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In the heart of Malawi’s Mangochi District, Benson Chitowe embarks on a 104-kilometer journey with vaccines carefully packed in a vaccine carrier strapped to his motorbike. Heavy rain turns the roads into mud and when his motorbike breaks down, he is forced to repair it under a darkening sky.
Despite these obstacles, Benson presses on, knowing that every minute counts. If the vaccines he carries are exposed to improper temperatures, they could lose their potency, leaving countless children unprotected. This is just another day for Benson, a Cold Chain Technician (CCT), whose work ensures that vaccines remain safe and effective, even in the most challenging conditions.
More Than Just Logistics
For Benson, being a CCT is more than just a job; it’s a calling. “This work holds significant personal importance for me,” he explains. “My role is crucial not only because it helps with effective vaccine management and immunization services, but it also plays a vital role in safeguarding community health and saving lives, especially among young children here in Mangochi district and with greater impact for the health outcomes of the country.”
Benson sees himself as a vital link in a chain that stretches from central storage facilities in Blantyre (Malawi’s second-largest city) to the most remote health facilities in his district. When he first became a CCT, he saw his role primarily as a technician—ensuring that fridges were working and vaccines were stored properly. But over time, his perspective has broadened. Now, he understands how every part of the vaccine supply chain—from storage to transportation to delivery—affects public health outcomes.
“As the primary contact for vaccine logistics, supply chain and management, I have come to realize that my CCT position underscores the importance of having someone who is dependable and committed to vaccine supply chain and management to provide effective immunization services to the community, ensuring community well-being and saving lives,” Benson says.
Overcoming the Odds
The job is not without its challenges. Benson vividly remembers an unforgettable experience in 2023 when he was tasked with delivering an emergency order of vaccines to Makanjira Health Center, a demanding 104-kilometer trip from the Mangochi District Health Office. Heavy rainfall and a mechanical breakdown threatened to derail the mission. “It took me an additional three hours to repair the motorbike before I could continue my journey, arriving at Makanjira Health Center in the evening,” he recounts. But Benson’s training and foresight saved the day. He had packed sufficient cool packs to maintain the vaccines’ temperature, a crucial detail that prevented degradation and ensured their efficacy. “The cool packs played a significant role in providing a stable cooling environment during this challenging situation,” he says.
It’s this dedication and resilience that keeps Benson motivated, even when faced with malfunctioning equipment or difficult travel conditions. “I take immense satisfaction in my role as a CCT, where I face and overcome many challenges of all sizes,” he says. “My work is crucial in providing essential immunization support that saves lives in my community. It is my passion for this mission that motivates me to push forward each day.”
The Digital Revolution
In recent years, digital tools have transformed Benson’s work, enhanced collaboration and improved efficiency. For instance, to enhance supervision of the vaccine supply chain, VillageReach, with the support of Gavi, the Vaccine Alliance, developed an interactive Immunization Supply Chain (iSC) supportive supervision tool and dashboard. The tool aims to improve community health worker (CHW) adherence to immunization supply chain best practices through ongoing capacity building and mentorship, ultimately enhancing CHWs’ ability to manage vaccine supply chains, particularly in hard-to-reach areas. This work is part of Gavi’s immunization supply chain (iSC) Strategic Focus Area, a funding mechanism that supports partners in implementing Gavi’s Comprehensive Vaccine Management strategy.
The digital supervision tool has fostered better teamwork between CCTs, district health officers (DHOs), health facilities and community health workers (CHWs). “Because our tasks as CCTs involve providing clear expectations, feedback and supervision, the tools have enabled CHWs and all of us to perform our immunization duties more effectively, ultimately contributing to improved health outcomes here in Mangochi district and beyond,” Benson explains.
He recalls a specific incident during a measles immunization campaign where the digital tool prevented a potentially disastrous error. A CHW nearly used an incorrect mixing solution, but the tool allowed Benson to quickly cross-check and confirm adherence to established guidelines, so he could guide the CHW to prepare the vaccine vials safely and correctly.
Building Bridges of Trust
Benson understands that his role extends beyond technical expertise; it’s about building trust and fostering strong relationships with the CHWs he supports. “Supervision, including using the digital tool, is all about providing guidance and constructive feedback, ensuring that you are all adhering to the protocols,” he says. “Building trust with CHWs, in this case, involves open communication, active listening and providing feedback. The use of [the] digital supervision tool has proven effective in enhancing this, including improving the working relationship with CHWs providing effective immunization services to the community.”
Embracing a philosophy of supportive supervision, Benson aims to create an environment where open communication and constructive feedback are encouraged. “Supportive supervision, in this case, involves actively engaging with my CHW colleagues to identify challenges we face in maintaining the cold chain and supply of vaccines,” Benson explains.
A Tangible Impact
For Benson, the most rewarding aspect of his job is witnessing the tangible impact of his work on the lives of children in his community. He recalls a time when he traveled 191 kilometers to collect a shipment of measles vaccines, carefully ensuring their temperature was maintained throughout the journey. Upon arriving at a clinic, he encountered a child who had missed previous vaccinations due to logistical challenges. “Thanks to our diligence in maintaining proper cold chain protocols, this child received their measles vaccination without any concerns about vaccine efficacy,” Benson says. “Follow-up visits revealed no reported cases of measles among vaccinated children, a testament to the effectiveness of proper vaccine storage and handling.”
As a cold chain technician, witnessing children in the Mangochi community grow up healthier and more protected from diseases profoundly influences my passion for this work,” Benson says. “Each successful vaccination not only protects an individual child but also the entire community, reducing the overall incidence of preventable diseases and even deaths.”
Looking to the Future
Benson envisions a future where cold chain management and immunization services in Malawi are even more robust and efficient. He hopes to see enhanced infrastructure, including strategically located vaccine cold storage facilities along the supply chain and dedicated offices with cold rooms for vaccine storage at the Mangochi DHO.
He believes digital tools will continue to play a crucial role in this evolution. “I think that although the digital supervision tool can always be perfected, it makes a very good starting point enhancing the efficiency and effectiveness of health workers, particularly cold chain technicians,” Benson says.
“As a cold chain technician working alongside CHWs in Mangochi district, I hope and foresee that the digital supervision tool will evolve significantly over the coming years. These advancements will not only streamline operations further but also enhance our ability to deliver critical immunization services efficiently and effectively here in Mangochi district.”
Benson Chitowe’s story is a powerful reminder of the dedication and innovation driving progress in global health. He is a cold chain guardian, a digital champion and a true hero in the fight against preventable diseases, ensuring a healthier future for the children of Malawi.