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 has offered ongoing support but, to its credit, MCH prefers 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.
Benadeta Singini is the manager of the P&O Centre at MCH. She took over from 500 miles’ joint managers, Australian husband and wife, Charlie Freeman and Samantha Burgio, on 1st July 2021.
500 miles sponsored Benadeta’s diploma in orthopaedic technology (2012) and her degree in prosthetics and orthotics (June 2019) 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 and 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.
Our internationally recognised Quality Improvement Consultant, Sandra Sexton created and installed a bespoke quality management system (QMS) at the P&O 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 P&O 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. This level of demand is unlikely to be sustained because approximately half of our patients were generated by 500 miles’ outreach programme which MCH has said it will not continue after handover.
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, the District Hospitals of northern region and also:
- 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 northern region with MACOHA.
- Luke International (lukeinternational.no), a Norwegian registered NGO with health, capacity building and community programmes in Malawi.
- 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.
- RIPPLE Africa (www.rippleafrica.org), a UK-based charity which is involved with education, healthcare, and environmental projects in Nkhata Bay District.
- Teneil Jayne, an American missionary, working in the Nkhata Bay area.
- Ekwendeni Mission Hospital.
- The Education Department of the Mzuzu Diocese supporting St Mary Magdalene School in Rumphi.
Although this outreach practice will not be continued by MCH, the P&O Centre at MCH should nevertheless be able to capitalise on these partnerships.