A pot-pourri of recent MalDent Project activities

Despite the challenges of the COVID-19 pandemic, many of the core activities of the MalDent Project continue to make good progress. This post provides an update on some of the recent developments.

Refurbishment of the Dental Department at Kamuzu Central Hospital

One of the projects that has been delayed by the pandemic is Phase 2 of the refurbishment of the Dental Department at Kamuzu Central Hospital in Lilongwe. Following the success of Phase 1, financial support from Scottish Government and the Royal College of Physicians & Surgeons of Glasgow HOPE Foundation has funded the collection and refurbishment of more dental chairs and dental simulator equipment which Dentaid has serviced ahead of transportation and installation in Lilongwe. We have purchased a shipping container and it was loaded just before lockdown. On 23rd September I had a call with my friend and colleague Stuart Bassham, Dentaid’s Warehouse and Engineering Manager.

Enjoying a conversation with Stuart – we’re moving forward with Phase 2

We have decided to arrange for shipping of the container from Dentaid’s depot in Southampton in the next few weeks. This should ensure it arrives in Lilongwe in early 2021, when it will be placed permanently on a site in the grounds of the College of Medicine campus, adjacent to Kamuzu Central Hospital. We will unload the equipment when we visit Lilongwe to undertake the installation, which is tentatively scheduled for June 2021.

Scotland Malawi Partnership Meeting Annual General Meeting, 3rd October 2020

Throughout the COVID-19 pandemic, the Scotland Malawi Partnership (SMP) has done a fantastic job of keeping partners in both countries connected and updated on the progress of the infection in our respective homelands. The regular Zoom meetings, which commenced on 31st April 2020, have been informative and, despite the challenges of the pandemic, inspirational in many ways. The COVID-19 hub on the SMP web-site is an excellent source of up to date information.

The SMP Annual General Meeting, held virtually on 3rd October 2020, was a highlight of this year’s activities. One of the centrepieces was the keynote speech from the President of Malawi, Dr Lazarus Chakwera:

In his uplifting speech, Dr Chakwera outlined the priorities he saw for the relationship between Scotland and Malawi in the coming years.

One presentation that was of particular interest for me was the update on the COVID-19 case numbers in Malawi, delivered by Dr Mwapatsa Mipando, Principal of the University of Malawi College of Medicine and a driving force behind the MalDent Project. The data he presented were very encouraging:

Dr Mwapatsa Mipando gave a very clear and positive presentation on COVID-19 in Malawi

However, fingers remain crossed that the pattern of disease seen in many other parts of the world, and currently presenting a major challenge in Scotland, is not repeated in Malawi. As I write this post on 23rd October, things remain hopeful, as demonstrated in the figure below, tweeted by the Government of Malawi Ministry of Health yesterday:

Other details of the SMP AGM are all available to interested readers on the Scotland Malawi Partnership web-site.

Participation in WHO Africa webinar on COVID-19 impact on oral health care service

Regular followers of this blog will have read previously of the MalDent Project links with Dr Yuka Makino, who is the WHO Africa Technical Officer for Oral Health, based in Brazzaville. Yuka played a central role in the National Oral Health Policy Workshop in Lilongwe held on 13th and 14th February 2020.

We were approached by Yuka to ask whether we would contribute to a webinar that she was organising entitled ‘Continuity of essential oral health service in the context of COVID – WHO African Region’. The event was run on 28th and 29th September.

Yuka introduced the objectives of the webinar:

Objectives of the webinar

Yuka had invited speakers from around the globe, including Dr Benoit Varenne who is the Dental Officer at the World Health Organization, based in Geneva:

The programme for Day 1

The presentation on the situation in Scotland and the broader UK was scheduled for Day 2:

The programme for Day 2

It was a privilege for the University of Glasgow to participate in the event.

In addition to speaking about the UK context, Yuka had asked me to provide an update on the MalDent Project, and the challenges that had arisen from COVID-19. I focused on the challenges of delivering on-line learning to students in Malawi because of issues around accessibility of digital devices, WiFi and affordable data bundles. It was good to be able to report on how joint working between Scotland and Malawi had been able to overcome some of these difficulties at the University of Malawi College of Medicine.

This was an excellent webinar, very well organized and run by Yuka. It finished with two concluding slides:

As I read the second of these slides, which focused on the now well-known phrase ‘Build Back Better’, it struck me how many of these recommendations are feeding directly into the ongoing work of the Government of Malawi Oral Health Policy Task Force. In a future blog post we will update on the work of that group, which aims to publish a finished policy document by the middle of 2021.

Recordings of both days of the webinar are available on YouTube and are recommended to all interested readers.

Day 1: 28th September 2020
Day 2: 29th September 2020

Progress with design of the integrated dental teaching facility and student hub

Further to the earlier post, the Stage 1 Report has now been finalised and presented to the MalDent Project team by Paul East and his colleagues at the Edinburgh offices of John McAslan + Partners. The final page of the report includes a rendering of the concept for the building at this stage of the design process.

An exciting vision of how the future may look

Following the initial presentation of the Stage 1 Report, Mwapatsa Mipando shared the draft document and the recording of the design team discussions with key stakeholders at the College of Medicine. He hosted a formal feedback session, to ensure inclusivity of all players who would benefit from this exciting enhancement to the campus infrastructure:

Subsequently, that feedback was shared with Paul East and the design team, followed by a Zoom meeting in which Mwapatsa Mipando and Peter Chimimba clarified queries raised by the local responses.

Following up on the points raised by the feedback session held in Malawi

Paul and the design team have now commenced on Stage 2 of the design process, which is scheduled for completion by the end of November 2020.

Developing a childhood caries prevention programme for Malawi

Ronald Manjomo, the recently appointed PhD student based at the College of Medicine, has made an excellent start on his study programme. He provided an update at a meeting held on 20 October with his two main supervisors, Professors Ken Maleta (College of Medicine) and Lorna Macpherson (University of Glasgow).

Ronald and his supervisory team enjoying a discussion on the current work plan

Since Ronald’s work feeds directly into the activities of the Oral Health Policy Taskforce, he is now joining the meetings of that group as an Observer in the first instance.

In addition to funding from the Scottish Government MalDent Project, Ronald is partly funded by the Borrow Foundation. The Borrow Foundation has recently updated its web-site, which now includes a link to the MalDent Project and specifically mentions the work that Ronald is undertaking as part of our overall programme.

In conclusion, we are maintaining momentum for the MalDent Project despite the COVID-19 challenges. Once again, it is the very strong partnership working at all levels, and the enduring support of our funders, that is enabling us to make progress.

In the very first post I wrote for this blog on 1st September 2018, I quoted Helen Keller, who said: “Alone we can do so little; together we can do so much”. That has proved so true for the MalDent Project to date and has laid the foundations that will see us through the COVID-19 challenges towards achieving our aim of ‘Oral health for all

Stage 1 building design concepts revealed to the MalDent team – great excitement!

At the third meeting between the design team members and the MalDent team, held recently on Zoom, Paul East of John McAslan + Partners, together with his colleagues, presented the work they have been undertaking to complete Stage 1 of the design process for the new Dental School / Student Hub Building on the Blantyre campus of the University of Malawi. It was an exceptionally exciting and eye-opening two hours. Little did we know what was to follow after the opening slide of the presentation.

Paul initially reminded us of the phasing of the project and associated timeline. The team is working to a very tight schedule but at present it is all on track, which is a fantastic achievement:

The time-line

For the the first part of the presentation, Sophie Burgess provided a description of the site analysis that had been undertaken. Of the three possible locations that had been previously identified, Site B was chosen as the one that best satisfied the design brief.

Consideration of the site selection – Site B proved the winner

This choice was superimposed on a photograph of the campus, which illustrates its position on the perimeter of the existing buildings but bordering open space for potential future developments.

Site B in the context of existing campus buildings

The site was also considered from the perspective of photographs taken from different locations. These pictures also serve to illustrate the stunning backdrop for the new building.

Photo survey of the site from different vantage points

We were next given information on the topographic analysis that has been completed. There is a significant slope to the site, which it later transpired would be very relevant to the design process.

Analysis of the topography of Site B

Paul and Sophie next handed over to Sam Haston from Buro Happold, to discuss the climatic analysis that has been completed. It was fascinating to hear how impactful the climate data are in relation to the design process.

Weather data were available from Chileka International Airport

Every aspect of the climate, including temperature, relative humidity, wind speed and cloud cover were considered at each time of the year.

Parameters of the local climatic conditions throughout the year

Sam explained how combined use of shading and air-flow could have massive impacts on levels of comfort for those using buildings and how relevant consideration of these factors were critical to the design process.

The importance of shade and airflow for human comfort

To explain this in more detail, Sam gave a description of what are known as passive design principles

He showed a diagram illustrating how overhangs can be used to provide shade to the North and South elevations, but that vertical structures are more efficient on the East and West:

There are also rules governing building designs that will increase the efficiency of cross ventilation:

The priority for this building is to use passive design principles as much as possible to reduce the amount of mechanical ventilation required. This improves natural efficiency, reduces power usage and enhances the green credentials of the building.

Prioritise natural over mechanical ventilation

In addition to natural ventilation, there are many other design features that can improve the overall efficiency of buildings and which are environmentally friendly. These are all being considered during the design process:

The final slide in this section summed up the opportunities provided by Site B and why it had been chosen over Sites A and C.

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The multiple opportunities provided by Site B

Paul then moved on to the brief, to explain the progress of the team through Stage 1.

One of the first considerations had been to consider how the functional elements should be organized within the structure, to ensure appropriate adjacencies.

Consideration of adjacencies

Having considered the adjacencies, the next step was to consider how the various elements should be organised. On their next slide, we were treated to the first set of architect’s hand drawings which then morphed into three possible organisational options – ‘organic’, ‘slices’ and ‘spine’.

Organisation of the functional components of the building

Paul then proceeded to take us through a series of slides which illustrated how each of these three organizational options could begin to translate into a concept for the building. The design team had come to the conclusion that Option 3 – Spine, worked best.

The building would extend over three floors and this is where the topography of the site became relevant to the design.

The distribution of facilities across the three floors of the ‘spine’ design

We were then treated to a series of pen and wash sketches, through which the design was developed and emerged. I have always loved this type of illustration, and to see the design concept appearing out of the page was incredibly exciting.

Early development of the spine design

In this sketch, the use of the lie of the land is becoming clear.

Further refinement of the initial sketches

Another sketch provided an illustration of how the entrances to the building and surrounding landscaping could be envisaged.

Landscaping and surroundings

Suggested floor plans were illustrated for each level of the building

An example of one of the floor plans

The design then emerged through a series of sketches …

… followed by computer simulations based upon those sketches:

Paul explained that some of the components of the design had stemmed from considering features of other buildings that had similar requirements in the brief, so-called precedents:

At the end of the two hour presentation, there was general discussion about progress and the vision for the building design that had been shared with the MalDent team. In summary, we were both astonished at the amount that had been achieved and delighted with what was being proposed.

It was agreed that Dr Mipando would share the recording of the presentation with other key stakeholders in Malawi, to garner their views and feedback. Paul agreed to send the printed Stage 1 report to all present.

Reflecting on the workshop held in Blantyre in September 2019, led by Professor Chris Platt, it is now extremely exciting to see the design appearing, based upon principles that flowed from those stakeholder discussions held a year ago. The benefits to the entire campus will be legion, quite apart from providing a teaching focus for the new BDS programme. Thanks to John McAslan + Partners, together with the design team they have established, we are off to a flying start!

On-line clinical examinations now a possibility at the College of Medicine

In an earlier post we reported on the generous support of Scottish Government International Development which allowed the purchase of digital devices to allow students at the University of Malawi College of Medicine to participate in remote on-line learning.

We were subsequently contacted by Dr Emma Thomson, the Director of the College of Medicine Education and Training Office, to ask whether we had any experience of delivering clinical examinations using on-line platforms. At Glasgow Dental School we have been very fortunate that a small team of academic staff has perfected a method for running Virtual Objective Structured Clinical Examinations (VOSCEs) via the on-line platform Zoom.

Recently my three colleagues James Donn, Alun Scott and Craig Mather delivered an excellent presentation for Emma, which demonstrated the methods they have developed. In addition to the VOSCE format, they also gave a demonstration of how the same on-line platform has been used recently to run the Case Presentation examination for our Fourth Year BDS students.

James Donn, Alun Scott, Craig Mather, Emma Thomson and I enjoying some informal conversation at the end of the presentation

The presentation was recorded and the video file made available to Emma so that she can share it with Prof Nyengo Mkandawire, the Dean of Medicine, and with other interested colleagues in Malawi.

Sharing ideas and novel methods for teaching and assessment during the COVID-19 era are an essential part of life for all higher education institutions. The potential for delivery of on-line examinations also provides added value to the investment made by Scottish Government in the purchase of the digital devices. A great example of collaboration and innovation!

First meeting of the Malawi National Oral Health Policy Task Force

The National Oral Health Policy Workshop held in Lilongwe last February resulted in the establishment of a task force to take the policy development work forward under the aegis of the Ministry of Health and Population (MoHP).

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Delegates at the National Oral Health Policy Workshop, Lilongwe, 13th and 14th February 2020

After the workshop, the Ministry drafted Terms of Reference for the task force, but by March we were being challenged both in Malawi and the UK by COVID-19. Inevitably this placed significant pressures on all parties to manage the pandemic, resulting in some delay, but on Thursday 27th August the first meeting of the task force was held via Zoom, chaired by Dr Nedson Fosiko, Deputy Director of Clinical Services in the MoHP.

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Participants in the first meeting of the Oral Health Policy Task Force

The main purposes of the meeting were to confirm acceptance of the Terms of Reference and then to map the way forward for developing the policy.

Brian Chaima, from the Policy Development Unit, Department of Planning & Policy Development at the MoHP, took us through a brief presentation on the standard process used for policy development by the Malawi Government.

The initial step is to develop a concept paper:

Screenshot 1 croppedMuch of the content required to create a concept paper was covered at the Policy Workshop in February and this stage will be relatively straightforward.

Once the concept note has been approved by the Principal Secretary, the next stage is to develop a Policy Analysis Document (PAD):

Screenshot 2 cropped

This phase of the process requires a situation analysis. One element will be a rapid review of relevant literature, which Lorna Macpherson and I have agreed to lead on, with involvement of Ronald Manjomo. We will also create a list of key questions relating to the local environment e.g. up to date statistics for the oral health workforce in Malawi. This will involve consultation with a wide range of stakeholders and we will work closely with Peter Chimimba and Wiston Mukiwa on this part of the programme.

On the basis of the situation analysis, policy options will be generated, followed by a process of policy impact assessment:

Screenshot 3 cropped

Ultimately a recommended option will be generated together with an accompanying implementation plan:

Screenshot 4 cropped

Finally, the Policy Framework Document will be developed, for review and approval by senior Ministry and Government officials up to the level of the Cabinet:

Screenshot 5 cropped

This is a complex and ordered process, but being led by Nedson Fosiko and Brian Chaima from the Ministry of Health & Population will ensure we keep on track. A series of regular meetings is now being scheduled to ensure we also keep to time!

 

Scottish Government support for digital devices unlocks on-line teaching at University of Malawi College of Medicine

The COVID-19 lockdown has affected all areas of our lives. The impact on higher and further education has been no exception. In the UK and many other high income countries the availability of internet based platforms such as Zoom has played a major role in helping to mitigate the cessation of face to face teaching on campuses. In the Dental School at Glasgow we were able to rapidly transition to on-line teaching and assessment methods which allowed us to complete the 2019/2020 academic session for all of our students in May / June 2020. The steep learning curve for both staff and students was challenging, and it is remarkable what has been achieved.

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Glasgow Dental School staff preparing for a Virtual Objective Structured Clinical Examination (VOSCE)

Whilst it may have been challenging we were fortunate to have access to the necessary digital technologies. Sadly, the same cannot be said for many low- and middle-income countries. At the University of Malawi College of Medicine the campuses were closed to students from the middle of March 2020, with no delivery of undergraduate teaching since then and no assessments undertaken. 

There have been two major challenges. One of these is the wide geographic variation in WiFi availability within Malawi. Many of the students have gone home to their villages in rural areas and are without readily accessible WiFi. Purchase of data bundles is relatively expensive and beyond the means of many students. The second major challenge is that many students do not have access to suitable digital devices on which to download teaching materials and undertake their studies. It would be very unfair for any university or college to deliver on-line teaching if some of the students were unable to access it, merely adding to inequalities within the student body.

The College of Medicine identified that 267 of its 1076 students did not have access to suitable digital devices for on-line teaching. In mid-June it therefore launched an appeal called #267forCOM to “bridge the digital divide”.

267 for COM Twitter

This digital access issue and appeal were of immediate relevance to the MalDent Project. The students on the BDS 1 course, which had commenced in August 2019, were severely affected along with all the other undergraduate programmes, including the foundation course which also included students keen to join the next cohort of dental students. However, regardless of their course of study, this challenge of digital access was impacting all students across the College of Medicine, and required an urgent partnership response.

By chance, I had been speaking about digital delivery of education to health care workers with my good friend Shaenna Loughnane, who is CEO of the charity Bridge2Aid, with whom we are working on the project to up-skill Medical Assistants in Malawi to deliver emergency dentistry. Shaenna is engaged in projects that use digital delivery for education of healthcare workers in Tanzania, and she was instantly keen to help.

We set up a Zoom meeting with Dr Mwapatsa Mipando, Principal of the College of Medicine and Dr Emma Thomson who leads the College of Medicine Education & Training Office, to consider possibilities. A number of options were discussed including fund-raising in the UK, an approach to the Turing Trust by Shaenna and an approach by myself to the Scottish Government to enquire whether some re-purposing of a small amount of the MalDent Project budget may be possible.

It soon became clear that fund-raising would be too slow to provide the urgent support needed to bring teaching back on track. Shaenna had a very productive discussion with the Turing Trust which raised the possibility of  purchasing, at low cost, up to 50 laptop computers from a consignment which, at the time, was in a container en route to Malawi and bound for distribution to schools via their partnership organisation the Centre for Youth and Development.

For my part, I worked with Deirdre Kelliher, our MalDent Grant Manager, and identified that in the 2020/2021 budget estimate we had costed in £20K for ‘Flying Faculty’ teaching which would not be used because of the travel restrictions, which are anticipated to be in force until at least 31 March 2021. However, much of that education and instruction could be delivered in a modified way by the ‘Flying Faculty’ volunteers if all the students had access to on-line teaching. Accordingly, we prepared a short briefing paper which was followed up by a very positive Skype call with the Scottish Government International Development Team. Our request was to re-purpose the £20k towards purchase of 100 suitable digital devices, as a contribution to the #267forCOM appeal. It was agreed that this request would be taken to the Minister for International Development, Ms Jenny Gilruth MSP.

I was delighted when we were informed recently that our request to re-profile the £20K towards the purchase of digital devices had been approved. What I had not been prepared for, nor was expecting, was the offer of additional funding from the Scottish Government of up to £33K to support purchase of 230 of the digital devices required. I was completely overwhelmed by this generous response, the impact of which will be immense.

Through their own local fund-raising, the College of Medicine had sufficient monies to cover the cost of an additional 37 devices. The following photograph shows the Principal receiving MWK 6,000,000 (approximately £6000) from one of its supporters, NICO Holdings plc, which is helping with purchase of devices.

NICO
The Principal (left) receives the donation from a senior executive of NICO Holdings plc

Reaching this milestone, which now enables purchase of the 267 devices required to satisfy the #267for COM appeal, in effect unlocks the delivery of on-line learning and, potentially, assessment for 1076 healthcare students in Malawi. It represents a massive step forward and will have a lasting impact even beyond the COVID-19 pandemic.

Following the award of this additional funding, Malawi’s Public Procurement and Disposal Authority (PPDA) allowed the University of Malawi College of Medicine to use an emergency but transparent procurement process. The advert was floated on the PPDA website and two companies tendered their bids. Subsequently the College’s Internal Procurement and Disposal Committee met to identify the preferred bidder and it is anticipated that the devices will be delivered within a matter of days.

The other piece of the jigsaw is the access to affordable data bundles and there has been success on this front too. The Principal, DrMipando, has been interacting with the Malawi Government and with telecommunications companies to identify a way forward.

Mwapatsa and Minister of Information
The Principal, at a meeting with the Malawi Government Minister of Information, the Honourable Gospel Kazako

Through negotiations involving the Malawi Government and Telekoms Network Malawi (TNM),  Dr Mipando has secured a reduced rate on data bundles, which the College of Medicine will purchase on behalf of the students.

For the MalDent Project, there is relief and excitement that we can now move forward with delivery of on-line learning and once more engage fully with the students on the BDS and foundation programmes. However, on a much broader scale this outcome provides the opportunity for all the students at the College of Medicine to revert to their studies and, we hope, obviate the need for them all to face lengthy extensions to their degree programmes. The generosity of the Scottish Government and Malawian sponsors in facilitating this major step forward will have a lasting impact on the lives of many young healthcare workers and, ultimately, the patients they look after, for many years to come.

The last word should come from Dr Mwapatsa Mipando, Principal of the University of Malawi College of Medicine, who established the #267for COM appeal and has worked tirelessly to see it succeed:

“ As a Principal of COM and as a Malawian, I am thankful for the support that we have received from Scottish People, our local companies and our alumni. This support will allow us to purchase Tablets for all our needy students. This is really the spirit of UBUTHU!!  This UBUTHU has surmounted the digital divide that was amongst our students.  The cherry on top, is the partnership that the COM has entered with Telekom Networks Malawi PLC (TNM) resulting in the College providing 10Gbs of internet data every month to every student.  COM is a trailblazer in Malawi  through the above support and we hope to release more health care workers into our already overstretched health system!”

 

 

Design team members visit Glasgow Dental Hospital & School

At the recent Zoom meeting of the design team for the new dental teaching facility / student hub building on the Blantyre campus of the University of Malawi College of Medicine, it was agreed that a visit to Glasgow Dental Hospital & School could provide useful contextualisation for the architects and engineers involved.

On Thursday 30th July, Niall Rogerson and I were delighted to host a visit by Paul East and Sophie Burgess, from John McAslan + Partners, together with Sam Haston from Buro Happold. We are very grateful to Andy Hamilton, the NHS Greater Glasgow & Clyde Dental Hospital Estates Manager, who kindly accompanied us for the whole duration of the visit.

Architects
Sophie Burgess, Paul East, Niall Rogerson, Maryanne Ferguson, Sam Haston and Andy Hamilton in the pre-clinical skills (‘phantom head’) facility

We spent the first 45 minutes in a socially distanced face-to-face meeting, which set the scene for the subsequent walk round.

One of the main issues which was discussed related to ventilation and air changes in the clinical teaching areas. Dentistry as a profession is currently suffering badly because many of the procedures undertaken involve use of instruments, such as high speed handpieces, which generate aerosols. In the COVID-19 era this poses wicked problems in relation to safety of patients, staff and students. Additional infection control procedures are required, for example fallow times in surgeries between patients who have been treated with aerosol generating procedures  (AGPs) to allow sufficient air changes to dilute aerosol particles, and the use of additional personal protective equipment (PPE). The problem is even greater in many dental schools because the students undertake patient treatment in open-plan multi-chair clinics, to allow close supervision by clinical tutors. Control and management of aerosols in such spaces is very difficult.

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Niall Rogerson with Glasgow dental students in a multi-chair polyclinic

The timing of the MalDent Project building design project will allow us to develop and build in features which will help to overcome these challenges around air-flow and ventilation.

The design team members were able to visit all the key elements of a dental school building and learnt a significant amount from Andy about some of the specialised technical aspects linked to dental equipment and associated infrastructure. Andy has kindly provided his contact details to the design team members so that they can liaise with him directly as necessary – another willing partner is welcomed into the MalDent Project team!

 

Inaugural meeting marks the beginning of the student hub / dental teaching facility design programme for CoM

As reported in an earlier post, the contract to design the new student hub and clinical dental teaching facility at the University of Malawi College of Medicine Blantyre campus was awarded to a consortium led by John McAslan + Partners.

The first meeting of the project team was held on Friday 17th July by Zoom.

First John McAslan meeting screen shot
Project team members from the John McAslan + Partners design consortium, University of Malawi College of Medicine and the University of Glasgow, after the first successful meeting

This initial meeting, chaired by Paul East, established administrative, working and communication methods.

A variety of surveys are required in the early stages of the programme. Quotations for a topographical survey and geotechnical site investigations are currently awaited and a number of other items of information are being sought, as outlined in the following screenshot.

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Work has begun on the surveys required for the design project

It was exciting to see a plan of the College of Medicine site with a cross hatched area which identifies where the new building is to be sited – suddenly this part of the project is coming alive!

CoM plan
Exciting to see the site of the planned new building (arrowed) on the campus plan

Lines of external communication have been set up through John McAslan + Partners, the University of Malawi College of Medicine Communications Team and the University of Glasgow Communications Office. An initial press release has been drafted for distribution to media outlets in Malawi and Scotland.

Weekly meetings will be scheduled for the foreseeable future as the work to develop the design brief and the subsequent stages of the project progress. We will keep readers updated!

Ronald Manjomo, PhD student, joins the MalDent Team

One element of our successful MalDent grant application to the Scottish Government was to appoint a PhD student to collaborate with us on the work stream to develop a model programme for prevention of dental disease in children that would be applicable in Malawi. Subsequently, this element of the project has received a major boost with additional funding of $75,000 from the Borrow Foundation.

The PhD studentship was advertised in 2019 and interviews for the short-listed candidates took place by Zoom on 19th December 2019. Professor Lorna Macpherson and I took part from Glasgow and the process was chaired by the Dean for Postgraduate Studies at the College of Medicine, Dr Fanuel Lampiao.

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Lorna Macpherson and I in Glasgow, with Dr Fanuel Lampiao in Blantyre, as we prepare for the interviews.

Following the interviews, we identified Ronald Manjomo as the preferred candidate, and he was duly recommended to the Vice-Chancellor for approval .

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Smiling faces after the interviews – Dr Fanuel Lampiao, Ms Siphiwe Lino
(Assistant Registrar – Academics) and Ms Annie Mwapasa (Maldent Project Administrator)

We are very excited about Ronald’s appointment, as his skills and experience fit very well with the work that is required for this oral health improvement project. Ronald graduated with a Bachelor of Social Science degree from the University of Malawi, Chancellor College in 2010. He majored in sociology, economics and psychology, and completed a dissertation entitled ‘Assessing the socio-economic impacts of a resettlement scheme on a local community in Machinga District’ as part of his course-work. From 2012 he worked for the Baobab Health Trust and in 2018 completed his Master of Public Health degree at the University of Malawi College of Medicine. His MPH project was entitled ‘Assessing the integrated management of non communicable diseases at Area 25 Urban Health Centre in Lilongwe, Malawi: experience from a human resources limited setting’.

Lorna Macpherson and I were able to meet Ronald in person when we visited Lilongwe in February this year for the National Oral Health Policy Workshop. We were joined by James Mchenga, the Academic Head of Dentistry at the College of Medicine, and enjoyed a very productive discussion.

Restaurant with Ronald
With Ronald Manjomo at the Sunbird Capital Hotel, Lilongwe

The various administrative procedures that have been necessary for Ronald to take up his studentship have now been completed and on Monday 13th July we held the first Zoom meeting with Ronald and his supervisory team. Professor Ken Maleta, who is Professor of Public Health at the College of Medicine School of Public Health & Family Medicine, is the Lead Supervisor in Malawi and Professor Lorna Macpherson will co-supervise from the Community Oral Health Research Group at Glasgow Dental School. Dr James Mchenga will provide the academic link to Dentistry within the Faculty of Medicine. Other academic colleagues will link into the project as it develops.

Supervisor meeting
Ronald and his supervisory team – ready for the off!

Many thanks are due to the Scottish Government and to the Borrow Foundation for the funding that supports the studentship to which Ronald has been appointed. The work to develop a dental caries prevention programme for children in Malawi is a crucial strand of the MalDent Project. We look forward to working closely with Ronald and with the other stakeholders, including the Ministry of Health & Population and WHO Africa, in this project to develop a sustainable prevention model based upon the principles of Scotland’s successful Childsmile programme.

John McAslan + Partners appointed to design the new dental teaching facility and student hub at University of Malawi College of Medicine

It is nearly three months since I published a post on our MalDent blog. The COVID-19 situation has inevitably impacted on progress with some aspects of the project, including the shipping of equipment from Dentaid HQ to Lilongwe for Phase 2 of the KCH Dental Department refurbishment.

All students at the College of Medicine, including the BDS students, have been off campus since late March and plans are in place to commence delivery of some teaching on-line. However, this is challenging because many students do not have access to WiFi in their homes or, in many cases, availability of suitable computers, tablets or phones. There has been regular contact between the CoM and University of Glasgow in order to find ways in which we can provide support and this partnership work is continuing.

Nevertheless, there has been significant activity in other areas. During April, we completed all of the documentation for the End of Year 2 reporting to Scottish Government. This was a large piece of work, which included the generation of a COVID-19 risk assessment. The latter was a valuable exercise and we are very fortunate that there are two major strands of work which can continue over the next few months, despite the lockdown and travel restrictions:

1. Drafting of the National Oral Health Policy

Following the very successful workshop in Lilongwe on 13th and 14th February 2020, the Terms of Reference and task force have both been agreed and we can work on development of the policy document through digital communication and video conferencing.

2. RIBA phases 1 and 2 of the design of the dental teaching facility and student hub on the Blantyre campus of CoM

Following the very successful design workshop held in Blantyre in September 2019, a schedule of accommodation was created, together with a cost estimate. This in turn informed documentation that was created with support from the University of Glasgow Procurement Office to allow us to tender for a design team via the Public Contracts Scotland portal. Bids were received and assessed formally according to standard procedures,  including interviews that were held on-line. Grateful thanks are due to Gillian Ray from the University of Glasgow Procurement Office for her expert and cheerful support throughout the process.

I am delighted to announce that the contract has been awarded to John McAslan & Partners, working in a consortium with Studio KAP, Buro Happold, David Narro Associates and Quant Consult Associates.

This is a massive step forward for the MalDent Project and very exciting. John McAslan + Partners is an award-winning international architectural practice, with headquarters in London but further studios in Edinburgh and Sydney. It has an extensive portfolio of projects in the UK and overseas including education, cultural, hospitality, commercial infrastructure, residential, urban design, heritage and landscape sectors.

John McAslan + Partners has a long-term commitment to volunteering in Africa and in Malawi in particular. This has included work with the Clinton Global Initiative, Malawi Ministry of Education and The Hunter Foundation on the Malawi Schools Programme. The requirements for those school buildings were very similar to those for the new building on the Blantyre campus:

  •  An inclusive design, which would welcome parent engagement
  • Extended schools that would enable the community to use the buildings beyond school hours for other activities eg adult learning
  • Embedding of the school buildings within the community
  • Teaching spaces that would allow students to learn in different forms – group work, individual work, activity-based work – otherwise known as transformational learning environments.

The design incorporated features that improved the quality of light in the buildings and their environmental performance, at a very competitive cost.

Malawi School 2
A completed classroom building in Malawi, designed by John McAslan + Partners

An outstanding example of the work of John McAslan + Partners which will be known to many who travel from London to the North-East of England and Scotland by train is the beautiful transformation of Kings Cross station that was unveiled in 2012.

Western concourse at London Kings Cross station. Central postion
Kings Cross Station, London – another John McAslan + Partners project

The design work for the MalDent Project will be delivered by the Edinburgh Studio, which consists of four RIAS Chartered Architects and three technologists, headed up by the studio lead, Paul East.

There are four other partners in the consortium:

This Glasgow based architectural practice is known for innovative, award-winning human scale designs which are built with a high degree of craftsmanship. Their work has been published internationally and is characterised by a strong empathy for physical and cultural settings and a design process which involves clients in a collaborative role in shaping each project. They have long-standing research and practice relationships in low income countries in the Global South, particularly in their ongoing collaboration with Abba architects in Ethiopia.

  • Quant Consult Associates

This Project Management and Chartered Quantity Surveying Firm, was registered in 2000 by Joseph Malingamoyo and the late Morrison Alfred Sulumba. Since 2011, Yvonne Sulumba-Phiri is Partner Designate. The strength of the firm lies in the collective experience of the partners and members of staff who have held various positions, responsibilities and portfolios in Central Government, Local Government and Private Sector both in Malawi and abroad. Since its inception in 2000, the firm has undertaken a number of challenging commissions, including a notable positive contribution in the tertiary education sector and in particular for the University of Malawi College of Medicine campus.

This practice of Consulting Structural Civil Engineers, with offices in Edinburgh, Glasgow, Forres and Stirling, was established in 1986.  The practice has considerable experience in the design of education and research buildings for private, public and university sectors and has a long association with a number of clients in this field. This project will be delivered from their Glasgow Office, where they have 12 Chartered Engineers.

This international, integrated consultancy of engineers, consultants and advisers operates in 24 locations worldwide, with over 1,900 employees. Sustainability is intrinsic to the economic and social impact of their work. They always strive to deliver solutions with a sense of economy for our planet and its resources. This project will be delivered from their Edinburgh office, where they have 23 MEP Engineers.

This carefully chosen consortium, with tremendous experience of working in the Global South, can now start on the next exciting stage of the journey to deliver not only the infrastructure required for the clinical teaching of dental students on the Blantyre campus, but also a student hub that will offer great benefits for all staff and students on the campus as well as the local community. As part of their bid for the project, the consortium provided an early impression of how the facility may look:

Malawi Dental School Perspective
Preliminary vision of the new student hub / dental teaching facility 

Suddenly this important strand of the MalDent Project is coming alive – exciting times ahead!

Acknowledgement: Thanks to Paul East, Associate at John McAslan + Partners, for the final image in this post.

 

 

Big thanks to Scottish Government International Development and the RCPSG HOPE Foundation for support

Previous posts have described the first phase of the refurbishment of the Dental Department at Kamuzu Central Hospital, which was completed in May 2019. We recognised then that there was further work still required and we have since been planning Phase 2. This has entailed collection of more donated equipment, both by the Dentaid team and the Glasgow Dental School team, work which has also been reported previously.

By the Autumn of 2019, much of the equipment required had been identified and we began to plan the logistics of transportation of the kit to Malawi, followed by its installation. Rather than renting a shipping container, we decided to purchase one. The container will subsequently be installed in the grounds of the College of Medicine campus in Lilongwe, where it can act as a storage facility for dental equipment / materials for the MalDent Project and to support the work of our partner charities Smileawi, Bridge2Aid and Dentaid.

The costs associated with the container purchase, shipping, equipment servicing and installation were significant, and not part of our main MalDent Project grant. We therefore made applications to both the Scottish Government and the Royal College of Physicians & Surgeons of Glasgow HOPE Foundation for financial assistance.

HOPE Foundation

We are delighted and very grateful to both organisations for the financial support they have made available. This funding has supported all components of Phase 2 of the KCH Dental Department refurbishment.

On 3rd February 2020, our container arrived at the Dentaid Headquarters in Southampton. This was not just any container – it was now ‘our container’, which will continue to serve a valuable role long after the consignment reaches Malawi, once it is installed as a storage facility in Lilongwe.

Dentaid 8
Precision reversing as the truck manoeuvres into position at Dentaid’s HQ 

 

Once the truck was in position, it was time for the container to be unloaded into its new temporary space in the Dentaid Headquarters yard.

Dentaid 7
Ready to off-load

The operation proceeded without a hitch and the container was soon in situ, ready for its next consignment of materials and equipment for Lilongwe.

Dentaid 6
The container in place and ready for loading

Dentaid’s fantastic team of volunteers has been busy identifying and preparing the items to be packed into the container. These range from small pieces of equipment …

Dentaid 1

… to the large items which still require servicing and checks before dispatch.

Dentaid 2
Stuart Bassham, Dentaid Warehouse & Engineering Manager, at work preparing items for the container

Dr James Mchenga, Academic Head of the BDS programme at the College of Medicine, had sent some lists of equipment that he needed to procure as he establishes an oral surgery service at the Dental Department of the Queen Elizabeth Hospital in Blantyre

James lists 2
One of the lists of requested items – ticks indicate that the instrument is available and will be supplied by Dentaid.

Dentaid has extensive stocks of donated instruments, a small selection of which can be seen on these demonstration mounts:

Forceps

As a result, many of the items requested by James will find their way into the container as part of the consignment of dental items and equipment.

The packing of the container began immediately after it arrived:

Dentaid 3
The first items are in the container – lots more to follow

Our plan had been to arrange for uplift of the filled container in late March / early April, followed by a one-week visit for the installation in June 2020. However, these scheduled activities have had to be put on hold because of the COVID-19 lockdown in the UK. As I write this piece, Malawi is reporting four confirmed cases of SARS-CoV- 2 infection.

Clearly it is impossible to predict when we will be able to resume the work towards Phase 2 of the KCH Dental Department refurbishment, but all the ground-work is complete for when more normal operations can begin. In the meantime, the most important thing is for all of us to follow the rules of our respective governments and to ensure the safety of ourselves and those around us.

I would like to finish by reiterating the thanks of all those involved with the MalDent Project to the Scottish Government International Development team and to the Board of the Royal College of Physicians & Surgeons of Glasgow HOPE Foundation for their financial support of this equipment replacement project.

I would also like to thank the many volunteers who work with such commitment to deliver the equipment and dental instrumentation elements of Dentaid’s work – none of our re-equipping activity would be possible without them.

Thanks to Jill Harding, Communications Manager, Dentaid and to Stuart Bassham, Warehouse and Engineering Manager, Dentaid, for the photographs in this post.