Samuel Walker

• Age: 26
• Profession: Physiotherapist MCSP BSc (Hons)
• Home town: Kirkby In Ashfield, Nottingham
• Work History:
  • NHS Physiotherapist at Sherwood Forest Hospitals NHS Trust for 4 years.
  • Physiotherapist in Tanzania 3 months and in Albania 4 months.

Seeds are sown…

Back in July 2012 I, Sam Walker, started my walk with 500 miles; how time has flown and the amount exciting things that has happened over that same period of time! I had been working in the UK for about 4 years as a NHS physiotherapist when I saw the opportunity to work with 500 miles in helping to set up and develop a Prosthetic and Orthotic service in the northern region of Malawi. Since my first year at university at the University of Nottingham I had started to find the field of prosthetics and amputee rehabilitation a very interesting and inspiring area of Physiotherapy. I soon realised that the field of amputees and physically disabled was where I wanted my learned skills to be used if the opportunity arose. During the 4 years after graduating as a qualified physio I also started to set my eyes on using my skills further afield than the roots of my homeland. After about 8 trips to different developing countries, each between 2 weeks to 4 months, either with physiotherapy work or healthcare development as a focus for the trips mostly in Africa I discovered this was also where I eventually wanted to be using my skills. So when saw the opportunity to work with 500 miles my heart leaped, and then when I was actually given the opportunity to work with 500 miles in Africa my heart did a cartwheel! And then when my NHS trust accepted me to have a career break to do this opportunity you can imagine what my heart was doing…

New roots…

In August 2012, following a month’s training with the previous manager of 500 miles P&O centre in Lilongwe Joanna Cole-Hamilton, I arrived in Mzuzu the biggest settlement in the Northern region. Even though it is named a city it still has kept its town-like feel with its open vibrate markets and more bicycles to cars ratio. I have been told the air is a bit thinner here as Mzuzu sits on a plateau that is apparently as high as Ben Nevis, this probably a small factor to the relaxed and less hectic vibs that are evident here. The first task I had as manager when arriving was to help manage the building site of the new P&O 500 miles centre on the grounds of the Mzuzu Central hospital that was a little delayed in its completion.

Once completed with good cooperation from the hospital all the heavy machinery were installed and set up making the centre ready and fully operational in November 2012, when the first clients started to come and get assistance. This challenging time to get everything in place ready for opening was also a fruitful time of understanding the hospital systems and developing firm foundations for good relationship with the hospital. I love that the building is made with the same design of the rest of the hospital, and I do believe clients and hospital staff feel it is an established part of the hospital already, that 500 miles is here to stay and being welcomed to graft into itself into the healthcare system of Malawi.

New fruits…

Some of the first clients that came to the new 500 miles centre at Mzuzu Central Hospital were in fact old clients that had previously been delivered a device from 500 miles in Lilongwe. The names Susan Banda and Robert Kamanga will be familiar to some who have followed 500 miles in the past (you can see their stories by clicking here). They were both very excited to hear the new centre was opening as it meant they would not have to travel so far to get the specialised service. There are lots of exciting stories also about new individuals who have been struggling for decades without assistance either because they did not know there was a service that could help them or that it was just too far and expensive to go to Lilongwe.

It is amazing to see the 500 miles staff find a long-standing problem that has been with that individual for years and fitting a new device that corrects the deformity, relives some pain and improves mobility almost instantly! For example 83 year old Haiton Tembo, who is a village headman, came last month to the centre and had a deformed limb which was weak and shortened limb from polio at age 4. Therefore for about 80 years he had walked struggling, but now fitted with a KAFO with a joint orthosis he is able to mobilise much easier and with a lot more comfort. You can see the improvement by watching the before and after videos in his story here. The number of new clients with similar stories is growing as the message of 500 miles in the northern region expands its reach. To date we have been able to assist over 250 new clients with new devices to improve their mobility and give them hope that they have not been forgotten!

New grafting…

One of parts of the job which I have enjoyed over the last year and half is developing partnerships with other services or organisations that are also involved in assisting the disabled in Malawi. We are always in whatever setting in life stronger and more effective when we work together! It is exciting to hear about other groups of people’s hearts for the disabled in the communities around us and that same heart and desire beats at 500 miles to help disabled become restored and valued. It has been amazing to see how this side of developing the service has taken off in the north, sometimes the organisation has just come to the door of 500 miles and say ‘we have these people we would like to help more but can’t, we are happy this 500 miles P&O service is now available in the northern region to help these individuals how can we help them?’. Through these other organisations, like St John of God, Ripple Africa and MAP, it has been shown to be the most effective way to identify those who need this service in the area which we should be serving. Another aspect that has been interesting to watch develop is how physiotherapy can be integrated into the service to benefit 500 miles clients.

We were very blessed in April 2013 that the amputee rehabilitation team from my old NHS trust wanted to give their old set of PPAM aid early walking aid equipment to 500 miles. This equipment (pictured in the photograph) allows an amputee client to mobilise very early after surgery, which helps prepare them or assess them for using a prosthetic limb. It also encourages stump healing, can reduce phantom limb pain and swelling. I can see that this new aspect to the 500 miles service will be a very important step in assisting amputees here in Malawi as normally for the CRE technique used to make a prosthetic limb a client has to wait for 3-4 months from surgery before using a new limb, due to stump healing and swelling. Now with this equipment we have been starting the rehabilitation process earlier with clients when they are still even on the surgical wards, so promoting their overall mobility and confidence in becoming a potential limb wearer.

New rapid growth…

I am excited for the coming year ahead for 500 miles in the northern region, there are going to be lots of continuing opportunities to provide our services to many more needy Malawians. Earlier in 2012 we embarked on a comprehensive sensitisation and outreach assessment programme for the whole of the northern region where the service should reach. We started this in Mzimba North district close to Mzuzu but still very rural at the same time. The response was astonishing! Over 250 physically disabled individuals were assessed by the 500 miles staff in 5 days of outreach assessments and this revealed about 150 of these individuals were appropriate for the P&O service and were booked appointments. This is only a third of one district out of seven that are in the northern region! The need here is great, people in the villages rarely move far and often don’t know about specialised services or where to get assistance. Also there can be a lot of discrimination towards disabled individuals particularly in the more remote and less educated areas; this always causes people to lose hope and feel rejected by their society. My hope is that as we continue to reach out with the information about the new 500 miles service and create access for those who need it, we will continue to find those individuals that have been struggling along on their own. That they are if possible given some assistance with their mobility and function that helps their communities, often in a dramatic way, to see their lives are full of worth, respect and dignity. And as these disabled individuals continue to battle on with their wealth of strength and spirit of determination they will eventually see discrimination defeated in their communities.

View from the tree top…

I have thoroughly enjoyed my time as manager of 500 miles in Mzuzu so far and learnt so much from the challenges that have sprouted up along the way. I am looking forward to what the next year holds for us where there will be more growth and more development of the service (added with more challenges to learn from!) so that we can together continue to reach and assist more disabled individuals here in Malawi.

Thank you for this opportunity to grow and to watch something very special mature to benefit those who really need this assistance and who are truly grateful for it!

Sam Walker