The Borrow Foundation – a new friend for the MalDent Project

In 2018, Professor Lorna Macpherson had kindly introduced me to Nigel Borrow, Director of The Borrow Foundation, and his colleague Margaret Woodward, during a visit they made to Glasgow. That visit was associated with work being undertaken on oral health improvement in Thailand, which is funded by The Borrow Foundation. During my brief time with Nigel and Margaret we talked about the MalDent Project, in particular the strand that relates to establishment of a prevention strategy for Malawi. It was agreed that we would meet again at a later date to look at possibilities for collaboration.

That meeting took place on Friday 1st February 2019. Lorna and I flew to Southampton on the Thursday afternoon and were picked up at the airport by Nigel and Margaret who drove us to The Old House Hotel in Wickham, where we would stay overnight.

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The Old House Hotel – full of charm and character and a lovely place to stay

Informal discussions began over a very convivial dinner that evening. After a good night’s rest we set off after breakfast on the Friday morning for The Borrow Foundation Headquarters in Waterlooville.

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Nigel Borrow, Margaret Woodward, Lorna Macpherson and myself at The Borrow Foundation Headquarters

The morning was spent in the Board Room. Our meeting commenced with a comprehensive summary from Nigel and Margaret on the fascinating history of The Borrow Foundation and the extensive range of projects it is currently supporting. The Foundation is a UK Registered Charity whose mission is “to promote the improvement of oral health, primarily in children, through  the prevention of oral diseases”. It interacts extensively with Government departments / agencies, academic institutes, dental associations, NGOs and other charities in order to deliver its agenda. Details of The Borrow Foundation’s impressive array of existing projects are available on its web-site at http://www.borrowfoundation.org.

It became clear that the strand of work within the MalDent Project which aims to develop, in conjunction with the Ministry of Health, an oral health strategy for Malawi fits very closely with the mission of The Borrow Foundation. We enjoyed a very positive discussion, the outcome of which was agreement that Lorna and I would develop a short briefing paper describing areas of activity in which collaboration with The Borrow Foundation would be worthy of further consideration by the Trustees.

After lunch, Nigel drove us to Southampton Airport for our flights home. Despite the snow our flight was only slightly delayed and FlyBe had us back in Glasgow by early evening.

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It had been a very busy and intense 24 hours, characterised by positivity and enthusiasm. Lorna and I are very grateful for the generous hospitality afforded us by Nigel and his team at The Borrow Foundation and we look forward to the exciting collaborative opportunities that lie ahead for the MalDent Project.

Dentistry meets optometry – useful lessons for MalDent

In an earlier post I described the Health Forum organised by the Scotland Malawi Partnership on 23 October 2018 and held in Edinburgh City Chambers. One of the delegates present was Dr Karen L. Paarz who has been heavily involved in developing optometry training in Malawi. Karen recognised many parallels between the optometry project on which she has been engaged and the MalDent Project. Very kindly, Karen agreed to come across to Glasgow Dental School to speak with me and we finally met on 23rd January 2019. Karen was accompanied by her husband, William Elliott, who had supported the work to establish optometry training in Malawi.

Karen’s work has been undertaken under the auspices of the Brien Holden Vision Institute (https://www.brienholdenvision.org), an Australian not-for-profit, non-governmental organisation which is dedicated to eye care research and enhancing delivery of eye care.

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Karen at work in Malawi

Karen has been the Principal Investigator on the ‘Malawi Optometry Human Resource Development Study’, the Executive summary of which can be accessed at: https://brienholdenvision.org/news/item/140-mzuzu-university-graduates-report-on-experience-as-optometrists.html

Karen’s description of her work in Malawi held many lessons for us as we move forward with the MalDent Project. We look forward to continuing interaction and I am grateful for access to Karen’s experience and advice following her extensive involvement in developing both training and clinical service in optometry within Malawi.

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With Karen and William following our meeting

 

Thank you Dentaid – the MalDent container is packed with equipment and on its way!

Those of you who follow the MalDent Project blog regularly will remember seeing these photos some months ago, when the dental chairs that have been donated by the NHS Greater Glasgow & Clyde Oral Health Directorate were loaded onto our rented 7.5 tonne truck by Paul and Robert, two members of our great hospital portering team, and then delivered by Will McLean, Mike Broad and I to the Dentaid Headquarters near Salisbury.

Since then Stuart Bassham, Dentaid’s Workshop & Engineering Manager, has been working with his team of volunteers to ensure that all of the chairs are in good working order, replacing parts where necessary. In addition, Dentaid is donating six pre-clinical skills phantom head units, all of which they have refurbished and checked fully.

Excitement mounted in the week beginning 17 December, when this arrived in the Dentaid yard:

The next stage of the journey from the basement of Glasgow Dental Hospital to Lilongwe was about to begin and it was time for Stuart and his team to load all of the dental equipment that had been carefully serviced and repaired into the 33.2 cubic metres of this shipping container.

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About halfway there!
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Loading the last few items – packed to the gunwales!

This is heavy work and Stuart and his team will have been more than ready for a good brew by the time they had finished:

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Job done – ready for the truck to arrive for Southampton

Whilst their work is done for now, as the cargo rides the waves, Dentaid’s involvement is far from over. Stuart and a small team of engineers will be involved with the installation of the equipment after its arrival in Malawi, to ensure that the clinical facility and the pre-clinical skills laboratory in Lilongwe are fully functional to support both clinical service and teaching.

The involvement of Dentaid as a partner in this phase of the MalDent Project has been critical. I would particularly like to thank Andy Evans, the CEO of Dentaid, Jacqueline James, their Overseas Projects & Volunteering Manager, John Elkins, Finance Director and Stuart Bassham, Workshop & Engineering Manager, along with all the volunteers who have participated.

If you would like to support the work of Dentaid and its volunteers, there is some information here and lots more on their web-site at http://www.dentaid.org.

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Finally, I would like to acknowledge the generous financial support of Scottish Government International Development, without which none of this element of the MalDent Project would have been possible. You can follow their activities on Twitter @ScotGovID.

A trip to Edinburgh – the Scottish Government International Development Grant-holder’s Information Day

A Scottish Government International Development Grant-holder’s Information Day was held at the Norton Park Conference Centre in Edinburgh on Thursday 13 December 2018. Alex Mackay from the Wellcome Centre for Molecular Parasitology represented the University of Glasgow Blantyre – Blantyre Project and we travelled across from Glasgow together to join the event on behalf of our respective projects.

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With Alex Mackay representing the University of Glasgow 

The invitees were from a broad range of backgrounds with projects in Zambia, Rwanda and Malawi. It was a full house for what turned out to be an excellent event.

The agenda was a packed one but with plenty of opportunity for networking and some very important learning on areas such as safeguarding and project reporting:

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After some brief words from Joanna Keating, the Minister for Europe, Migration and International Development, Ben Macpherson MSP, arrived to deliver the Opening Remarks. In a very passionate presentation he spoke of his experiences during his first six months as Minister, particularly the importance of collaboration as a fundamental pillar of the work we are all involved in delivering. He described Scotland’s ambition to be a positive voice on the global stage and of its ‘Beyond Aid’ agenda, taking an holistic approach to sustainable development. The need for behavioural change in the context of issues such as climate change was viewed as critical in the bid to end poverty and fight inequality. The Minister stressed the importance of two major issues on the day’s agenda – safeguarding and gender equality –  and the need for us all to build public confidence in international development activity. He described how privileged he felt to have worked with a variety of international development teams and to see for himself the difference being made on the ground. In closing he looked forward to a positive and purposeful 2019.

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The Minister, Ben Macpherson MSP, delivers his Opening Remarks and sets the tone for the day’s events 

Following the Minister’s presentation, Joanna Keating, Head of the International Development Team, took us on a whistle-stop tour of the work of her team over recent months. It was extremely impressive, as reflected in one of the many tweets during the day from Alex!

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You may also like to read an account by the Minister of his recent visits to Zambia and Malawi which can be found at: https://blogs.gov.scot/international/2018/10/25/minister-we-should-be-proud-of-how-we-play-our-part-in-tackling-global-challenges

There followed an excellent presentation by Philippa Ramsden of the Scottish Development Alliance on safeguarding, an issue that has been thrust into prominence by a number of revelations within the charity and international aid sector over the past year. Philippa described the on-line “Safer for All” safeguarding support package launched by the Alliance on 5 December 2018 (https://www.intdevalliance.scot).

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Philippa Ramsden spoke about the safeguarding work undertaken by the Scottish Development Alliance and introduced the new ‘Safer for All’ support package

This package “...is designed to provide organisations with the information, tools, resources, and support needed to ensure that safeguarding practice meets the highest standards”

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Eileen Flanagan of the Scottish Government Equality Unit followed the safeguarding presentation with a talk on the role of gender equality as part of culture change. She spoke about the Equally Safe strategy, which is Scotland’s strategy for preventing and eradicating violence against women and had been updated in 2018. Details are available at https://www.gov.scot/publications/equally-safe/.

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Eileen Flanagan speaking on gender equality

After a brief coffee break, Bernie O’Hare gave a presentation on the NHS Scotland Global Citizenship Programme.

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Bernie O’Hare at the lectern, speaking on global citizenship

This recent innovation was discussed at the Global Citizenship Conference at the Royal College of Physicians & Surgeons of Glasgow (RCPSG) earlier this year and has been mentioned in a previous blog post.

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The Scottish Global Health Coordination Unit (https://www.scottishglobalhealth.org) has been established to support NHS Scotland Global Health workers to provide capacity and expertise to the co-ordination of health partnership work in NHS Scotland.

We have submitted details of the MalDent Project which you can view at: https://www.scottishglobalhealth.org/.projects/towards-a-dental-school-for-malawi-the-maldent-project Thanks to Kerry Chalmers, Senior Policy Manager at NHS Scotland Global Citizenship, for facilitating this.

Next up was a fascinating presentation from Martin Rhodes, Chief Executive of the Scottish Fair Trade Forum.

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Martin Rhodes updating delegates on the Scottish Fair Trade Forum

The Scottish Government is committed to the fair trade agenda. Martin pointed out that doing trade fairly is part of the ‘Beyond Aid’ agenda. You can read more about the Scottish Fair Trade Forum at: http://www.scottishfairtradeforum.org.uk

After a short but very interesting interactive session which gave us all an insight into the daily work (and challenges!) for the Scottish Government International Development team in dealing with public enquiries and ministerial questions, we broke for lunch. This was a great opportunity for discussion and networking and was a chance for me to have a catch up with Lisa McManus who was representing the RCPSG for the Livingstone Fellowships, but of course the RCPSG is also a key stakeholder in the MalDent Project.

Immediately after lunch we broke into groups by country of activity. The session in the ‘Malawi Room’ started with a presentation from David Hope-Jones OBE, Chief Executive of the Scotland-Malawi Partnership (SMP). The earlier post which covered the SMP AGM has provided much information about the excellent work of this organisation, which is funded by the Scottish Government (https://www.scotland-malawipartnership.org).

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David Hope-Jones OBE describing the activities of the Scotland-Malawi Partnership

David mentioned the forthcoming launch of the full official Conference Report from the Malawi and Scotland: Together for Sustainable Development conference in Lilongwe on 28 and 29 September 2018. That report has now been published and can be viewed at the following web address:

https://issuu.com/scotland-malawipartnership3/docs/conference_report_-master/76

Following this presentation, a number of grant-holders gave 3 minute presentations about their individual projects – a fascinating range and depth of activity.

After the ‘country huddles’ we all came back together for an outstanding presentation by Professor Bob Kalin of Strathclyde University who has a distinguished track record of working on water resource management in Malawi:

He pointed out just how critical water supply is to economic growth and overall well-being of a country:

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In his very pragmatic talk he introduced the concept of stranded assets:

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This is a concept that is of immediate relevance to the MalDent Project, because of the complexity of the equipment required to deliver dentistry and the challenges around maintenance and repair. Actions that are designed to mitigate these risks are built into the project plan but will require careful and vigilant monitoring.

Finally we were treated to an excellent and very practical presentation from Carrie Sweeney on mid-year and annual reporting.  The key dates of 30 April (end of year) and 30 October (mid-year) were stressed as hard deadlines. Furthermore, underspend forecast reports were required by 31 January each year.

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Carrie Sweeney delivering her master-class on grant reporting

One of the key messages was “Don’t mess with Carrie’s spreadsheets” – the format is fixed for a reason – there are hidden formulae!

A brief summary of the day and a short quiz brought the event to a close. I, for one, had learnt a great deal and was very grateful for the opportunity to meet with all the other grant-holders.

Judging by their smiles, Nicola Cogan and Ian Nicol, our grant managers for both  the Blantyre Blantyre Project and the MalDent Project, looked happy with how the day turned out.

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Nicola and Ian with the Malawian flag as backdrop

Let’s hope we can maintain those smiles during our mid-year and end-of-year review meetings!

Back to Mangochi – the final BDS curriculum conference

One of the first and critical milestones for the MalDent Project is to develop the curriculum that will form the basis of the teaching on the new Bachelor of Dental Surgery programme at the University of Malawi. If the first intake of students is to take place in August 2019, then University approval of the curriculum is an urgent priority. To this end, significant work has been taking place in recent months, involving the Dental Association of Malawi, the College of Medicine and external partners, including Wits University and the University of Glasgow.

In September, Peter Chimimba intimated to me that a final Curriculum Conference was to be organised in Mangochi from 26-29 November 2018. It was agreed that I would attend and that my colleague, Niall Rogerson, should accompany me. In addition to his role as a member of teaching staff in Restorative Dentistry in Glasgow, Niall is also the Quality Officer for the College of Medical, Veterinary & Life Sciences, with an extensive knowledge of assessment and quality assurance procedures. In addition, he has been supporting the newly established Dental School at the University of Rwanda for the past four years, through which he has developed significant understanding of the logistics and challenges of delivering dental education in sub-Saharan Africa.

We started our journey from Glasgow Airport on Friday 23 November:

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The flights to London Heathrow and from there, overnight, to Johannesburg were on time and smooth. We had three hours to kill before the connecting flight to Blantyre, and enjoyed some eggs, smashed avocado and coffee during the stopover.

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Great re-fuelling and rest stop for an aviation enthusiast!

Our final flight with South African Airways was also on time. We were served a very tasty meal and landed on schedule at Chileka Airport, Blantyre, where we organised visas and were met by a College of Medicine driver, who transported us to the Sunbird Mount Soche Hotel.

After a good night’s sleep, we were collected on the Sunday and driven to the Sunbird Nkopola Lodge Hotel at Mangochi – a roughly four hour journey. On arrival we checked into Rooms 24 and 25 – each one a self-contained small chalet …

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… with beautiful views over Lake Malawi

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… and a chess set next door!

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Monday 26 November was the first day of the Curriculum Conference. When we arrived in the meeting room, we were surprised at the number of delegates – 50 in total.

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Delegates gathering before the opening of the conference
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Niall ponders the day ahead

The day’s events were chaired by Professor Nyengo Mkandawire, the Dean of the Faculty of Medicine, who will be familiar to those of you following the blog. The BDS programme will sit within the Faculty of Medicine.

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Professor Nyengo Mkandawire opens the day’s events, which started with a prayer

The Principal of the College of Medicine, Dr Mwapatsa Mipando, set the scene for the conference, with a high level overview of the project to establish a Dental School in Malawi.

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Dr Mwapatsa Mipando, Principal of the College of Medicine, who has been an inspirational driving force behind the MalDent Project, delivering the first presentation of the day

The Principal’s address was followed by an excellent presentation from Dr Peter Chimimba, the Coordinator for the MalDent Project at the College of Medicine.

IMG_8226~photoPeter detailed the progress that has already been made and it was astonishing to hear of the tremendous volume of work that had been undertaken by him and his colleagues in a short space of time. This work had culminated in the draft curriculum document that would form the basis for the work due to commence the following day.

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Peter delivers his update on the current status of the MalDent Project

The timelines for the project were shared, which reminded delegates of the relatively short time-frames within which we are working:

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The pressure to move the project forward efficiently was further emphasised by a Malawian newspaper headline from 29th September announcing that the new dental school would open in 2019!

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The Guest of Honour was Dr Jones Kaponda Masiye from the Ministry of Health, who was representing the Minister of Health, Hon Atupele Muluzi MP.

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Dr Masiye delivering his Guest of Honour speech

Dr Masiye explained that he had graduated in medicine from the University of Malawi College of Medicine, but before that he had been a qualified dental therapist. Ideally, he would have wished to study dentistry, but no course was available – an uncanny coincidence that he had been given the opportunity to speak at this dental curriculum conference! He stressed the commitment of the Ministry of Health to the MalDent Project and later in the morning gave a second, excellent presentation on the current oral health status and scope of practice in Malawi, covering both staffing and clinical facilities, which highlighted graphically the need for investment in oral health services.

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The Principal, myself, Peter, Niall, Prof Simon Nemutandani (Wits University), Prof Jennifer Webster-Cyriaque (University of North Carolina) & Mr Richard Ndovhie (Medical Council of Malawi) enjoying Dr Masiye’s lecture

The last presentation before the morning break was from myself, covering current trends in dental education and the importance of preventive dentistry in the overall strategy for oral health in Malawi.

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My presentation contained a significant amount of content relating to the Scottish Childsmile disease prevention model

Before coffee was served, we were invited to walk out into the sun-drenched morning for a group photograph.

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Prof Dixie Maluwa Banda, Deputy Director of the National Council for Higher Education and Dr Masiye head out for the photo – two very important figures for the MalDent Project, both of whom were extremely supportive

Once assembled, the large group of delegates who had been invited to participate in the curriculum conference made for an impressive and colourful photo:

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After the photograph was taken, there was much discussion in the open air before we moved back inside for the refreshments:

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Profs Dixie Banda and Simon Nemutandani in deep discussion with Peter

There was considerable media interest in the event. Before coffee, Dr Masiye, Dr Mipando and I all gave interviews and I understand that there was subsequently an item on MBC News. The following video clip shows part of the Principal’s interview with the gathering of journalists:

After coffee, Prof Simon Nemutandani, Dean of the Dental School at Wits University, delivered his presentation, which provided a very insightful analysis of the MalDent Project from an African perspective.

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Prof Simon Nemutandani delivers an African perspective on the project

He reiterated comments made earlier by the Principal about the direct contact made by the President of Malawi to the College of Medicine, stressing the need to establish a Dental School for the country:

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Particularly important is the requirement that from the outset the BDS programme is designed to reflect the needs of Malawi:

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It must also take into account the background and needs of the students themselves,  in addition to the needs of their future patients:

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Simon’s perspective was of particular value and relevance to those of us supporting the MalDent Project but who come from European and American healthcare environments, which vary in so many ways from the Malawian situation.

After a very enjoyable lunch (the finest mushroom soup I’ve ever tasted!) Niall delivered a presentation about his experiences providing support to the new Dental School at the University of Rwanda:

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This project had received very significant support from Harvard University and Niall stressed how important he believed this had been in the early stages of the course. His slide showing some of the first Rwandan BDS graduates celebrating after receiving their degrees was a very positive motivator for all of us as we set out on the journey of establishing a similar course in Malawi.

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Students from the first group to complete the new BDS programme in Rwanda celebrating at their recent graduation ceremony

Professor Jennifer Webster-Cyriaque from the University of North Carolina, USA, has been working with the Dental Therapist programme at the Malawi College of Health Sciences for a number of years. Jennifer’s presentation focused on development of the teaching faculty, a critical element of the MalDent Project as outlined in one of her early slides:

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Mentorship at all levels will be an important component of the project and I particularly liked the following slide:

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The Principal then spoke about the various aspects of the financing of the Dental School. The infrastructure needed to teach dentists is expensive and careful financial planning is essential. The funding from the Scottish Government is providing the critical support needed to begin the journey towards a sustainable Dental School and already other partners are becoming engaged with the project, so the momentum is building.

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The Principal, Dr Mipando, discussing resourcing of the Dental School

The first day of the conference finished with a dinner in one of the function rooms – a relaxing end to a busy day.  However, the really hard work was about to begin as the conference progressed!

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Relaxing with good food and conversation at the Conference Dinner

On the Tuesday, delegates assembled in casual clothes to begin the curriculum work proper. The first session commenced with a summary of the previous day’s presentations and discussion delivered by Dr Jessie Mlotha-Namarika. 

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Jessie providing a summary of the previous day’s events

We then moved on to consider the draft curriculum document in detail. There was a considerable amount of discussion which culminated in a division of the work. Prof Nyengo Mkandawire took the lead on the curriculum for Years 1 and 2, which would be delivered jointly with the MB BS students. A second group, which included all the dental delegates, was chaired by Prof Simon Nemutandani and concentrated on Years 3-5. For both groups, the discussions resulted in a large volume of re-formatting and editing of the curriculum content, which continued through into the evenings.

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Many minds concentrating on the curriculum content and documentation!

Simultaneously, other aspects of the documentation were being worked upon. These included assessment methods and quality assurance, areas in which Niall was able to play a significant role.

The groups joined forces again on the Wednesday morning to present the re-worked outlines of  each year of the curriculum. Much had been achieved and agreement was reached on the overall structure. This was a big step forward and allowed final editing to commence.

Mr Richard Ndovhie from the Medical Council of Malawi had been invited to deliver a presentation about the internship which each of the new dental graduates would be required to complete before professional registration.

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Mr Richard Ndovhie represented the Medical Council of Malawi

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He described the functions of the Medical Council, its powers and the content of the internship year, concluding with a slide that summarised the expectations of an intern:

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As the formal meeting drew to a close, it was clear that there remained a large amount of editing and formatting to complete. However, as Niall and I were not leaving for the UK until Saturday morning, there was still time to assist with this work on the Thursday and Friday once we returned to Blantyre.

The meeting had been intense but a great success. Dr Emma Thomson, a paediatric surgeon who is the Head of the College of Medicine Education and Training Office, had been present throughout the event to provide support and guidance

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Dr Emma Thomson taking an uncharacteristic break from her laptop!

The Secretariat of Lucia Msiska (PA to the Principal), Brenda Maluwa (PA to the Dean of Medicine) and Gift Kayuni (who has supplied many of the photos in this blog) did a fantastic job. The organisation was first-class and their hard-work ensured that the conference and associated logistics ran very smoothly.

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Lucia and Brenda hard at work behind the scenes – thank you.

We were due to leave Mangochi on the Thursday morning to return to Blantyre. Accordingly, our bags were packed into the car at 10am, leaving just enough room for a large sack of fresh mangoes!

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Our driver looks sceptical as the mangoes are pushed into the boot – the lid did eventually close!

We arrived back at our hotel in Blantyre in the afternoon. After dropping our bags, we were taken to the Principal’s Office at the College of Medicine to meet with Jerome Galagade, for a discussion about the changes to the MalDent Project log-frame that had been suggested by Chrissie Hirst at my recent meeting at the Corra Foundation. The changes were agreed and we then headed back to the hotel, in a torrential downpour,  to continue work on the curriculum editing.

On the Friday morning, editing continued. Niall was taken by Peter to visit the recently refurbished dental clinic at the Blantyre Adventist Hospital, that I had seen previously. After lunch, we headed back to the College of Medicine. Peter took Niall on a tour of the campus and to visit the Queen Elizabeth Hospital Dental Centre whilst I spent time in the magnificent College of Medicine Library, finalising some edits for Years 3-5.

At 3.30pm we were due to meet with the Principal and the Dean.  It was St Andrew’s Day and in keeping with the Scottish Government’s wish to spread a little kindness in “celebration of the nation’s shared values and inclusive view of the world” we took a photo that reflected the collaboration and friendship between Scotland and Malawi which underpins the MalDent Project. What an excellent opportunity for us to wear our Scotland Malawi Partnership gear and for Lucia to show off the University of Glasgow hoodie she had received from Alex Mackay during her visit to Glasgow last March!

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St Andrew’s Day in the Principal’s Office

After a very positive round-up meeting in the Principal’s Office, Peter, Niall and I accompanied Nyengo to his office to discuss the final knitting together of the curriculum document. A plan was hatched and by the time Niall and I were picked up at 10.30am on the Saturday morning to head for the airport, the final draft of the curriculum document was complete – mission accomplished.

It had been an exceptionally intense week, with a number of ups and downs, but through it all the collegiate spirit had kept us going. The energy and enthusiasm of all involved in the MalDent Project is infectious and as we said farewell to Peter at the hotel, we were already looking forward to our next visit.

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With Peter at the Sunbird Mount Soche just before Niall and I left for the airport 

Our journey home was smooth and we returned home feeling that one of the important milestones, the drafting of the curriculum, had been achieved.

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The A380 that would transport us from Johannesburg to Heathrow

Since returning to Glasgow we have heard that the curriculum document has been approved by the College of Medicine Academic Board. It can now move forward through the other levels of the University of Malawi approval process for eventual ratification by its Senate – fingers firmly crossed!

 

Working together – Childsmile, Bridge2Aid, Smileawi, Rwanda and MalDent

One of the things that has struck me most strongly since I became involved with the MalDent Project is the large number of organisations and individuals undertaking support and development work in low and middle income countries. This was exemplified by the presentations at the recent Scotland Malawi Partnership AGM and NHS Scotland Global Citizenship Conference, both of which were described in earlier posts.

Historically, oral and dental health have been viewed as relatively low priorities in many low income countries, when compared with such overwhelming health challenges as HIV, malaria and tuberculosis. Nevertheless, groups such as Rotary International and the UK charities Dentaid and Bridge2Aid have been operating in this sphere for many years. More recently, the Scottish charity Smileawi was established by Glasgow BDS graduates Nigel and Vicky Milne, as discussed in a previous post.

A number of friends and colleagues have voiced to me the potential value of “joining up some of the dots”, by linking together organisations and activities where there are synergies and benefits from working together, both from a skill-mix and capacity perspective. With that in mind, Glasgow Dental School hosted a meeting recently which brought together a group representing the charities Bridge2Aid and Smileawi for discussions with University of Glasgow staff involved with the dental school projects at the Universities of Rwanda and Malawi and two leading academics from the Childsmile programme.

The first part of the meeting was devoted to a presentation and discussion of Scotland’s Childsmile programme (www.child-smile.org.uk).

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Lorna Macpherson describing the Childsmile Programme

Lorna Macpherson gave an excellent overview of the programme, from its inception to the present day. Points that came through very strongly were:

  • The Childsmile programme is a theory-based initiative founded on established sociological and public health principles.
  • It has benefitted from the combined power of academic, health service and political buy-in, under-pinned by continual evaluation of the programme and its outcomes, with ongoing modifications as necessary.
  • The proven, significant health economic benefits of the Childsmile programme provide a persuasive argument for policy-makers:

Childsmile economics

This approach has significant implications for those attempting to improve oral health in low and middle-income countries, where prevention of dental disease, as opposed to treatment of established disease, is a number one priority.

After a break for coffee, Nigel and Vicky Milne described the work of their charity Smileawi, since its inception in 2012.

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Vicky and Nigel Milne describing the work of Smileawi

The scope of their activities in Northern Malawi has been growing annually, including delivery of dental care through teams of volunteers, provision of oral health education, re-equipping of dental clinics and sponsorship of Malawian students training as dental therapists. They had approached Glasgow Dental School in 2017 to enquire about the possibility of taking some student volunteers to the villages in which they work to begin collecting some baseline epidemiological data. This will come to fruition in June 2019 when five BDS4 students will join a volunteer team for that purpose. Lorna Macpherson and David Conway have agreed to guide development of the data collection forms. These pilot data, once collected, will feed into the activities of the MalDent Project, one stream of which is the establishment of a version of Childsmile suitable for use in rural African environments.

Lunch in Café AntiPasti, just across the road from the Dental School, was followed by an update on the progress of the MalDent Project. Next, Niall Rogerson spoke about his experiences over the past four years collaborating with the University of Rwanda, which has seen its first cohort of students from the new Dental School graduating this year.

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Celebrations for the first group of BDS graduates from the University of Rwanda!

This is a tremendous achievement and provides strong encouragement for the ongoing work in Malawi.

Finally, Shaenna Loughnane, CEO of Bridge2Aid, and Andrew Paterson, who is a clinical lead and trustee of the charity, spoke about its work up-skilling clinical officers to perform emergency dentistry in Tanzania.

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Shaenna Loughnane and Andrew Paterson outlining the work of Bridge2Aid in Tanzania

I had observed their work first hand in September this year when I was privileged to visit one of their volunteer teams in action in Chato (see earlier blog post). The model of working was very impressive and over the past 14 years a large number of clinical officers have been trained, providing access to emergency dental care for many residents in rural parts of Tanzania

The afternoon closed with a wide-ranging discussion that identified multiple ways in which joint working would be feasible. Already, Niall’s experiences at the Dental School in Rwanda are providing valuable indicators for the Malawi Dental School Project. The Childsmile model lends itself to a wide variety of modifications suitable for different environments and will be developed as part of the prevention package for the MalDent Project, but would be equally applicable in Tanzania and Rwanda. Similarly, the Bridge2Aid model has clear potential in Malawi and it was agreed that further exploration of this possibility would be undertaken.

Discussions centred on collaboration continued into the evening over dinner. A number of plans were hatched – follow the blog for updates!

Thanks for log frame support from the Corra Foundation

I mentioned in an earlier post how helpful and efficient the Corra Foundation (https://www.corra.scot) had been during the Scottish Government Malawi Funding Round 2018. Queries were answered swiftly and always in a very helpful and friendly manner.

One of the more challenging aspects of the submission was constructing the log-frame. This type of tool, for measuring progress of a project against pre-determined milestones, is used widely in the management of international development projects.  The following WHO slide provides a useful summary of the value of a log-frame:

WHO log frame slide

The terms ‘Impact’, ‘Outcomes’ and ‘Outputs’ all have very specific connotations, requiring a disciplined application and particular mind set, which requires practice! Whilst the log frame we submitted with the grant application was adequate, there was room for improvement and in the MalDent Project grant award letter there was a condition that we re-visit the log-frame within the first six months of the project. The Corra Foundation kindly offered to help with this review and once again has provided exceptional guidance and support.

The offices of the CORRA Foundation are in Riverside House on Gorgie Road in Edinburgh, about a 30 minute walk from Haymarket Station.

502 Riverside House

On 6th November I visited the office for a meeting with Chrissie Hirst, who spent 90 minutes delivering a master class in the art of log-frames. As a newcomer to the discipline I fear that I was a rather hapless pupil, but by the end of our meeting I felt equipped to develop a further draft based on Chrissie’s expert advice.

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Following many deletions and amendments, together with prolific use of a green highlighter, Chrissie directed me towards a re-drafted log-frame

The new draft, once approved by all stakeholders, will act as the blueprint against which our progress with the MalDent Project will be assessed at regular intervals over the lifetime of the grant.

Many thanks to the Corra Foundation, and to Chrissie in particular, for this very valuable input. The phrase below was on the wall of the room in which we were working – let’s hope the MalDent Project manages to do just that.

Making lasting change