The hospital is a referral facility for 4 small hospitals and 57 health centers. It serves a catchment area of 1.4 million people and has more than 400 beds. The maternity ward has 12 delivery beds, and it's always running at full capacity with over 30 deliveries a day!

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This is a governmental training hospital connected to the Kamuzu University of Health Sciences. Two experienced tropical medical doctors coordinate a four-year training program for family medicine specialists. The hospital can't afford a salary for all doctors, and the foreign residents like Andrea contribute monthly for the scholarships of local doctors.

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The hospital encounters challenges often seen in lower-resource settings. These include occasional power outages, making diagnosis unreliable. X-rays become impossible without electricity, and lab tests can't always be trusted. Shortages of medicines are also a major problem the district hospital has to deal with.