This post relates to the second phase of a visit I made to Malawi last June. It has been delayed in publication and forms the first of a series of four posts which cover an exciting collaborative project that took place between the charity Smileawi and dental students from Glasgow and Dundee Dental Schools. Three of the students have written reflections of their experiences, which complete the ‘mini-series.’
My involvement started with a very early morning flight on Tuesday 11th June from Lilongwe to Blantyre, following meetings on the previous day with Paul Tasman from Bridge2Aid, Ministry of Health officials, Wiston Mukiwa from the Dental Association of Malawi, and the Christian Health Association of Malawi (https://www.themaldentproject.com/2019/06/23/with-the-scotsman-bridge2aid-and-malawian-partners-in-lilongwe-two-busy-days/). Chris, a local taxi driver, picked me up from my hotel at 04.30 and I caught the 06.15 flight south. We landed at 06.50 and I was picked up by a College of Medicine driver who delivered me to my hotel. After some breakfast I headed straight to the College of Medicine and met with the Principal, Dr Mwapatsa Mipando, and his PA, Lucy Msiska. Following a variety of discussions during the day at the College of Medicine I returned to the Sunbird Mount Soche Hotel for some dinner and an early night.
On the Wednesday Peter Chimimba arrived after breakfast to pick me up and deliver me to the College of Medicine. He was accompanied by Martin Laird and Rosie Grimes, two Glasgow BDS 4 students who had arrived in Blantyre the previous Thursday and who, at the generous insistence of Peter and his wife, Frider, were staying at their house. With the impending enrolment of the first group of BDS students at the College of Medicine, I had been keen to engage students at Glasgow Dental School with the MalDent Project. Ultimately, we would aim to establish a student exchange programme between the two schools. I was, therefore, delighted that Martin and Rosie had chosen to visit the College of Medicine for their elective project this year.
On arrival at the College of Medicine, we went straight to the office of Professor Nyengo Mkandawire, Dean of the Faculty of Medicine, where I was presented with a bound copy of the BDS curriculum and the signed certificate from the University of Malawi Senate confirming its approval. This was symbolic of the completion of the first milestone in the MalDent Project – partnership working to achieve an approved BDS curriculum.
Next, we headed to the other side of the Library Building to see Peter Chimimba’s new office. In addition to his office, Peter now also had an assistant, Annie Mwapasa, who had recently been appointed with support of the Scottish Government funding of the MalDent Project. This was great progress as Annie’s role would be essential when the first BDS students were enrolled, as well as the management of the other strands of the project linked with policy development at the Ministry of Health and the design of the new dental facility, together with its construction, on the Blantyre site.
That morning, Peter went with Martin and Rosie to visit a primary school in Blantyre, which they reported later to have been a great success. I had a significant amount of written work to complete linked to the elective students’ project with Smileawi, so I spent much of the day working in Peter’s new office.
At 12.30pm I decided to have a break and head to the Beit CURE Café for some lunch. By chance I met Martin, Rosie and Annie heading to the same venue and then, whilst there, we met the team from the University of Glasgow Institute of Infection, Immunity & Inflammation who were busy installing laboratory equipment as part of the Scottish Government-funded Blantyre Blantyre Project. Inevitably, we decided to have a group photo – far too good an opportunity to miss!
During the evening, Martin and Rosie treated Peter, Frider and I to dinner at 21 Grill, a very nice restaurant at Ryalls Hotel. It was a lovely evening and one way in which Martin and Rosie were able to show their appreciation for the exceptionally kind and generous hospitality afforded them by Peter and Frider during their stay in Blantyre.
On the Thursday, Martin, Rosie and I headed to Mulanje to visit some friends of Martin’s that he had got to know many years previously as part of a twinning project between his school in Lanarkshire and a primary school in Mulanje. You will be able to read Martin’s story in his own blog post which will be published shortly. For my own part, I would just wish to say that we met some utterly inspirational people on that day, including the most engaged and cheerful children I think I have ever met. My reflection, having met the teachers and children we came across, was that a caries prevention programme based upon the supervised toothbrushing model of Scotland’s Childsmile programme would likely be adopted with enthusiasm.
On the Friday, Martin, Rosie and I, complete with our luggage, left the College of Medicine to head to Mzuzu. The College kindly provided us with a minibus and driver for the nine hour road trip north.
It was a long journey but by and large the roads were of good quality. We stopped and enjoyed lunch with our driver at Salima before the final push, arriving at Mzuzu just after dark.
Our home for the next two nights was ‘Joy’s Place’, a backpackers’ lodge which boasted a Korean Kitchen. There was a power cut as we arrived, so we checked in by candlelight, but shortly afterwards power was restored.
Just after we reached the lodge, Nigel and Vicky Milne, together with the rest of the Smileawi team, Conor O’Brien and our remaining elective students from Glasgow and Dundee arrived to greet us (see: https://wordpress.com/post/themaldentproject.com/621). They were staying nearby at Umunthu Lodge, and we agreed that we would all eat together there later that evening. An hour later the full team was assembled and we enjoyed a lovely meal together – an excellent introduction to Mzuzu for Rosie, Martin and I.
We were up early on the Saturday morning for breakfast, when we met Nathan Bradley, a Peace Corps volunteer who was a soil scientist from Virginia, USA. He was reaching the end of a two year visit to Malawi, and was working with a local group of beekeepers to put their honey through the various analyses and certifications necessary to allow them to export their product. He told us he frequently visited Joy’s Place, together with other Peace Corps volunteers, for relaxation at weekends.
After eating, we headed to the Saint John of God Conference Centre, where Smileawi had organised a conference for dental therapists. As part of the programme, Conor O’Brien, an oral surgeon from Glasgow Dental Hospital, had agreed to deliver a minor oral surgery update lecture and I was to provide a presentation on the problem of antibiotic resistance and the importance of antimicrobial stewardship. After lunch I had agreed I would provide an update on progress with the MalDent Project. The students from Glasgow and Dundee were also keen to speak about their background and experiences to date.
One of the highlights of the day for me was meeting Edward Hara, who had worked in the area as a therapist for many years. I had heard a lot about Edward previously from my good friend Lisa Taylor who had worked as a VSO dentist in Mzuzu many years ago, shortly after she completed her masters degree at Cardiff Dental School. It was a great pleasure to meet him in person at the conference.
The Guest of Honour at the meeting was Dr Owen Msopole, from the Ministry of Health Directorate of Quality. We spoke at length during the morning coffee break and it transpired that he was a good friend of Dr Nedson Fosiko, with whom we had met in Lilongwe earlier in the week to discuss the Bridge2Aid initiative (see: https://wordpress.com/post/themaldentproject.com/834).
As with any self-respecting conference, a group photo was in order. It is hard to believe that by Malawian standards this was a winter scene!
Conor delivered an excellent presentation on minor oral surgical techniques, incorporating a significant amount of content on quality and governance issues.
More sun was lapped up during lunch, which was served outdoors.
Towards the close of the event, the four dental students who had been working with the Smileawi team delivered a first class presentation. They talked about their BDS course back in the UK and also described with great enthusiasm and clarity the work in which they had been engaged since arriving in Malawi. You can read more in their reflections that will be published immediately after this post.
The event finished with an excellent networking opportunity enjoyed over tea, coffee and snacks. It was fascinating and very valuable to hear from the therapists themselves about their day-to-day work. They were clearly very stretched because of the workforce challenges (nationally there are only 137 therapists in Malawi against a Ministry of Health establishment of 300). There was also great interest in the BDS programme which was due to commence at the College of Medicine in August 2019 and two of those present had submitted applications for entry.
After the conference, we all returned to Umunthu Lodge and turned to data entry from the hard copies of the clerking forms used for the dental inspections. This was a massive job, which the team had been tackling every evening until the sun set. The industry and enthusiasm of the team was extremely impressive and by the time they left Malawi all of the data had been uploaded.
Once it became too dark to continue working, dinner was ordered and there was great conversation over a beer (or cider) or two! Adjacent to the eating area was a log-burning fire pit which was where the evenings ended, with a sense of time well spent and a tremendous team spirit.
Massive thanks are due to Nigel and Vicky Milne, the founders of Smileawi, for having invited our students to Malawi for this unforgettable experience. The joint working between Smileawi, the University of Glasgow and the University of Dundee has been an outstanding success and will hopefully continue long into the future.
On the Sunday morning, Martin, Rosie and I headed back south to Lilongwe – a drive of about five hours. There was some beautiful scenery and the following video clip gives an idea of the ‘road home’, which was not unlike some of our Scottish scenery:
That evening, I had invited Martin and Rosie to have dinner with me, as I was flying back to Glasgow the following day. As it turned out, Dr Mipando, the College of Medicine Principal, had arranged for Peter Chimimba and I to accompany him early on the Monday morning to deliver a presentation about the MalDent Project to the Senior Management Meeting at the Ministry of Health. As a result, Peter also had to come up to Lilongwe on the Sunday evening, so we all had dinner together.
It was a complete surprise when Steve Mannion, a well-known orthopaedic surgeon (http://www.stevemannion.com), appeared in the restaurant. He had arrived that day with his team from the UK to undertake a series of operating sessions in Malawi. I know Steve as a result of sitting on the Royal College of Physicians & Surgeons of Glasgow Global Health Group (GHG). Indeed, it had been Steve who had stressed during my first attendance at the GHG in 2017 the importance of trying to develop dental services in Malawi, long before the MalDent Project had emerged. We had some excellent chat!
The following morning, the Principal, Peter and I had very positive feedback from those attending the Senior Management Meeting at the Ministry of Health. It was a most uplifting way to finish this visit to Malawi and as I headed to the airport I felt very buoyed by the enthusiasm and support that had been displayed.
I had a trouble-free journey back to the UK, arriving in Glasgow on the Tuesday morning. That afternoon we had our Dental School Prize Giving and the following day was BDS Graduation. Both were proud occasions for our students, relatives and staff. With Malawi still ringing in my ears, I reflected on what a great day it will be when the College of Medicine graduates its first cohort of dentists in Blantyre.