Spacers for inhalers are not available in Malawi. Here is how you can make your own with supplies that can be purchased at most pharmacies.
Illness/ Injury – Healthy Global Kids
DIY Inhaler Spacer
Asthma: Using a metered-dose inhaler (MDI) with a spacer
: Health & Personal Care
Aerosol Spacer Chamber - Compact Asthma Inhaler with Masks (Suitable for Children and Adults) (2)
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Inhale Automizer Spacer Mist Storage Tank Nebulizer with Mask CompMist Compressor Nebulizer Cup Mouthpieces for Child Baby Adult - AliExpress
Spacer for Adult and Kids
Spacer for Using Puffer - Adaptive Aid for Better and Deeper Puff Delivery Into Lungs - Coordinates Puff Inhalation with Natural Breath : Health & Household
Spacer for metered-dose inhaler
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Portable Inhale Chamber Automizer Spacer Mist Storage Compressor Nebulizer Tank Aerochamber Mask Cup Mouthpiece for Child Adult - AliExpress
Project Angkor - Julie Tea, MD - KP Global Health Blog
Doc Saves Toddler By Ingeniously Using Makeshift Nebulizer - Newsy