In developing countries, 0.5% of the population need a prosthesis or orthosis but less than 13% of that number will be able to get one. People often assume that the way we help is by sending out to Malawi and Zambia surplus supplies of the components and materials we use in the UK – even second hand devices. We don’t because we are trying to help establish ongoing, sustainable and affordable prosthetic and orthotic services within these countries. On the recommendation of the World Health Organisation for developing countries, the in-country manufacturing system we use and promote in our projects is polypropylene technology.
500 miles has two prosthetic and orthotic centres in Malawi, both currently run by 500 miles in cooperation with and under the umbrella of the Malawi Ministry of Health (MoH).
The first 500 miles centre was built in the grounds of Kamuzu Central Hospital (KCH) in Lilongwe, the capital. Managed and funded for MoH/KCH by 500 miles, it has carried out over 10,500 patient fittings since opening in March 2009 and it has 6,500 registered patients. It is available for referrals from all over the central region of Malawi.
The second 500 miles centre is in the grounds of Mzuzu Central Hospital (MCH) in Mzuzu in the north of Malawi, and it opened to patients in November 2012. It has dispensed over 4,500 prosthetic and orthotic devices to a register of 2,500 patients. This centre serves the whole of the northern region of Malawi. We will hand over administrative and fiscal responsibility to MCH on 1st July 2021.
Zambia is a vast country and high-level prosthetics and orthotics services are not available outside the largest towns. Poverty, disability itself, the huge distances, difficult terrain and lack of infrastructure all combine to make travel to these places more or less impossible for the majority.
500 miles has sponsored the international training of at least half of the qualified prosthetic and orthotic workforce in Zambia and we have supported people in Zambia with disabilities who need prosthetic and orthotic devices but who cannot afford to pay for them.
500 miles sponsors a low-level prosthetic and orthotic service at St Francis Hospital in Katete in Eastern Province.
The long-term success of all of 500 miles’ projects depends on us ensuring that there are sufficient, well-trained Malawian and Zambian prosthetists and orthotists to provide a high-quality service which is not dependent on ongoing expatriate support. Therefore, the key element of 500 miles’ input in both countries has been sponsorship of training. If our current Zambian student qualifies, 500 miles will have sponsored 20 African technicians for 22 qualifications.