Shoring up Pharmaceutical Storage Systems

How Immunization Services Quickly Resumed Following a Hospital Fire in Malawi

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Fire due erupts at Mangochi District Hospital in Malawi, destroying critical vaccine supplies. Photo Credit: MSH

Vaccinating a newborn or immunizing a pregnant woman may seem like a simple interaction between a health care provider and a patient. In reality, providing a quality vaccine to someone who needs it involves managing a complex network of organizations, individuals, processes, and actions. When one part of that system fails due to interruption or delay, patients and families are left vulnerable to preventable disease.

Immunization saves millions of lives every year from preventable diphtheria, tetanus, pertussis (whooping cough), and measles and an additional if global vaccination coverage improves.

On April 15, a power surge following an electrical blackout started a fire inside the Mangochi District Hospital in Malawi. The fire destroyed the entire maternal and child health unit, which held vaccines intended for the more than 45,000 children and an equal number of pregnant women served by the hospital.

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Much of the Maternal and Child Health block was completely destroyed by fire. Photo credit:MSH

Worse still, 44 health facilities and 312 outreach sites rely on stock from Mangochi in order to administer vaccines to women and children under Malawi’s National Expanded Program on Immunizations (EPI). Refrigerators, including those storing vaccines for polio, measles, and tetanus, were also damaged in the fire.

The fire at Mangochi illustrates how quickly circumstances can change, compromising vaccine quality, inflicting major costs on health systems, and putting lives at risk.

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A newborn receives an oral vaccine during a 2017 vaccination campaign in Malawi. Photo credit: MSH

The USAID-funded, MSH-led Organized Network of Services for Everyone’s (ONSE) Health Activity works in 16 districts across Malawi to reduce maternal, newborn, and child morbidity and mortality. One of its health systems strengthening activities includes supporting the collection and distribution of immunization supplies to facilities to help increase vaccine coverage in these districts. ONSE also provides targeted supervision and mentorship on EPI.

In response to the fire, ONSE quickly mobilized to help re-establish a temporary vaccine storage depot in Mangochi and collaborated with the national EPI program to arrange emergency transport of supplies and equipment from Lilongwe, Malawi’s capital, to Mangochi. The shipment included adequate stocks of vaccines, four refrigerators capable of storing about 8,000 vaccine vials each, cold boxes to ship the vaccines between regional storage sites and the district, vaccine carriers used to ship the vaccines to outreach clinics, and other equipment required to carry out the vaccination program.

Following this rapid response, immunization services resumed just two days after the fire.

ONSE was able to mobilize quickly and support an emergency response, but going forward the Activity will consider how health facilities can be better prepared and how districts can incorporate disaster planning into their district plans. ONSE can work with district counterparts to continue supporting electrical and infrastructure assessments and upgrades, including ensuring the presence of smoke detectors, fire extinguishers, and emergency action plans in health facilities.

ONSE can also work with health facilities to include fire preparedness as part of its mentoring strategy; support districts to include mentoring for fire and emergency preparedness as part of their planning and ongoing activities; and be available to support transport and other resources as needed should another incident like the Mangochi fire occur.

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