators to manage long-term cases. "We were simply told to go to the nearest local hospital for oxygen treatment," Aisha recalled. Desperate, the family sought refuge at Mua Hospital, a Christian Health Association of Malawi (Cham) mission facility, on January 1, 2026. "At the facility, we were required to pay K8,000 daily for oxygen alone. Paying those hospital bills was a tall order for us. We had already exhausted everything we owned. We even sold our livestock just to support her through this long illness." Aisha said At Mua Hospital, they were advised to buy a personal medical gas cylinder for home use. "We were told that this gas cylinder was what we would be using at home upon discharge, but it was difficult for us to raise the money," she said. Caloreen's death exposes a critical gap in Malawi's healthcare system: the lack of reliable access to medical oxygen for chronic patients. This deficit directly undermines Sustainable Development Goal (SDG) 3, which champions good health, well-being, universal health coverage and the eradication of preventable deaths. It also threatens the Malawi 2063 vision promise of quality, equitable and affordable healthcare. A 2023 cross-sectional study published in the BMC Health Services Research report found that no district or central medical ward in Malawi had piped bedside oxygen outlets. The study further revealed that 44 percent of district hospitals and 25 percent of central hospitals lacked reliable oxygen availability. Although the World Health Organisation designates oxygen as an essential medicine, supply in Malawi's public facilities remains dangerously inconsistent. This creates a lethal divide where life-saving air is accessible only to those who can afford private or mission-facility fees, directly violating SDG 10 on Reduced Inequalities. In response to the crisis, the Ministry of Health launched Malawi's National Medical Oxygen Ecosystem Roadmap on December 21, 2021. The 2021–2026 framework aims to deliver oxygen from source to patient and reduce morbidity and mortality cases arising from low blood oxygen. Yet for families like the Alicks, this strategy reads like a folktale. Caloreen is not an isolated case. Over 40 kilometres from Nkhata Bay Boma, in Mzenga Village under TA Kabunduri, 26-year-old Jonas Mwale is fighting his own battle for survival. For almost seven years, he has endured a debilitating respiratory condition. In 2018, Mwale scored 19 points in Malawi School Certificate of Education (MSCE) examinations. The results earned him a place at Kasungu Teachers' Training College. However, his academic dreams were abruptly cut short. He has been to Nkhata Bay District Hospital, Mzuzu Central Hospital, KCH and Queen Elizabeth Central Hospital (QECH). At QECH, he was diagnosed with cardiac enlargement and pulmonary scarring. "While at college, I started having serious breathing problems, weakness and swelling in my stomach. The illness got worse and I had to drop out and go back home. Because of the severe damage to the heart and lungs, I was told that surgery was not possible and was placed on specialised medication," Mwale said He now relies entirely on oxygen concentrators and cylinders to breathe. However, the financial burden is crushing; K30,000 a month for electricity alone. WANTS TO LIVE A NORMAL LIFE—Mwale "I need at least K30,000 worth of electricity every month just to keep my oxygen concentrator running at home. During frequent power outages, we switch to an oxygen cylinder. While Nkhata Bay District Hospital refills the cylinder for free, it costs us roughly K50,000 in transport fees for each trip to the Boma, sometimes twice per month," Mwale explained Mwale lives with his mother, who has no reliable source of income because caregiving consumes all her time. Despite the hurdles, Jonas is turning to entrepreneurship for survival. "I have viable business ideas. I am hoping to start selling eggs and cooking oil from home. With the proceeds, I can support my own medical costs rather than relying on well-wishers, which is unsustainable. The only thing stopping me right now is capital," he said Caloreen and Jonas' crisis is mirrored across the country, exposing a fatal flaw in post-discharge care. In Machinga, Rangwani Gatwell was fit for discharge from Queen Elizabeth Central Hospital (QECH) in February 2026 but spent weeks stranded in the ward because his family could not afford a home oxygen cylinder and regulator. In Nancholi Township, Blantyre, Margaret Phiri faced a similar monthly limbo until well-wishers purchased her breathing equipment. They are both struggling to buy medical oxygen. The crisis is not unique to Malawi. A 2025 report by the Lancet Global Health Commission on Medical Oxygen Security revealed that six out of every 10 people in the world lack access to safe, quality, affordable medical oxygen. This is contributing to hundreds of thousands of preventable deaths each year from a large number of acute medical conditions, and is reducing the quality of life for millions more living with chronic diseases. PATH Senior Programme Officer Happy Banda said that while Malawi has made progress on hospital-based oxygen through the Roadmap, the biggest gap remains after discharge. "Without sustainable financing and a home-oxygen programme, we risk discharging patients, only for them to suffer at home," Banda said. He notes that areas needing urgent development include clinical guidance for home-based oxygen, sustainable financing, community logistics for cylinders and follow-up systems for patients outside facilities. Executive Director for the Malawi Health Equity Network and Chairperson for the CSOs Coalition for Medical Oxygen Access in Malawi, George Jobe, says the crisis is caused by underfunding and that the system fails patients even after they leave the hospital ward. "The root issue is inadequate funding within public facilities. Oxygen is expensive, and hospitals struggle to afford it, yet oxygen has no substitute. Any delivery delay is immediately fatal, meaning it must be available instantly. We need ring-fenced funding dedicated only to oxygen supplies. "For chronic respiratory patients, the government must establish clear frameworks to support home-based oxygen therapy. Currently, the mortality rate for oxygen-dependent patients remains tragically high simply because they cannot be connected to the life-saving system in time," Jobe explained Months after her daughter's death, Aisha Alick still wakes up to care for the 15-month-old grandchild Caloreen left behind. She has one request to the government: "Please help other people. Do not let another child grow up without a mother due to lack of oxygen. No family should sell everything just to buy air. If the government can help with oxygen at home, please do the right thing." Ministry of Health and Sanitation spokesperson Benedicto Mbewe was yet to respond to our questionnaire at press time. While Caloreen lost her battle with the disease in January, Jonas Mwale continues to pay K30,000 every month in Nkhata Bay just to keep breathing. The National Medical Oxygen Ecosystem Roadmap ends this year. For Aisha, the remaining question is simple: Will policy finally deliver medical oxygen to the poor before more mothers bury their children?

Times Malawi Times Malawi · Wire Report · 3 hours ago · 7 min read

When the heart fails: Tales of living on oxygen machines

Image via wire syndication · Times Malawi

WIRE — FACED A SIMILAR MONTHLY LIMBO— Phiri By Imam Wali: Caloreen Alick, 19, from Mwaiza 2 Village, Traditional Authority (TA) Kachindamoto, in Dedza District died on January 14, 2026. She had battled interstitial lung disease since giving birth in September 2024. She left behind a 15-month-old child, now cared for by her grieving grandmother, Aisha Alick. Aisha said her daughter (Caloreen) was repeatedly referred to public institutions, including Dedza District Hospital and Kamuzu Central Hospital (KCH) in Lilongwe, for oxygen therapy. "We suffered a lot. For a year, we moved from one hospital to another and my child lost her life because all the public hospitals discharged us. They did not have medical oxygen to keep her on it long term, even though she had become entirely oxygen-dependent," Aisha said Public facilities were overwhelmed and lacked medical oxygen concentrators to manage long-term cases. "We were simply told to go to the nearest local hospital for oxygen treatment," Aisha recalled. Desperate, the family sought refuge at Mua Hospital, a Christian Health Association of Malawi (Cham) mission facility, on January 1, 2026. "At the facility, we were required to pay K8,000 daily for oxygen alone. Paying those hospital bills was a tall order for us. We had already exhausted everything we owned. We even sold our livestock just to support her through this long illness." Aisha said At Mua Hospital, they were advised to buy a personal medical gas cylinder for home use. "We were told that this gas cylinder was what we would be using at home upon discharge, but it was difficult for us to raise the money," she said. Caloreen's death exposes a critical gap in Malawi's healthcare system: the lack of reliable access to medical oxygen for chronic patients. This deficit directly undermines Sustainable Development Goal (SDG) 3, which champions good health, well-being, universal health coverage and the eradication of preventable deaths. It also threatens the Malawi 2063 vision promise of quality, equitable and affordable healthcare. A 2023 cross-sectional study published in the BMC Health Services Research report found that no district or central medical ward in Malawi had piped bedside oxygen outlets. The study further revealed that 44 percent of district hospitals and 25 percent of central hospitals lacked reliable oxygen availability. Although the World Health Organisation designates oxygen as an essential medicine, supply in Malawi's public facilities remains dangerously inconsistent. This creates a lethal divide where life-saving air is accessible only to those who can afford private or mission-facility fees, directly violating SDG 10 on Reduced Inequalities. In response to the crisis, the Ministry of Health launched Malawi's National Medical Oxygen Ecosystem Roadmap on December 21, 2021. The 2021–2026 framework aims to deliver oxygen from source to patient and reduce morbidity and mortality cases arising from low blood oxygen. Yet for families like the Alicks, this strategy reads like a folktale. Caloreen is not an isolated case. Over 40 kilometres from Nkhata Bay Boma, in Mzenga Village under TA Kabunduri, 26-year-old Jonas Mwale is fighting his own battle for survival. For almost seven years, he has endured a debilitating respiratory condition. In 2018, Mwale scored 19 points in Malawi School Certificate of Education (MSCE) examinations. The results earned him a place at Kasungu Teachers' Training College. However, his academic dreams were abruptly cut short. He has been to Nkhata Bay District Hospital, Mzuzu Central Hospital, KCH and Queen Elizabeth Central Hospital (QECH). At QECH, he was diagnosed with cardiac enlargement and pulmonary scarring. "While at college, I started having serious breathing problems, weakness and swelling in my stomach. The illness got worse and I had to drop out and go back home. Because of the severe damage to the heart and lungs, I was told that surgery was not possible and was placed on specialised medication," Mwale said He now relies entirely on oxygen concentrators and cylinders to breathe. However, the financial burden is crushing; K30,000 a month for electricity alone. WANTS TO LIVE A NORMAL LIFE—Mwale "I need at least K30,000 worth of electricity every month just to keep my oxygen concentrator running at home. During frequent power outages, we switch to an oxygen cylinder. While Nkhata Bay District Hospital refills the cylinder for free, it costs us roughly K50,000 in transport fees for each trip to the Boma, sometimes twice per month," Mwale explained Mwale lives with his mother, who has no reliable source of income because caregiving consumes all her time. Despite the hurdles, Jonas is turning to entrepreneurship for survival. "I have viable business ideas. I am hoping to start selling eggs and cooking oil from home. With the proceeds, I can support my own medical costs rather than relying on well-wishers, which is unsustainable. The only thing stopping me right now is capital," he said Caloreen and Jonas' crisis is mirrored across the country, exposing a fatal flaw in post-discharge care. In Machinga, Rangwani Gatwell was fit for discharge from Queen Elizabeth Central Hospital (QECH) in February 2026 but spent weeks stranded in the ward because his family could not afford a home oxygen cylinder and regulator. In Nancholi Township, Blantyre, Margaret Phiri faced a similar monthly limbo until well-wishers purchased her breathing equipment. They are both struggling to buy medical oxygen. The crisis is not unique to Malawi. A 2025 report by the Lancet Global Health Commission on Medical Oxygen Security revealed that six out of every 10 people in the world lack access to safe, quality, affordable medical oxygen. This is contributing to hundreds of thousands of preventable deaths each year from a large number of acute medical conditions, and is reducing the quality of life for millions more living with chronic diseases. PATH Senior Programme Officer Happy Banda said that while Malawi has made progress on hospital-based oxygen through the Roadmap, the biggest gap remains after discharge. "Without sustainable financing and a home-oxygen programme, we risk discharging patients, only for them to suffer at home," Banda said. He notes that areas needing urgent development include clinical guidance for home-based oxygen, sustainable financing, community logistics for cylinders and follow-up systems for patients outside facilities. Executive Director for the Malawi Health Equity Network and Chairperson for the CSOs Coalition for Medical Oxygen Access in Malawi, George Jobe, says the crisis is caused by underfunding and that the system fails patients even after they leave the hospital ward. "The root issue is inadequate funding within public facilities. Oxygen is expensive, and hospitals struggle to afford it, yet oxygen has no substitute. Any delivery delay is immediately fatal, meaning it must be available instantly. We need ring-fenced funding dedicated only to oxygen supplies. "For chronic respiratory patients, the government must establish clear frameworks to support home-based oxygen therapy. Currently, the mortality rate for oxygen-dependent patients remains tragically high simply because they cannot be connected to the life-saving system in time," Jobe explained Months after her daughter's death, Aisha Alick still wakes up to care for the 15-month-old grandchild Caloreen left behind. She has one request to the government: "Please help other people. Do not let another child grow up without a mother due to lack of oxygen. No family should sell everything just to buy air. If the government can help with oxygen at home, please do the right thing." Ministry of Health and Sanitation spokesperson Benedicto Mbewe was yet to respond to our questionnaire at press time. While Caloreen lost her battle with the disease in January, Jonas Mwale continues to pay K30,000 every month in Nkhata Bay just to keep breathing. The National Medical Oxygen Ecosystem Roadmap ends this year. For Aisha, the remaining question is simple: Will policy finally deliver medical oxygen to the poor before more mothers bury their children?

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