LILONGWE Malawi President Bingu wa Mutharika was in a coma on Thursday after a heart attack and was about to be flown to South Africa for treatment, a senior minister said, raising fears of a political crisis in the impoverished southern African nation.
A Reuters reporter in Lilongwe witnessed chaotic scenes as the 78-year-old leader's wife, Callista, and senior cabinet ministers left Kamuzu Central Hospital, where Mutharika was admitted on Thursday morning after collapsing.
"There was panic," one hospital staffer told Reuters. "We have never been prepared for such an eventuality. He suffered a cardiac arrest and his condition is still unstable."
Malawi is one of the world's poorest countries, and a senior minister said Mutharika would be flown to South Africa for emergency treatment. An ambulance carrying the president left the hospital and headed towards the airport.
Vice-President Joyce Banda wished Mutharika a speedy recovery, domestic media reported, though the two have had a difficult relationship since Banda was expelled from the ruling DPP party in 2010 after a row over the succession.
The constitution makes clear she is first in line to take over, putting her on a potential collision course with Mutharika's inner circle, including his brother and foreign minister Peter, who normally deputizes in Bingu's absence.
Police deployed in force across the capital, especially near the hospital, while 15 army officers took up position around Banda's residence, witnesses said.
Mutharika's condition drew little sympathy on the streets of Blantyre, the commercial capital, where many people view him as an autocrat who has mishandled the economy, causing chronic shortages of fuel, food and foreign exchange.
"Perhaps the end of our suffering is also nigh," said Benson Msiska, a taxi driver stuck in a long queue for petrol.
Mutharika, a bespectacled former World Bank economist, came to power in 2004 and presided over a seven-year boom - underpinned by foreign aid and favorable rains - that gave Malawi one of one of the world's fastest-growing economies.
The good times came to a juddering halt last year after a dispute with Britain led to tit-for-tat diplomatic expulsions and the freezing of millions of dollars of aid.
The cause of the row was a leaked diplomatic cable that accused Mutharika of being "autocratic and intolerant of criticism".
The aid freeze by Malawi's biggest donor exacerbated an already acute dollar shortage, hampering imports of fuel, food and medicines, and leading to a fall in the value of the kwacha against the dollar.
Malawi's diplomatic isolation and economic plight worsened in July 2011 when the United States shelved a $350 million programme to overhaul the dilapidated power grid after police killed 20 people in a crackdown on an unprecedented wave of anti-government protests.
Mutharika hit back in typically combative style, urging his supporters last month to "step in and defend their father rather than just sit back and watch him take crap from donors and rights groups".
(Additional reporting by Frank Phiri in Blantyre and Olivia Kumwenda in Johannesburg; Writing by Ed Cropley; Editing by Jon Herskovitz and Tim Pearce)