One of the first and critical milestones for the MalDent Project is to develop the curriculum that will form the basis of the teaching on the new Bachelor of Dental Surgery programme at the University of Malawi. If the first intake of students is to take place in August 2019, then University approval of the curriculum is an urgent priority. To this end, significant work has been taking place in recent months, involving the Dental Association of Malawi, the College of Medicine and external partners, including Wits University and the University of Glasgow.
In September, Peter Chimimba intimated to me that a final Curriculum Conference was to be organised in Mangochi from 26-29 November 2018. It was agreed that I would attend and that my colleague, Niall Rogerson, should accompany me. In addition to his role as a member of teaching staff in Restorative Dentistry in Glasgow, Niall is also the Quality Officer for the College of Medical, Veterinary & Life Sciences, with an extensive knowledge of assessment and quality assurance procedures. In addition, he has been supporting the newly established Dental School at the University of Rwanda for the past four years, through which he has developed significant understanding of the logistics and challenges of delivering dental education in sub-Saharan Africa.
We started our journey from Glasgow Airport on Friday 23 November:
The flights to London Heathrow and from there, overnight, to Johannesburg were on time and smooth. We had three hours to kill before the connecting flight to Blantyre, and enjoyed some eggs, smashed avocado and coffee during the stopover.
Our final flight with South African Airways was also on time. We were served a very tasty meal and landed on schedule at Chileka Airport, Blantyre, where we organised visas and were met by a College of Medicine driver, who transported us to the Sunbird Mount Soche Hotel.
After a good night’s sleep, we were collected on the Sunday and driven to the Sunbird Nkopola Lodge Hotel at Mangochi – a roughly four hour journey. On arrival we checked into Rooms 24 and 25 – each one a self-contained small chalet …
… with beautiful views over Lake Malawi
… and a chess set next door!
Monday 26 November was the first day of the Curriculum Conference. When we arrived in the meeting room, we were surprised at the number of delegates – 50 in total.
The day’s events were chaired by Professor Nyengo Mkandawire, the Dean of the Faculty of Medicine, who will be familiar to those of you following the blog. The BDS programme will sit within the Faculty of Medicine.
The Principal of the College of Medicine, Dr Mwapatsa Mipando, set the scene for the conference, with a high level overview of the project to establish a Dental School in Malawi.
The Principal’s address was followed by an excellent presentation from Dr Peter Chimimba, the Coordinator for the MalDent Project at the College of Medicine.
Peter detailed the progress that has already been made and it was astonishing to hear of the tremendous volume of work that had been undertaken by him and his colleagues in a short space of time. This work had culminated in the draft curriculum document that would form the basis for the work due to commence the following day.
The timelines for the project were shared, which reminded delegates of the relatively short time-frames within which we are working:
The pressure to move the project forward efficiently was further emphasised by a Malawian newspaper headline from 29th September announcing that the new dental school would open in 2019!
The Guest of Honour was Dr Jones Kaponda Masiye from the Ministry of Health, who was representing the Minister of Health, Hon Atupele Muluzi MP.
Dr Masiye explained that he had graduated in medicine from the University of Malawi College of Medicine, but before that he had been a qualified dental therapist. Ideally, he would have wished to study dentistry, but no course was available – an uncanny coincidence that he had been given the opportunity to speak at this dental curriculum conference! He stressed the commitment of the Ministry of Health to the MalDent Project and later in the morning gave a second, excellent presentation on the current oral health status and scope of practice in Malawi, covering both staffing and clinical facilities, which highlighted graphically the need for investment in oral health services.
The last presentation before the morning break was from myself, covering current trends in dental education and the importance of preventive dentistry in the overall strategy for oral health in Malawi.
Before coffee was served, we were invited to walk out into the sun-drenched morning for a group photograph.
Once assembled, the large group of delegates who had been invited to participate in the curriculum conference made for an impressive and colourful photo:
After the photograph was taken, there was much discussion in the open air before we moved back inside for the refreshments:
There was considerable media interest in the event. Before coffee, Dr Masiye, Dr Mipando and I all gave interviews and I understand that there was subsequently an item on MBC News. The following video clip shows part of the Principal’s interview with the gathering of journalists:
After coffee, Prof Simon Nemutandani, Dean of the Dental School at Wits University, delivered his presentation, which provided a very insightful analysis of the MalDent Project from an African perspective.
He reiterated comments made earlier by the Principal about the direct contact made by the President of Malawi to the College of Medicine, stressing the need to establish a Dental School for the country:
Particularly important is the requirement that from the outset the BDS programme is designed to reflect the needs of Malawi:
It must also take into account the background and needs of the students themselves, in addition to the needs of their future patients:
Simon’s perspective was of particular value and relevance to those of us supporting the MalDent Project but who come from European and American healthcare environments, which vary in so many ways from the Malawian situation.
After a very enjoyable lunch (the finest mushroom soup I’ve ever tasted!) Niall delivered a presentation about his experiences providing support to the new Dental School at the University of Rwanda:
This project had received very significant support from Harvard University and Niall stressed how important he believed this had been in the early stages of the course. His slide showing some of the first Rwandan BDS graduates celebrating after receiving their degrees was a very positive motivator for all of us as we set out on the journey of establishing a similar course in Malawi.
Professor Jennifer Webster-Cyriaque from the University of North Carolina, USA, has been working with the Dental Therapist programme at the Malawi College of Health Sciences for a number of years. Jennifer’s presentation focused on development of the teaching faculty, a critical element of the MalDent Project as outlined in one of her early slides:
Mentorship at all levels will be an important component of the project and I particularly liked the following slide:
The Principal then spoke about the various aspects of the financing of the Dental School. The infrastructure needed to teach dentists is expensive and careful financial planning is essential. The funding from the Scottish Government is providing the critical support needed to begin the journey towards a sustainable Dental School and already other partners are becoming engaged with the project, so the momentum is building.
The first day of the conference finished with a dinner in one of the function rooms – a relaxing end to a busy day. However, the really hard work was about to begin as the conference progressed!
On the Tuesday, delegates assembled in casual clothes to begin the curriculum work proper. The first session commenced with a summary of the previous day’s presentations and discussion delivered by Dr Jessie Mlotha-Namarika.
We then moved on to consider the draft curriculum document in detail. There was a considerable amount of discussion which culminated in a division of the work. Prof Nyengo Mkandawire took the lead on the curriculum for Years 1 and 2, which would be delivered jointly with the MB BS students. A second group, which included all the dental delegates, was chaired by Prof Simon Nemutandani and concentrated on Years 3-5. For both groups, the discussions resulted in a large volume of re-formatting and editing of the curriculum content, which continued through into the evenings.
Simultaneously, other aspects of the documentation were being worked upon. These included assessment methods and quality assurance, areas in which Niall was able to play a significant role.
The groups joined forces again on the Wednesday morning to present the re-worked outlines of each year of the curriculum. Much had been achieved and agreement was reached on the overall structure. This was a big step forward and allowed final editing to commence.
Mr Richard Ndovhie from the Medical Council of Malawi had been invited to deliver a presentation about the internship which each of the new dental graduates would be required to complete before professional registration.
He described the functions of the Medical Council, its powers and the content of the internship year, concluding with a slide that summarised the expectations of an intern:
As the formal meeting drew to a close, it was clear that there remained a large amount of editing and formatting to complete. However, as Niall and I were not leaving for the UK until Saturday morning, there was still time to assist with this work on the Thursday and Friday once we returned to Blantyre.
The meeting had been intense but a great success. Dr Emma Thomson, a paediatric surgeon who is the Head of the College of Medicine Education and Training Office, had been present throughout the event to provide support and guidance
The Secretariat of Lucia Msiska (PA to the Principal), Brenda Maluwa (PA to the Dean of Medicine) and Gift Kayuni (who has supplied many of the photos in this blog) did a fantastic job. The organisation was first-class and their hard-work ensured that the conference and associated logistics ran very smoothly.
We were due to leave Mangochi on the Thursday morning to return to Blantyre. Accordingly, our bags were packed into the car at 10am, leaving just enough room for a large sack of fresh mangoes!
We arrived back at our hotel in Blantyre in the afternoon. After dropping our bags, we were taken to the Principal’s Office at the College of Medicine to meet with Jerome Galagade, for a discussion about the changes to the MalDent Project log-frame that had been suggested by Chrissie Hirst at my recent meeting at the Corra Foundation. The changes were agreed and we then headed back to the hotel, in a torrential downpour, to continue work on the curriculum editing.
On the Friday morning, editing continued. Niall was taken by Peter to visit the recently refurbished dental clinic at the Blantyre Adventist Hospital, that I had seen previously. After lunch, we headed back to the College of Medicine. Peter took Niall on a tour of the campus and to visit the Queen Elizabeth Hospital Dental Centre whilst I spent time in the magnificent College of Medicine Library, finalising some edits for Years 3-5.
At 3.30pm we were due to meet with the Principal and the Dean. It was St Andrew’s Day and in keeping with the Scottish Government’s wish to spread a little kindness in “celebration of the nation’s shared values and inclusive view of the world” we took a photo that reflected the collaboration and friendship between Scotland and Malawi which underpins the MalDent Project. What an excellent opportunity for us to wear our Scotland Malawi Partnership gear and for Lucia to show off the University of Glasgow hoodie she had received from Alex Mackay during her visit to Glasgow last March!
After a very positive round-up meeting in the Principal’s Office, Peter, Niall and I accompanied Nyengo to his office to discuss the final knitting together of the curriculum document. A plan was hatched and by the time Niall and I were picked up at 10.30am on the Saturday morning to head for the airport, the final draft of the curriculum document was complete – mission accomplished.
It had been an exceptionally intense week, with a number of ups and downs, but through it all the collegiate spirit had kept us going. The energy and enthusiasm of all involved in the MalDent Project is infectious and as we said farewell to Peter at the hotel, we were already looking forward to our next visit.
Our journey home was smooth and we returned home feeling that one of the important milestones, the drafting of the curriculum, had been achieved.
Since returning to Glasgow we have heard that the curriculum document has been approved by the College of Medicine Academic Board. It can now move forward through the other levels of the University of Malawi approval process for eventual ratification by its Senate – fingers firmly crossed!