? The cursed position of “Director of Clinical services” in the Ministry of Health in Malawi

The Director of Clinical services at the Ministry of Health Headquarters is responsible for directing all services relating to clinical matters in all the Government Hospitals in Malawi .This is a very high position in the Ministry and the person heading the post is responsible (among many other things) for posting of Specialist Doctors, General doctors Clinical officers, medical offers and other paramedical clinical staff in various hospitals in Malawi. Most importantly this is the person who acts as a technical advisor to the Principal Secretary (PS) and sometimes directly to the Minister.
The appointment of a person to this position is political and no interviews are conducting whenever a vacancy exists. However the post is that of a top civil servant (Contract position –almost equivalent to PS ) and I do not know who appoints the officer but anecdotal evidence suggests that it is t the Health PS in position who suggest the suitable name to the Secretary of President and cabinet .
In a system where ministers of Health and PS’s are frequently changed one would expect the Director of clinical services to be the gate keeper of ministry of Health and remain in that vital position for a while.
In my 12 years of working in the ministry of Health I have noted that this position is one of the most cursed position in the Ministry; and that when one is nominated to take up the post; they should be preparing to leave the post anytime regardless of their performance (for once I do not know how they are assessed and who assesses them).
Just within the last 12 years there have been 7 Directors of Clinical Services (of whom 6 have been doctors and one a clinical officer).

The table below summarises terms served by the persons involved
Year, Directors names, What happened and where now?
1996-1998 Dr W Chaziya Removed & Practising outside Malawi
1998-1999 Dr R Pendame Promoted to PS and later removed; working outside Malawi
2001-2004 Dr R Mpazanje Removed and working outside Malawi
2004-2005 Mr Mthotha Demoted in 2005;working outside Malawi
2005-2006 Dr D Lungu Removed ;sent to work as a specialist in a hospital in Malawi
2006-2007 Mr Mthotha Promoted and sent outside Malawi as medical attaché
2007- Dr MC Joshua Demoted ;sent back to district hospital
2007-2008 Dr GC Mwale Currently in position

It is worth noting that once these top civil servants have been removed from the position of Director of clinical services; they normally get jobs outside Malawi.

But the question remains; with such a rapid turnover are these people able to grasp and act on the Ministry of Health needs? I don’t think so. By the time they start understanding the politics of the ministry and are ready to start implementing their plans then they are replaced.
Are wrong people being selected? Considering that this is such an important position should there be interviews to select people with appropriate credentials?

Next time the vacancy of Director of Clinical services exists at the Ministry of Health in Malawi, don’t suggest my name- because this position is cursed and one can not last no matter how good they claim to be.

Do you believe in Curses? I don’t!!

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