GHSC Interview with Malawi MEO Robert Matengula

Speeches Shim

Tuesday, July 27, 2021
Robert Matengula, Mission Environmental Officer (MEO) and Climate Integration Liaison (CIL) for USAID/Malawi

GH EnviroLinks (GH): Robert, thanks for taking the time to chat with us. Could you please introduce yourself for our readers?

Robert Matengula (RM): I am the Mission Environmental Officer (MEO) and Climate Integration Lead (CIL) for USAID/Malawi. I have been with the mission since 2017 and my primary responsibility is to ensure that USAID activities are designed with environmentally sound principles and promote development outcomes that safeguard the environment. Previously, I worked as an environmental and social impact assessment specialist for Malawi infrastructure projects.

GH: Could you share with our reader some key features about the Malawi in-country supply chain system management?

RM: The Malawi health supply chain system management activity helps the Government of Malawi improve the provision of essential health services and strengthen medicine and health commodity management. The activity is largely responsible for procurement, warehousing, and monthly distribution of USAID-procured health commodities to all public health facilities in Malawi, totaling more than 650 sites. The activity has installed 238 prefabricated pharmaceutical storage units throughout the country. To strengthen the public-sector health supply chain, the activity provides technical assistance to the Ministry of Health through a range of activities. These include training and supportive supervision to supply chain management staff at health facilities, supporting forecasting and quantification, developing, and rolling out information management systems to support tracking of health commodities at the facility level, and strengthening health commodities accountability mechanisms at various supply chain levels.

GH: As the MEO, what type(s) of environmental compliance monitoring do you undertake relating to the supply chain program?

RM: My focus is ensuring that potential environmental impacts are identified and that measures to adequately mitigate the impacts are described and clearly planned for in the activity’s Environmental Mitigation and Monitoring Plan (EMMP). The mitigation measures must be fully and effectively implemented, and the resources needed, including human and financial, are made available to the implementing partner (IP) to affect the EMMP.

GH: What are the most significant environmental compliance challenges faced by supply chain system management in Malawi?

RM: The most significant environmental compliance challenge is medical waste management, including temporary storage and transportation of waste. This is particularly true with expired pharmaceuticals, the proper management of which is a key challenge for most health facilities. In addition, in the absence of a modern incinerator, the reliance on landfills makes safe healthcare waste (HCW) disposal difficult.

Most of the health clinics do not have secure waste storage facilities. This creates opportunities for thieves and scavengers to access the sites and remove stored items. In addition, HCW is often disposed of in an open pit. These pits can be located hydraulically upgradient of nearby groundwater boreholes and/or surface water sources, creating significant contamination risks to human health and the environment. In some cases, clinic staff do not have appropriate personal protective equipment and inadvertently expose themselves to biological and/or infectious wastes. This creates significant personal safety risks. It is not unheard of for some health care staff to wear slip-on, open-toed shoes while accessing these waste storage sites.

Another big emerging challenge is the widespread misuse of insecticide impregnated mosquito bed nets (a.k.a., long-lasting insecticide treated nets (LLINs)) for malaria protection by recipients and artisanal fishers. This improper use causes unintended impacts on freshwater fisheries, including the biologically rich Lake Malawi. For example, misused LLINs with very small netting contributes to overfishing of the fish populations and also introduces chemical insecticides to the freshwater resources.

Small-scale construction works under the supply chain activity, and other infrastructure-related efforts (e.g., schools, solar power stations, storage facilities, etc.) can also create challenges. Not only does the IP have to plan for construction waste disposal, but often the site is too small to accommodate the installation of the new prefabricated storage units. Additionally, the uncontrolled cutting of indigenous trees contributes to soil erosion and the poor survival rate of the new trees planted as a mitigation measure. In Malawi, nearly all new trees planted do not survive due to poor replacement tree selection, inadequate care and survival plans, and/or a general lack of space.

GH: Unmanned aerial vehicle (UAV) integration activity was first piloted in Malawi under the Global Health Supply Chain Program - Procurement and Supply Management (GHSC-PSM) project. Could you tell us about the program and provide us some insight related to environmental issues that you encountered related to UAV activity in Malawi?

RM: Through the USAID Office of HIV/AIDS, GHSC-PSM received funds to explore the use of drones for HIV/AIDS commodity deliveries to isolated and hard-to-reach communities and to better understand the potential to improve health outcomes in low resource settings. The resulting activity was designed to focus on rural settings which experience limitations in the existing distribution system and laboratory sample network. Though the UAV activity did not result in any direct environmental concern, the activity included integrated mitigation measures to account for any flight failures, hard landings and crashes which could have resulted in fire, damage to properties and contamination from Tuberculosis (TB) samples. An EMMP was prepared for the activity and mitigation measures included routing the flight away from populated areas and forests as well as proper packaging of samples to prevent spilling in case of hard landing or crashes.

GH: What else would you like to share with our Bureau for Global Health audience about GHSC projects in Malawi?

RM: One critical aspect that requires attention is sharing of environmental compliance documentation such as Environmental Mitigation and Monitoring Reports (EMMRs) and other relevant information with mission activity managers to verify compliance of the activity with USAID procedures. The mission should be kept informed at all times.


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Last updated: September 15, 2021

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