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The hospital was built by the Dutch Reformed Missionaries in 1959. Some buildings were builted with mud-bricks.It is a training institution offering two nurse training programmes.Bridging course for Proffesional nurses and two Year Programme for enrolled nurses.Madwaleni hospital is situated in the rural part of the Eastern region.It is 96 km from Mthatha and Nelson Mandela Academic Hospital which is its referral institution.Population served 262,326. Communities served are from Elliotdale, Mqanduli, Dutywa, Willowvale and parts of Mthatha. It is a hospital with 220 beds.