The 500 miles Prosthetics and Orthotics Centre is in the grounds of Kamuzu Central Hospital (KCH), the main tertiary care hospital for central region. 500 miles built and now runs this facility for the Malawi Ministry of Health (MoH) as part of the Malawi government health service. We have responsibility for management and funding.
In line with Malawi government policy, 500 miles is a “paying service” and we always ask for an affordable contribution to try to secure its future sustainability, but we will always meet the cost of devices for those who cannot afford to pay.
Our current premises are a modern kit building which was provided, erected and fitted out for us in 2010 through a joint venture among the Lord Provost & International Office of Glasgow City Council (Glasgow LP’s Office), Glasgow City Building (GCB) and 500 miles (funded by The Maitri Trust). The Glasgow LP’s Office and GCB kindly refurbished the building in September 2019.
Our manager is Evelyne Huizinga, a physiotherapist from the Netherlands. She is one of the founders of a charity in Malawi called DIPD with which we work closely. Evelyne is well known to 500 miles because she managed the centre for us for approximately two years in 2013/2014. We are delighted that she came back in July 2020.
We currently have four qualified Prosthetic and Orthotic Technicians (Maliwase, Peter, Mwayi and Samuel) and five Prosthetic and Orthotic Assistants (Dominic, Alwin, Monalisa, Mike and Charles) – and our receptionist, Maggie, who will welcome you on arrival.
We are in the process of creating and installing a quality management system (QMS) through our internationally recognised Quality Improvement Consultant, Sandra Sexton.The initiative is largely funded by Johnson & Johnson. The creation and implementation of a QMS is crucial for the sustainability of a high-quality service for our patients for the long term.
Since 500 miles at KCH opened to patients in March 2009, we have carried out over 10,500 patient fittings for a register of over 6,500 people. Our usual production rate is over 100 devices each month. Over half of our patients are returning patients.
Many of our patients are referred by KCH or other medical services and NGOs in the area, such as Children of Blessing Trust, and many of our patients “walk-in” because they have heard about us – but we also actively pursue an outreach programme with a view to making our service genuinely available to everyone in central region. In this we work closely and with great cooperation with a number of partners. They include KCH itself and all of the District Hospitals in central region and:
- Malawi Government agencies – MAP and MACOHA (funded by CBM).
- Beit Cure International Hospital, an American private hospital in Blantyre, which runs charitable children’s clinics in central region with MACOHA.
- DIPD (Development and Integration of People with Disabilities project) which was set up by our manager and operates mainly in the Mchinje area.
- Positive Steps (www.positivestepscharity.org), a UK charity set up by Jane Cherry which is dedicated to providing medical/health care assistance to people in the Nkhoma area through Nkhoma Mission Hospital.
- United Nations High Commissioner for Refugees (UNHCR) which runs the Dzaleka refugee camp near Dowa.
- African Vision Malawi (www.africanvision.org.uk), known in Malawi as the Landirani Trust, a UK charity which aims to create lasting change for children and vulnerable people in a 400km2 area north west of Lilongwe.
- St John of God Hospitaller Services (www.sjog.mw), a UK charity with an Order in Malawi which provides health and social care to sick, vulnerable and disadvantaged people.
We intend to move our Lilongwe service into the rehabilitation section of the new Lilongwe Institute of Orthopaedics and Neurosurgery (LION) when it is completed (estimated Spring 2022) and then, around 2024, to hand over fiscal and administrative responsibility for running our service to the management of LION (a public/private partnership with MoH), by which time all of the staff will need to be employed by MoH. 500 miles will then continue to support the service by funding and subsidising the purchase of devices for those who cannot afford to buy them and by meeting its training needs.
Completing and implementing the QMS over the next four years will enable us to build and secure the capacity and quality of the prosthetic and orthotic service at the centre for the long-term and that is a top priority.