Swaziland and Malawi are moving closer to better health systems, and they’re doing it by partnering with U.S. Africa Command.   After each country asked for support, a U.S. Africa Command health care specialist made the trip for an opportunity to observe, learn and assess each country’s systems and structures.

Air Force Captain Uzoamaka Odimegwu Mbakwem was joined by specialists in military health care from U.S. Army Africa (USARAF) and the U.S. Department of Military and Emergency Medicine Uniformed Services University of the Health Sciences. They traveled to the continent to conduct doctrine, organization, training, materiel, leadership, personnel and facility (DOTMLPF) assessment visits in Swaziland and Malawi. 

DOTMLPF is a concept used to look at a country’s system or structure to identify strengths and gaps in order to build a strategic plan for the country, according to Odimegwu Mbakwem, an International Health Specialist with AFRICOM’s Medical J47. 

“With the information we gathered from this initial visit, we were able to understand the strengths and gaps in their health systems, which will help us emphasize on their strengths and build the roadmap that will help bridge the gaps,” said Odimegwu Mbakwem.  “This information matched with their goals will aid us to build and propose a strategic path for them.”

The DOTMLPF visit in Swaziland took place from June 1-7 followed by Malawi from June 10-14, 2013.

The request for the Swaziland’s visit was a collaborative effort between the country’s defense force and U.S. Department of Defense HIV/AIDS Prevention Program (DHAPP) personnel.

During the visit, the U.S. team met with Swaziland’s top officials, Lieutenant General Sobantu Dlamini, Umbutfo Swaziland Defense Force Commander, and Principal Secretary Andrias Mlumgisi Mathabelm from the Ministry of National Defense and Security, who briefed them on the country’s military medical operations, strengths and challenges.

While the visit to Swaziland was intended to promote the country’s initiative to stand up its medical corps, the visit to Malawi was aimed at helping improve the Malawi Defense Force’s (MDF) existing capabilities. 

While in Malawi, after meeting with the top U.S. official and interagency partners in the country, the team also talked to officials from the Office of the President and Cabinet’s Department of Disaster Management Affairs. 

“The overall goal was for AFRICOM/USARAF to gain an understanding of how the Malawi Military Health System works within the Malawi Defense Force and their relationship with the referral hospital under the Ministry of Health,” said Major Ronald Aquino with USARAF Medical Logistics, Plans and Operations.  

In order to gain first-hand knowledge about the strengths and gaps in the country’s existing medical corps, they visited Malawi Military Health Services (MMHS) Hospital on Kamuzu Barracks and a civilian medical establishment, Kamuzu Central Clinic. 

“We assessed their capabilities,” said Odimegwu Mbakwem.  “We looked at their equipment and the logistical aspects of their day-to-day mission.  We also looked to see if there were any limitations.  This assessment helps paint a picture about how to better assist them in reaching their day-to-day goals.”

The visit is also particularly important for Malawi to build its capabilities before Exercise Southern Accord, slated for 2014 in Malawi.

Some of the gaps common to the countries were in areas of written doctrines, infrastructures, equipment and adequately trained technicians. 

“The visit went very well,” Aquino said.  “The organization is very professional and the officers and soldiers we spoke to were very forthcoming with information.  I certainly learned a lot about how medical works for the MDF - a worthwhile experience for me.  This was the first visit that I believe we've conducted and the information gathered will definitely help AFRICOM build a better strategic objective for years to come.”  

Apart from the African militaries professionalism, the U.S. visitors were also impressed by their African partners’ enthusiasm and ability to improvise. 

“Their ability to do so much more with so much less is a very positive strength,” said Odimegwu Mbakwem. 

“Not only was it impressive, it was very motivating for me,” she added. 

“It reassures the point that it is not always about what you have, but how you take care of what you have,” she said. “When you make the best out of what you have, the sky is the limit.”

This visit sets the tone for other engagements with Malawi and Swaziland, said Odimegwu Mbakwem, who described it as a successful beginning of long-term relationships and partnerships in military health care.

“This is the beginning,” Odimegwu Mbakwem said.  “This is a start of a continuous engagement with our African partners.  It is the start of so many things that will support our African partners build on their capabilities and develop solutions to their challenges. ”