500 miles created a prosthetic and orthotic centre and service for Mzuzu Central Hospital (MCH), the main tertiary care hospital for northern region. The centre opened in November 2012 and was managed, funded and developed by 500 miles until it was fully handed over to MCH and the Ministry of Health in Malawi (MoH) on 1st July 2021. 500 miles offered ongoing support but, to its credit, MCH preferred to be independent.
All of the buildings at MCH are uniform and so the premises, which consist of a 250 sqm modern clinic and workshop and a 100sqm hostel to accommodate travelling patients, had to be constructed using a traditional Malawian building method and local labour. The layout of the buildings was designed by Andreas Huck of Sophies Minde Ortopedi and the centre was constructed during 2012 using a Malawian professional team and construction company.
On 1st July 2021, 500 miles’ joint managers, Australian husband and wife, Charlie Freeman and Samantha Burgio, handed over management responsibility for the prosthetic and orthotic centre at MCH to Benadeta Singini. Benadeta’s training to degree level was sponsored by 500 miles and she received extensive management training from Samantha and Charlie over the two years leading up to handover.
500 miles also sponsored the training to diploma level of Tiwonge Nyahoda and Maxwell Goliath for MCH. Eviness Nkumba and Clinstone Kamanga were trained on the job as prosthetic and orthotic assistants. All of these people were employed by MoH in readiness for handover
Internationally recognised prosthetist/orthotist Sandra Sexton created and installed a bespoke quality management system (QMS) at the prosthetics and orthotics centre at MCH, largely funded by Johnson & Johnson. Its purpose was to secure the future quality of both the product and service at the centre by systematising every aspect of it.
From when the prosthetics and orthotics centre at MCH opened to patients in November 2012 up to the handover of the centre on 1st July 2021, 500 miles carried out 5,182 patient fittings for a register of 2,694 people. Our usual production rate was around 60 devices each month.
Due to the different and more challenging demographics of northern region (compared with central region), from late 2013 onwards, 500 miles developed and ran an outreach programme to ensure that people in the north of the country who needed our service were aware of it and were able to access it. We embarked on a comprehensive, systematic, community by community sensitisation and screening programme, concentrating on the largest and most populated district, Mzimba. In addition, we carried out regular outreaches in Rumphi and Nkhata Bay.
We also developed the centre’s client base through collaborating with a number of partners locally and in our outreach work, including MCH itself and the District Hospitals of northern region. Although this outreach practice has not been continued by MCH, the prosthetics and orthotics centre at MCH should nevertheless be able to capitalise on these partnerships.