Earlier this year, we were thrilled to receive extremely positive reports from Malawi on the impact of the SMP’s Oxygen Appeal: an appeal underpinned by listening to the priorities of Malawian clinicians, coordinating various different efforts, and developing new strategic partnerships.  Following this approach, the SMP raised £45,000 and used this to fix over £1m of essential medical equipment.

In early 2021, as access to clinical oxygen became the top priority in Malawi's fight against Covid-19, the obvious response would have been to mobilise resources to purchase oxygen concentrators and ship them to Malawi. However, taking time to really listen to healthcare practitioners in Malawi, it became clear that there was a significant quantity of existing hardware already in Malawi which was not currently working but could be fixed relatively cheaply.

There was embarrassment within Malawi at the amount of non-functioning medical equipment and the lack of capacity to maintain and fix key items. Trusted, long-standing relationships allowed this to be discussed respectfully; for Malawi to outline the challenge and decide the solution. Too often donors miss this step, rushing to move quickly and assuming they have the solution. The consequence of this, over many years, has been vast quantities of non-functioning equipment building up, littering Malawi’s hospitals.

Following this Malawi-led approach, the SMP’s Oxygen Supply Expert Coordination Group, chaired most capably by Consultant Orthopaedic Surgeon, Alberto Gregori, invested appeal funds to support a local Malawian NGO ‘Open O2’, which coordinated Malawian volunteer engineers to travel across Malawi fixing and maintaining oxygen concentrators and identifying essential equipment and supplies that were lacking. At the request of these Malawian engineers, the SMP also purchased 500kg of zeolite (essential for fixing oxygen concentrators in Malawi), 100 Oxygen Saturation Monitors (essential for the treatment of those with Covid-19), and 52 Bullnose regulator valves and 52 flowmeters (to allow usage of oxygen cylinders at district and central hospitals).  

More than 300 organisations and individuals (including HRH The Princess Royal, a former Prime Minister and a former First Minister) donated to the appeal, with a total of over £45,000 raised.

With this £45,000, through ‘Open O2’, the SMP supported over £1 million of oxygen concentrators to be fixed, with systems established for their sustainable future maintenance.

In May 2022, Alberto Gregori was in Malawi treating 600+ patients and performing 87 operations. He reported that he toured the hospitals and clinics across the north of Malawi and found that every oxygen concentrator he came across was functioning (something never before achieved), with clear evidence of systematic asset management and maintenance, thanks to this appeal.

In August 2022, the Global Health Informatics Institute in Malawi wrote to the SMP, saying: “With your support, a total of 649 oxygen concentrators were returned to service, doubling the number of functional oxygen concentrators in Malawi. No value can be placed on the impact that this has had on the availability of medical oxygen in Malawi.”

All credit for this success must go to the inspiring leaders on the ground in Malawi who have managed this response so effectively, and also to Alberto Gregori for his strong commitment to listening to, and being led by, those in Malawi.

Read more about the Scotland-Malawi Oxygen Supply Co-ordination Group here.