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.
Benadeta Singini has been our manager since July 2023. Benadeta is a Malawian, fully qualified prosthetist/orthotist. 500 miles sponsored Benadeta’s diploma in orthopaedic technology (2012) and her degree in prosthetics and orthotics (June 2019). Benadeta previously worked at the 500 miles prosthetics and orthotics centre in Mzuzu where, after qualifying with her degree from Mahidol University, she received two years of extensive management training from 500 miles’ expatriate managers there before taking over from them as the manager herself. Read more about Benadeta here.
We currently have three additional qualified Prosthetic and Orthotic Technicians (Maliwase, Peter, and Mwayi all of whose training to diploma level was sponsored by 500 miles) and five Prosthetic and Orthotic Assistants (Dominic, Mike, Mona, Charles and Yohane) – and our receptionist, Maggie, who will welcome you on arrival.
We are in the process of installing the quality management system (QMS) created for us by internationally recognised prosthetist/orthotist, 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 14,200 patient fittings for a register of over 9,125 people. Our usual production rate is over 120 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:
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 December 2023) and then, around the end of 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. Following that handover, 500 miles intends to continue to support the service for a few years. We will do this by funding and subsidising the purchase of devices for those who cannot afford to buy them through our One Smile fund and also possibly by sponsoring further training.
Completing and implementing the QMS over the period leading up to the handover 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.