The MalDent Project is presented at the UUKI International Higher Education Forum 2021

A few weeks ago I was privileged to be invited to participate in a breakout session at this year’s Universities UK International Higher Education Forum. I am very grateful to Professor Paul Garside, our Dean of Global Engagement (Middle East & Africa) at the University of Glasgow, who had suggested to the organisers that the MalDent Project would be a suitable example of a capacity building collaboration between a UK HEI and a university in a low-income country.

The conference took place on 13-14 April 2021.

The MalDent Project presentation was part of the following breakout session:

The session was chaired by Professor Richard Follett, Deputy Pro-Vice-Chancellor & Associate Vice President (International), at the University of Sussex. There were three 10 minute presentations, followed by a discussion between Dr Joanna Newman, Chief Executive & Secretary General of the Association of Commonwealth Universities and Professor Follett.

The first presentation was delivered by Professor Ernest Aryeetey, Secretary-General of the African Research Universities Alliance. I had heard Professor Aryeetey speak previously in Glasgow at the ‘Capacity Strengthening in Africa Symposium on 28 February 2020, when an MOU was signed between the University of Glasgow and the African Research Universities Alliance.

Professor Sir Anton Muscatelli, Principal of the University of Glasgow and Professor Aryeetey signing the MOU

Professor Aryeetey laid out very clearly the importance of the higher education sector in African countries and provided clear insights into ways in which UK HEIs could provide support.

At the outset, he delivered three main messages:

He then spoke about the fundamental importance of investment in Africa’s higher education sector, with a particular emphasis on partnerships and collaboration:

The significant value of international research collaborations was illustrated in a slide that demonstrated how research outputs in least developed countries were increased significantly by working together:

Prof Aryeetey developed this theme further, stressing the importance of international partnerships to strengthen HEIs in Africa:

He looked at various options, some of which resonated very strongly with ongoing interactions between the University of Glasgow and the University of Malawi College of Medicine:

Professor Aryeetey’s concluding slide gave a very clear steer on how ARUA viewed the way forward:

Our presentation on the MalDent Project was the second of the 10 minute presentations. Those who follow our blog will be very familiar with the various components of the work stream and the progress we have made to date. Our contribution to the meeting was to provide an illustration of an ongoing partnership between a UK HEI and a university in a low-income country, with a focus on capacity-building.

The question I was asked to address was:

What are the mutual benefits of partnerships such as the MalDent Project and why should UK universities be supported financially to implement projects such as this?

One of the main capacity building successes of the MalDent Project to date has been the establishment of Malawi’s first Bachelor of Dental Surgery degree programme, based at the University of Malawi College of Medicine:

Malawi’s first ever BDS students at the launch of the degree course in August 2019

However, this is only one element of a much broader programme, which includes work to develop a national oral health policy, with an emphasis on disease prevention. The strong collaboration between the University of Glasgow and the University of Malawi College of Medicine is under-pinning developments that are of direct value and interest to the citizens of Malawi.

Simultaneously, the partnership brings significant value to the University of Glasgow, in the context of its vision in the 2025 strategy to be The World Changing University:

The basis of the established interaction between the University of Glasgow and the University of Malawi College of Medicine embraces three key principles, which I was keen to highlight:

In the context of the MalDent Project, it was our Malawian colleagues who sought advice with issues relating to oral and dental health in their country. In turn, we responded by developing in partnership the work programme that forms the basis of the Maldent Project. In doing so, we have established strong bonds of respect and trust, which have been, and continue to be, essential to our ongoing progress.

The partnership working has expanded far beyond the two central HEIs involved, as I demonstrated in a slide towards the end of the talk. Links with government, professional and civic organisations, charities, NGOs and the broader health sector are critical and illustrate the point that Professor Aryeetey was making about the centrality of strengthening Africa’s HEIs for the common good. Universities carry a major civic responsibility, both locally and globally, a duty which activities like the MalDent Project illustrate very clearly.

The network of partners involved in the MalDent Project

Finally, I was very keen to thank the Scottish Government for its tremendous support of the Maldent Project. It is true to say that without the financial backing of the £1.3m grant from the Scottish Government Malawi Development Funding Round 2018, virtually none of what has been achieved would have been possible. It, therefore, seemed very apt to close with a photograph of Ben Macpherson MSP, former Minister for Europe, Migration and International Development, on a visit to the Lilongwe campus of the University of Malawi College of Medicine, when we had the privilege of explaining our work and showing how the Scottish Government investment was being used.

(L to R): Jeremy Bagg, Peter Chimimba (College of Medicine MalDent Project Lead), Ben Macpherson MSP and Mwapatsa Mipando (College of Medicine Principal)

The final 10 minute presentation was delivered by Mostafa Al-Mossallami, who is the lead adviser on higher education and skills at the UK Government Foreign, Commonwealth & Development Office (FCDO). He talked about the Strategic Partnerships for Higher Education Innovation and Reform (SPHEIR) programme , which aims to strengthen higher education in focus countries to better meet the needs of students, employers and societies. His talk spoke to the question:

‘How is SPHEIR supporting universities in low-income countries to contribute to national development and what role does the FCDO see for higher education in the longer term for global development?’

The breakout session closed with a very interesting discussion between Dr Joanna Newman and Professor Follett on some of the issues raised in the three presentations, giving consideration to whether the newly created FCDO should invest in higher education reform and, if so, why.

It was a really enjoyable 60 minutes. For any of you who would like to view the session in its entirety, it can be accessed below:

Many thanks to UUKI team members Richard Grubb (Senior Policy Officer, sub-Saharan Africa & International Development) and Anna Zvagule (Communications Officer) who briefed us all very fully and ensured that the technical aspects ran smoothly.

Ministry of Health Technical Working Group gives ‘green light’ to Oral Health Policy drafting

At the National Oral Health Policy Workshop held in Lilongwe on 13th and 14th February 2020, Brian Chaima from the Ministry of Health Planning Department provided a clear exposition of the stages that are required to develop a new policy in Malawi. This sequence of activities is explained in detail in an earlier post on this blog, but in summary the first steps are to produce a Concept Paper and a Narrative Review of existing relevant literature, together with completion of a detailed Situation Analysis.

The Oral Health Policy Task Force has now met via Zoom on 13 occasions, with scheduled two hour meetings taking place twice per month. Final drafts of the three preparatory documents listed above were completed by March 2021 and the next stage was for the Ministry of Health Essential Health Package Technical Working Group (EHP TWG) to consider the work completed to date and, if satisfied, to provide a mandate to the Task Force to draft the Oral Health Policy Document itself.

With financial support from the MalDent Project grant, a meeting of the EHP TWG was set up in the Viphya Conference Suite at the Sunbird Capital Hotel in Lilongwe on Thursday 8th April 2021. Those members who were local attended the meeting in person, with appropriate social distancing, whilst others of us joined via Zoom.

Annie Mwapasa, the MalDent Project Administrator at the University of Malawi College of Medicine, made an excellent job of organising and running the meeting. I joined from my desk at Glasgow Dental School.

The EHP TWG meeting about to commence – online for those of us who could not get to Lilongwe in person

In the two weeks prior to the meeting, we had prepared a slide deck so that we could give a detailed presentation to the TWG members. Peter Chimimba, the Maldent Project lead at the College of Medicine, had travelled to Lilongwe from Blantyre and he made an excellent job of delivering the presentation to the delegates.

Peter Chimimba shows our opening slide to introduce our work to date

The three images we chose for the title slide included photos taken during the pilot oral health survey conducted by Smileawi in 2019 in six schools, a photograph of Peter with Ben Macpherson MSP when he visited the College of Medicine Lilongwe campus in September 2018 and finally, one of the images from the Stage 1 design work for the new dental teaching facility and student hub planned for the Blantyre campus of the College of Medicine.

Peter took the TWG through key details of the Policy Concept Paper…

the Narrative Review and the Situation Analysis…

The presentation and the three documents themselves stimulated a lively discussion, with many interesting and valuable perspectives aired by those present.

Ultimately, it was agreed by the TWG that our preparations were in order and that we should now proceed to draft the Policy Document itself, informed by all the previous work we have completed. That drafting will now form the basis of the continuing twice monthly meetings of the Task Force. We have set the end of June 2021 as the deadline for completion and approval of the policy, so we have our work cut out. However, there is a real determination and drive from those involved to move forward and to progress to the implementation phase of the work, which will be critically important if we are to convert the words that appear in our policy into actions that improve the oral health of Malawi’s citizens.

Grateful thanks are due to Noel Kasomekera, Technical Assistant – Non Communicable Disease Unit and National Coordinator, Malawi NCDI Poverty Commission, Ministry of Health Headquarters, for facilitating the EHP TWG meeting and for his continuing outstanding support of the Oral Health Policy Task Force.

Turning challenge to success -Smileawi and friends collaborate on a digital learning oral health initiative for Malawi

Those of you who follow our blog will be very familiar with Nigel and Vicky Milne, who established and direct the charity Smileawi. Their charity is a very close partner of the MalDent Project, as is Bridge2Aid, with whom we collaborate on several fronts.

Enjoying a break in the sun during the Smileawi Dental CPD meeting in Mzuzu, June 2019

I can be lazy in writing this blog post, because Nigel and Vicky have already published their own blog which describes in detail the recent project I would like to highlight. It’s a great read and you can access it here.

The comments I would like to make relate more to the way in which collaboration, joint working and mutual trust continue to play a central role in the efforts we are all making to improve oral health in Malawi.

The original grant awarded to Smileawi from Scottish Government had been to fund a collaboration between themselves, Bridge2Aid and the Dental Association of Malawi on a pilot task-shifting programme to teach Medical Assistants the fundamentals of emergency dentistry. When this was postponed in June 2020 as a result of the pandemic, it became necessary for Smileawi to identify a way in which the funding could be utilised by 31st March 2021 on an alternative project, which would retain relevance to the original concept but would be feasible under COVID-19 restrictions.

Bridge2Aid already had strong connections with a digital dental education platform called ProDental CPD. They were working together on oral health related materials that could be loaded onto smartphones and used in their work with Tanzanian health care workers. During a brain-storming session between Smileawi, Bridge2Aid, the Dental Association of Malawi and the MalDent Project, a concept for a project to produce 12 modules of dental educational materials that would be hosted by ProDentalCPD was hatched. These modules would be provided to Malawian dental therapists who could claim CPD following successful completion. Other details of the final package can be found in Nigel and Vicky’s blog. The proposal for re-configuration was accepted by Scottish Government and on 31st March 2021 the modules were launched.

The following aspects of this project are worthy of note:

  1. As a result of pre-existing collaborations and working relationships established between the various parties involved, it was possible to demonstrate a nimble and agile response to the re-profiling of the original proposal.
  2. This was a true collaboration between the Malawian and UK organisations involved, ensuring that the materials produced were relevant in the Malawian context. The Project Coordinator in Malawi, Dr Martha Chipanda and the Secretary of the Dental Association of Malawi, Dr Wiston Mukiwa, worked tirelessly with the equally industrious UK team to develop and test the educational materials.
  3. Sustainability is at the core of this work, which supports high level ambitions of the MalDent Project in relation to support and development of the oral healthcare workforce.

The list of acknowledgements at the end of Smileawi’s blog demonstrates what a truly collaborative effort this has been. There is now the opportunity to assess these materials in the field, before rolling them out more widely. Both Martha Chipanda and Wiston Mukiwa are members of the Ministry of Health Task Force which is developing an oral health policy for Malawi, and tools such as the one developed in this project have great potential in support of oral health policy implementation. This integration of approach bodes well for the future.

Induction week for the latest recruits to the BDS course at the University of Malawi College of Medicine

It was smiles all round recently as the latest group of students who have been selected to join the Bachelor of Dental Surgery programme at the University of Malawi College of Medicine were welcomed onto their Foundation Course, prior to entering BDS 1 in 2022. In due course they will form the third cohort of students to enter the new programme. Their induction was led by Dr James Mchenga, who is the academic head of the course and Dr Peter Chimimba, who is the overall lead in Malawi for the Scottish Government-funded MalDent Project.

Peter and James in full flow at the induction event for the BDS Foundation students

The students wore masks and followed the social distancing rules as they listened attentively to James and Peter.

A rapt audience for Dr Peter Chimimba

It seems to me only a short while ago that my University of Glasgow colleague, Dr Petrina Sweeney, and I were in this same lecture theatre in August 2019, participating in the induction event for the very first cohort of dental students. I am impatient for the easing of travel restrictions when I will once again be able to return to Malawi and interact directly with the students and my College of Medicine colleagues!

At that initial induction event in 2019, James had only just joined the College of Medicine. He is now well established in his role as Head of the BDS course and working hard to provide an excellent experience for the students and to develop the careers of the four junior members of staff who have been appointed as Assistant Lecturers.

Dr James Mchenga encouraging his latest students

It is wonderful to see this photograph of James and Peter with a further group of enthusiastic young people who are destined to join the team of dental professionals on the journey towards ‘Oral Health for All‘ in Malawi.

A lovely group photograph at the start of these students’ journeys to become part of Malawi’s dental workforce, under the guidance and tutelage of James, Peter and their colleagues

The final words should be left to Peter and James as they reflect on the progress to date.

Peter said:

Despite the Covid restrictions, the induction for our BDS ‘Foundation’ students went very well. We pretty much followed the induction we had 2 years ago when you and Petrina were here. I hope that this will be the standard going forward. It was delightful to see 23 students including 9 female,  young and enthusiastic and eager to learn. This augers well for Dentistry in Malawi. We crossed yet another historic milestone on this journey. With this third cohort of Dental Students we now have more dental students than registered dentists in Malawi. I feel very proud to be part of this process. Many thanks to the Maldent Project, to you Jeremy and the Glasgow University Dental School and the Scottish Government  for all the support given to us and COM. I look forward to many more years of collaboration with you.

James said:

It was double joy and excitement through and through when we met the largest group of dental students at the College of Medicine yet! And this happened on the day that the third Assistant Lecturer, Dr Don Chiwaya, landed in Johannesburg to commence his post graduate studies in Dentistry at the University of the Witwatersrand, following Dr. Tasneem Chikwatu and Dr Miriam Chipinga who had left 2 weeks earlier. On the same day Dr Nathan Lungu submitted his study visa application at the South African embassy in Lilongwe and we are hoping that he, too, will join his colleagues in the next week or so. So, the dream is becoming a reality and that is exciting.

Successful on-line Flying Faculty delivery of ‘Introduction to Dentistry’ teaching

In a previous post we described the generous financial support from the Scottish Government for the purchase of a large number of digital devices to enable the commencement of on-line teaching for students at the University of Malawi College of Medicine during the COVID-19 campus closure. In addition to under-spend from the MalDent Project as a result of cancellation of international travel plans, the Scottish Government provided a further major additional contribution.

Following receipt of the funding, the College of Medicine rapidly purchased a large consignment of tablet computers, which were distributed to students who required them by drivers from the College vehicle pool. Support was also provided with provision of inexpensive data bundles.

These devices were in heavy use by BDS students during the week beginning 1st February, when two of my good colleagues and I joined forces with local College of Medicine faculty to deliver a programme entitled ‘Introduction to Dentistry’. Richard Welbury, Al Ross and I had been due to fly out to Malawi in March 2020, to deliver the programme in person, but the trip was cancelled two weeks before we were due to leave, on account of COVID-19. The availability of the digital devices for the students had now facilitated delivery of much of our planned material through Zoom.

Professor Richard Welbury was previously our Professor of Pediatric Dentistry at Glasgow Dental School, a former Dean of the Dental Faculty of the Royal College of Physicians & Surgeons of Glasgow and a past President of the International Association of Paediatric Dentistry. Dr Al Ross is Senior Lecturer in Human Factors in Healthcare at Glasgow Dental School and a leading international figure in the field of human factors. Between the three of us we put together a series of presentations relating to paediatric dentistry, communication skills, patient safety, infection control, oral infections, antimicrobial drug use / abuse and antimicrobial stewardship.

On Day 1 we held an introductory session with both the local and Scottish teaching faculty to familiarise the students with the plans for the week’s events.

Introduction of the local and Scottish teaching faculty

The local faculty, Drs James Mchenga, Peter Chimimba, Wiston Mukiwa and Jessie Mlotha-Namarika, provided additional sessions on periodontology, oral medicine and on issues relating to professional regulation.

For my own part, I thoroughly enjoyed interacting with the students. We covered multiple aspects of oral infection ….

Introduction to dental plaque microbiology and plaque-mediated oral diseases

… principles of infection control…

… practical aspects of infection control in dentistry …

… and appropriate use of antimicrobial agents

The recordings of the lectures and the Powerpoint presentations have all been made available to the students in support of their ongoing learning and revision.

A formal post-course questionnaire has been issued to the students so that we can learn from their feedback how to enhance our delivery of on-line teaching for the future.

The COVID-19 pandemic has caused havoc in many ways with education in schools and universities. However, as teachers we have been forced to learn rapidly the principles and practice of teaching and assessment on-line. For international educational initiatives, such as the MalDent Project, it has emboldened us to embrace digital technologies and harness them to our advantage. In this era of serious climate change concerns and the need to make careful choices about volume of air travel, our learning from courses such as the one described above will actually help us to engage in a more regular and sustainable way with students overseas. To quote a famous French artist:

There are always flowers for those who want to see them

Henri Matisse

Thanks are due to the Scottish Government for financial support towards purchase of the digital devices to allow equitable access of all College of Medicine students to on-line teaching. We would also like to thank Ev Wallace at Glasgow Dental School and Annie Mwapasa, the College of Medicine MalDent Project Administrator, for their support in the organisation of the ‘Introduction to Dentistry’ programme.

The MalDent Project is cited in a recent FDI World Dental Federation report

The MalDent Project has recently been cited as a case study in a new report from the FDI World Dental Federation.

The FDI World Dental Federation is an international, membership-based organization that was founded in 1900. It acts as a representative body for over one million dentists worldwide, and is involved with around 200 national dental associations and specialist groups in close to 130 countries. The organisation is based in Geneva, Switzerland, from where it pursues its mission to lead the world to optimal oral health.

The report in question is entitled Vision 2030: Delivering Optimal Oral Health for All’. The document was published on 18th January 2021, to coincide with the 148th session of the World Health Organisation Executive Board, where an oral health resolution was on the agenda for adoption by governments.

The membership of the Vision 2030 Working Group was as follows: Michael Glick (Co-Chair), David M. Williams (Co-Chair), Ihsane Ben Yahya, William W. M. Cheung, Enzo Bondioni, Pam Clark, Stefan Listl, Manu Raj Mathur, Peter Mossey, Hiroshi Ogawa, Gerhard K. Seeberger, Michael Sereny.

Professor David Williams, one of the co-chairs said: “Vision 2030 outlines the ways in which we can integrate our profession within global development agendas, including the UN Sustainable Development goals and the implementation of universal health coverage, that determine important health priorities.”

Fellow co-chair Professor Michael Glick said: “How can we, as members of the oral health community, anticipate transformational changes and trends in the global healthcare environment? How do we seize opportunities to become productive members of healthcare teams delivering person-centered care? These are some of the broad questions we strive to answer through Vision 2030.”

One of the key issues relates to better integration of oral health within overall health, an ambition that is central to the work currently underway by the MalDent Project team in conjunction with the Ministry of Health & Population and other stakeholders on the Oral Health Policy Taskforce in Malawi. Many of the other principles cited in the FDI Vision 2030 document also resonate with the Maldent Project activities.

We were delighted when we were approached by the Working Group to provide a short Case Study of the MalDent Project for inclusion and here it is:

Both the FDI Vision 2030 report and the oral health resolution adopted by the WHO are very important developments for the enhancement of oral health globally and of very special relevance to the work of the MalDent Project. The web-links in the narrative above to the Vision 2030 report and the WHO resolution provide easy access and are strongly recommended to all who have an interest in this area.

I would like to thank the Vision 2030 Working Group for all their work in producing such an excellent document and for having invited us to provide an illustrative example of some of the principles espoused.

The MalDent Project presents on partnerships in health education at Bridge2Aid Conference: ‘Global Remote and Rural Healthcare’

One of the distinguishing features of the Maldent Project is its close interaction with a number of charity partners. These include Dentaid, Smileawi, the Borrow Foundation and the organisation which is centre-stage in this post – Bridge2Aid.

I was introduced to Shaenna Loughnane, the Chief Executive Officer of Bridge2Aid (B2A), by Andy Evans, Chief Executive Officer of Dentaid, at the Scottish Dental Show in 2018. By then, the MalDent Project was already working closely with Dentaid on collection and refurbishment of dental equipment bound for the Dental Department at Kamuzu Central Hospital (KCH) in Lilongwe.

Shaenna explained the task-shifting model that B2A had developed which delivers training in emergency dentistry for Clinical Officers based in rural Tanzania. It immediately became clear that a model of this type could prove valuable in Malawi, which faces similar dental workforce challenges. Subsequently, Shaenna invited me to visit a B2A training programme in Tanzania, which was a real eye-opener as to the amazing results that could be achieved with their methods of training. Since then, Shaenna and her team have been working with the Malawi Government Ministry of Health & Population and the Dental Association of Malawi around introducing B2A’s task-shifting model to rural Malawi. A pilot programme, planned for June 2020, had to be postponed because of COVID-19 but is being re-scheduled for 2021.

In addition to our partnerships with charities, the MalDent Project has also received great encouragement and support from the company Henry Schein Dental, thanks to the interest shown by Patrick Allen, their Managing Director for the UK and Ireland. For example, the re-equipping activities at KCH were aided significantly by involvement of Jonathan Langley, a UK Henry Schein engineer, whose expert services were provided completely free of charge.

The following video is a very interesting discussion between Patrick and Shaenna, which gives a flavour of the enthusiasm and energy of these two colleagues for the partnership work we are all doing to improve oral health in low- and middle-income countries.

Patrick Allen and Shaenna Loughnane in conversation in 2019

For an organization led by someone with Shaenna’s energy and enthusiasm, it has not been surprising that despite the impact of COVID-19 on the training programmes run by B2A, other avenues for meaningful activity have been identified. One of these was the concept of an international e-conference which would bring together participants from across the globe to discuss a variety of issues relating to remote and rural healthcare. Those of us who have been involved in conference organization know what a huge amount of work is entailed, and for this type of on-line meeting there are additional complications such as consideration of delegates’ time zones. However, the conference was duly announced – a partnership between B2A and a well-known and respected on-line educational platform called ProDentalCPD:

This was an intense conference, delivered as six sessions over two days, as outlined below:

The programme for day 1
The programme for Day 2

Mwapatsa and I were delighted to have been invited to participate in the session ‘Partnerships in Health Education’, chaired by Bridge2Aid volunteer Kiaran Weil. We presented along with Dr Meredith Giuliani, a radiation oncologist and Education Director at the Princess Margaret Cancer Centre in Toronto who described a health education partnership with the King Hussain Cancer Centre in Jordan. The content of that session is available to view in the following video:

It was uncanny that so many of the principles of partnership working that we described from our experiences of the MalDent Project were mirrored in Meredith’s excellent presentation. There is definitely scope here for some joint working in 2021.

This conference was a tremendous success. Many congratulations must go to Shaenna and her team at B2A and also to Rob Dyas at ProDental CPD, whose technical wizardry kept things running smoothly. In due course, much of the conference content will be uploaded to YouTube and relevant links will be added to this post when they become available.

Let’s hope this COVID-19-induced innovation from B2A and ProDental CPD is not a one-off event – the MalDent team is already looking forward to the next one!

Big Smile Big Band and Smileawi’s Christmas Wish

Those who are regular followers of our blog will know of the partnership working between the MalDent Project and the charity Smileawi. Our first joint endeavour was a very successful pilot child oral health survey carried out in Malawi in July 2019, which was a collaboration between Glasgow Dental School’s Community Oral Health Research Group, six senior students from Glasgow and Dundee Dental Schools and Smileawi.

The successful team of Smileawi volunteers and dental students on their return with the survey data!

Since then, a strong working relationship has also developed between Smileawi, Bridge2Aid, the Dental Association of Malawi and the MalDent Project, leading work to establish a task-shifting emergency dentistry training programme in Malawi.

Like all charities, Smileawi is highly reliant on donations from members of the public. As a result of the COVID-19 pandemic, 2020 has been a very difficult year for fund-raising. Nigel and Vicky Milne, the founders and directors of Smileawi, are both University of Glasgow Dental School alumni and by a happy coincidence a festive on-line fund-raising opportunity arose at their alma mater.

Glasgow Dental School is immensely fortunate to have its own musical troupe – the Big Smile Big Band. Its founder and director is Callum Wemyss, a Class of 2016 Glasgow dental alumnus, who established the band whilst still a student and has maintained his role as band leader since qualifying. He is now a Specialty Trainee in Oral Surgery at Glasgow Dental Hospital & School, so he has returned home to his band’s base! Such is Callum’s drive and enthusiasm that many fellow alumni, as well as current staff and students, continue to support and perform with the band.

In full swing at the Big Smile Big Band event at the SEC – making music with local schoolchildren

Clearly the COVID-19 pandemic has brought an end to live events, but earlier in the year the band put together two on-line songs by individually recording their parts and then submitting them to be digitally edited together into final performances. These so-called ‘Dental Lockdown Sessions’ were part of a very successful fund-raising initiative for Glasgow’s Prince & Princess of Wales Hospice, led by another Glasgow dental alumnus, Clive Schmulian.

A few weeks ago I met Callum by chance in the Dental Hospital. He was toying with the idea of pulling the Big Smile Big Band together digitally again, to record two Christmas songs. Callum was keen to incorporate a fund-raising element into the project and we decided to have a discussion with Nigel and Vicky, about a plan to make Smileawi the recipient charity. Since then, the project has come together and the two songs were launched at 8pm on Tuesday 22nd December to an on-line audience.

It was a fantastic event and for those who were unfortunate enough to miss it, you can see it on ‘Big Smile Big Band Catch up TV’ here:

Massive thanks are due to Callum and all the members of the Big Smile Big Band. Special thanks also to Roger Marsh who completed the audio mixing (as well as playing trombone!) . Finally, big thanks to Clive Schmulian for kindly providing access to the digital platform and to Clyde Munro for sponsoring the event.

If you have just listened to the performances and would like to donate to Smileawi, you can still do so at:

Merry Christmas and warmest good wishes to all for 2021!

Student visit to Glasgow spawns Bwiza Childsmile Initiative in Rwanda


My colleague and friend Niall Rogerson, who works with me on the MalDent Project, was closely involved for several years with the establishment of the new Bachelor of Dental Surgery programme at the University of Rwanda. The initial connection had been made via a former University of Glasgow clinical academic, Professor Phil Cotton, the founder Dean of the University of Rwanda Medical School and subsequently the Principal and Vice-Chancellor of the University of Rwanda.

Professor Phil Cotton congratulates the first ever BDS graduates from the University of Rwanda

The experience gained by Niall at the University of Rwanda has been very helpful as we develop the new BDS programme at the University of Malawi College of Medicine.

University of Rwanda’s first ever BDS graduates shoot for the stars

Dental students at the University of Glasgow Dental School undertake an elective project over a period of four weeks between BDS 4 and BDS 5. For many years Niall was the Academic Lead for our electives programme and in 2017 one of our students, Katy Wood, spent four weeks at the University of Rwanda Dental School. In 2018, two more Glasgow students, Graeme Brown and Rebecca Baird, chose to visit the University of Rwanda Dental School for their elective study where they collaborated with Rwandan dental students in oral health improvement projects.

Graeme and Rebecca with students from the University of Rwanda Dental School

There is a long-standing criticism of international health electives that the educational benefits tend to flow to the developed countries, with little possibility for students from low- and middle-income countries to be advantaged by studying overseas. We were determined that this should not be the case as the Glasgow – Rwanda Dental School partnership developed and in 2018 we were able to identify funding to support an elective placement in Glasgow for a dental student from the University of Rwanda.

The Dean of the School of Dentistry, Doctor Chrispinus Mumena, identified a level four student who he believed would be particularly well placed to gain maximum benefit from undertaking an international health elective. The student he selected was Bizumuremyi Karebu. During his time in Glasgow, Karebu followed a busy academic schedule …

Karebu in the dental pre-clinical skills facility in Glasgow

and sampled many scenic and cultural delights of Scotland:

By chance, Karebu’s visit to Glasgow coincided with a visit by Dr Mwapatsa Mipando from the University of Malawi College of Medicine, one of the main driving forces behind the Maldent Project. It was a very happy coincidence that we were able to make this introduction.

Karebu meeting Dr Mwapatsa Mipando with Niall and myself

One of the highlights of Karebu’s elective placement in Glasgow was a meeting with one of our Professors of Dental Public Health, David Conway. Their discussions stimulated great interest in the Scottish Government Childsmile Programme and how such an oral health initiative could be transferable to Rwanda. On his return to Rwanda, Karebu grasped the nettle and has written the following blog post which describes the initial steps he is taking with colleagues to develop a Childsmile model suitable for use in his home country:

Bizumuremyi Karebu’s story – the Bwiza Childsmile Initiative

The Bwiza Childsmile Initiative has been established in Rwanda with reference to the Childsmile Programme in Scotland. It aims to promote and improve the health and wellbeing of children in Rwanda and to reduce inequalities in both dental health and in access to dental services.

The idea of Bwiza Childsmile arose in 2018 when Bizumuremyi Karebu (now a BDS Final Year student at the University of Rwanda) visited the University of Glasgow as part of an exchange programme between the two Dental Schools.

On his return to Rwanda, Bizumuremyi Karebu linked up with intern Dr Ndisanze Amini and a BDS Final Year student, Habumugisha Jean Marie Vianney. They sat together and took the initiative to establish Bwiza Childsmile. Bwiza Childsmile was launched officially on 8th May 2020. It launched with its first online campaign called the “TESTIMONIES CAMPAIGN” in which families took pictures and videos practising oral hygiene and shared them on social media platforms like Twitter or Instagram and tagged their friends. At this time the country was in total lockdown and children were not at school due to the COVID-19 pandemic, so this was an activity they could undertake from home.

At the end of this campaign the country was lifted from lockdown to curfews, so we were able to conduct an outreach campaign in a rural area of Kigali City, in Jabana sector, Bweramvura Cell. We have raised the awareness of oral hygiene practices and COVID-19 preventive measures within this community and we have distributed more than 1000 toothpastes and biodegradable toothbrushes to the families and children.

Karebu educating children about oral hygiene practices
Moses educating parents and children about oral hygiene practices and how parents can help their children
After the oral hygiene education the children were happy to receive their toothbrushes and toothpaste
Karebu visited a children’s home to educate them about oral hygiene practices and give them toothbrushes and toothpaste
Jean Marie Vianney and Elite Olga illustrating proper toothbrushing techniques

Happy families and children after receiving their oral health education, toothbrushes and toothpaste

The aim of the Bwiza Childsmile Initiative is to reduce inequalities in both dental health and access to dental services. We are working on a new project called the “CROCO SMILE PROJECT” which will be based on providing oral health education basic materials such as posters, videos, games and also handwashing education to nursery and primary school children. We will also introduce daily supervised toothbrushing for nursery and primary school children, and provide basic oral health training to the community health workers.


This post illustrates the value that can be gained by providing carefully designed elective experiences for senior undergraduates and the positive influence it can have on these individuals and their peers after they return to their home institutions. It was a pleasure and a privilege to host Karebu’s elective studies at the University of Glasgow and especially exciting to see the activities now ongoing in Rwanda that were stimulated by his visit to Scotland.

We are now in the process of linking Karebu and his colleagues with Ronald Manjomo, who is undertaking a PhD at the University of Malawi College of Medicine with a focus on developing a Childsmile type of intervention that would be applicable in Malawi. The potential opportunities for joint working and learning are extensive and we look forward to developments in 2021 and beyond.

Once the pandemic permits, we look forward to welcoming further students from Rwanda and other sub-Saharan African countries to Glasgow. The Maldent Project is all about partnerships and the involvement of young oral health professionals like Karebu, who are enthusiastic and motivated, is what will maintain its momentum and impact into the future.

Our farewell meeting with Karebu was just the start of something much bigger …!

Zero Water Day Partnership is engaging Schools and Youth around the world to take action

I am delighted that our MalDent Project blog is today publishing a guest post from my friend and colleague, Dr Julian Fisher.

Julian is a dental surgeon who qualified from the University of Birmingham in 1985. Subsequently he completed an MSc in HIV/AIDS from Stellenbosch University in 2002 and gained his MIH (International Health) from Charité University, Berlin in 2005. Julian, who is based in Germany, is now working as a policy advisor and analyst specializing in health workforce education, social and environmental determinants of health, and global oral health. These are aspects of health that are central to the MalDent Project and, not surprisingly, we have identified multiple synergies. Julian’s ongoing consultancy work with WHO, UNESCO / UNEP, provides further valuable input to our joint interests.

In this post, Julian describes a very exciting initiative in which the MalDent Project, University of Malawi College of Medicine and the University of Glasgow are among many participants across the globe.

Table Mountain, Cape Town, South Africa. Photo by J Fisher

In the early 2000s I worked in Brooklyn Chest Hospital in Cape Town, South Africa caring for the oral health of patients co-infected with HIV AIDS and TB. Every summer Cape Town would have water restrictions, but in 2018 the Western Cape Government warned that water reservoirs were so low that there was a real risk that 12th April would be ‘Zero Water Day’.

So what would happen when the water taps ran dry in Cape Town? At the end of the National Geographic short film ‘what happens when Cape Town runs of water’, the narrator of the film Ray De Vries sums up by saying that everyone can learn from Cape Town’s experiences, in his words “what we did wrong and what we are doing wrong, what we did right and what we are doing right”.

I teach Global Health and Sustainable Development at Universities in Europe, but also in local secondary schools where I live, and use UNESCO resources for education for sustainable development, and global citizenship education

But the children and Youth in my classes were often at Fridays for Future demonstrations and were becoming increasingly frustrated about not being able to ‘do something’. And they were right! I set out to develop a learning plan that I could use in both higher education / university courses as well as in secondary schools so that students could learn how to transform (Transforming our world: the 2030 Agenda for Sustainable Development). Learning to transform that would engage their families and friends, the whole school and local communities and work together to take action.

The result was  the Zero Water Day Partnership, which drew on my work for UNESCO around Lifelong Learning and Health, and my engagement with UN Mountain Partnership through the Training for Health Equity Network.

Screenshot of participants including MalDent team members

Zero Water Day Partnership (ZWDP) was launched via a webinar on Tuesday 24th November with over 25 participants from schools in 14 countries around the world. Prof Jeremy Bagg from Glasgow Dental School spoke about plans for the COP 26 Climate Change summit and the MalDent Project.

A key part of ZWDP is supporting learning in the classroom and applying it though whole school, whole community action. Action in school will support WHO UNESCO initiative of making every school a health promoting school. One of the core objectives of the ZWDP is connecting health promotion activities (SDG 3 Health) such as toothbrushing with the health of our planet through conversations around water use and management (SDG 6 Water), and reducing inequality (SDG 10). The MalDent Project has established Malawi’s first dental school and is supporting development of a national Oral Health Policy, including a dental caries prevention and health promotion programme for children.

Children at a school in Malawi.
Photo courtesy of Vicky Milne

EM Alcides Francisco Brantes, a ZWDP participating school in Salinas region of Nova Friburgo Brazil, has  programmes supporting sustainable practices such as family agriculture and water preservation practices for the communities within the 3 peaks state park.

The Salinas Region of Nova Friburgo, Brazil. Photo by Prof Luis Eduardo
EM Alcides Francisco Brantes School, Nova Friburgo, Brazil Photo by Prof Luis Eduardo

Project Learning to Smile in Nova Friburgo, uses health/environmental social practices such as milk teeth exchange and clean water preservation to formulate online literacy content and support teachers’ lesson plans. 

Our ambition, established in 2019, was to deliver a one-day high-level meeting with Scottish Government, WHO, UNESCO and other key stakeholders, followed by a two and a half day workshop. These were to take place just before the COP 26 Climate Change summit in Glasgow that had been scheduled for November 2020. The University of Glasgow had agreed to host the meeting and plans were developing well until the COVID-19 pandemic resulted in postponement of all these events to November 2021. Undeterred, we have re-booked our slot with the University and intend to run the same format of activities in November next year.

A highlight of the event, regardless of exact timing and mode of delivery, will be an opportunity for schoolchildren and their teachers to present materials they have generated through participation in the Zero Water Day Partnership activities during 2020 / 2021 (see below). This will provide a very powerful demonstration of the critical importance of linking education, health and care for the environment to empower young people through their learning in schools.

What is the Zero Water Day Partnership?

ZWDP is a voluntary partnership of schools with teachers and children learning with and from each other to take action on water and sustainable development in their homes, schools and communities. A key focus is on mountains as water towers of the world and promoting the  #mountainsmatter campaign in schools to empower Youth to play an active role in protecting ecosystems around the world’s summits for future generations, including issues such as sustainable mountain tourism

ZWDP looks to learn in and from the COVID pandemic and provides maximum flexibility for all schools to participate, so that children have the opportunity to share with others around the world despite all the immense challenges they are facing. Participating schools will have an opportunity to present during the 3.5 day workshop to be held in Glasgow the week before the COP 26 Climate Change Summit in Scotland, November 2021, and contribute to a short film and eBook.

Each school will follow a seven step learning plan based on UNESCO resources for education for sustainable development and global citizenship education. The first learning step will encourage children to imagine their future in 2050 and include a UNESCO Futures of education consultation, as well as building a planetary health weather station.

Students at Freie Waldorf School have started building the weather station, as well as a ZWDP signpost to all the other schools. Community action will use United Nations International Days including International Mountain Day to emphasize the interconnectedness and interdependence of issues, and promote multi-, inter- and intra-generational conversations.

ZWDP will help share and exchange experiences across schools, for example Wanakha Central School and Shaba Higher Secondary School in Bhutan (SHSS).

Wanakha Central School, Bhutan. Photo by Namkha Gyeltshen

SHSS and its Spring Water Conservation project was initiated by the Bhutan Centre for Media and Democracy. Members of the school, which includes teachers and students, helps citizens to understand their roles in democratic processes as well as to improve overall media literacy. One of their programmes includes teaching the youth to harness the power of the media to help their communities and volunteerism.  

Spring water conservation, Shaba Higher Secondary School, Bhutan. Photos by Chimi Wangmo

For information on the Zero Water Day Partnership visit our Facebook page:

So what happens when dentistry runs out of water?

I have been organising a series of Oral Health Navigators Training Programmes to dental students in Europe and around the world. A key element is exploring how a shift to a model of oral health and dentistry based on social determinants of health approaches can help to mainstream oral health across and between the 17 Sustainable Development Goals, and within SDG 3 (Health). Oral health is closely related to almost all SDG 3 targets.

Such an approach will open new ways of thinking, and new ways of working, which will help to create resilient and sustainable dental practice for the future.

For more details on Oral Health Navigators Training Programme, contact;

Other related social media sites:

Profile on LinkedIn: Julian Fisher

Researchgate: Julian Fisher

Twitter: @OralHealth17 and @julianmfisher

Instagram: fisher.julian

You tube: Julian Fisher

Facebook: Social Determinants of Health Education